{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T23:38:24Z","timestamp":1769297904956,"version":"3.49.0"},"reference-count":65,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,9,9]],"date-time":"2014-09-09T00:00:00Z","timestamp":1410220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Centre for Research Excellence in Sun and Health (CRESH)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Prospective observational studies uniformly link vitamin<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>deficiency with the incidence of type 2 diabetes mellitus (<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>), yet trials supplementing participants at risk of<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>with vitamin<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>to reduce progression to<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>have yielded inconsistent results. Inconsistencies between supplementation trials may be due to insufficient dosing or small sample sizes. Observational studies may also have reported spurious associations due to uncontrolled confounding by lifestyle or genetic factors. Alternatively, observational and intervention studies may not be entirely comparable. Observational studies show an association between higher vitamin<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>status, which is predominantly derived from sun exposure, and decreased incidence of<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>. Trials intervene with vitamin<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>supplementation, and therefore may be missing alternate causes of the effect of sun exposure, as seen in observational studies. We propose that sun exposure may be the driving force behind the associations seen in observational studies; sun exposure may have additional benefits beyond increasing serum 25\u2010hydroxyvitamin<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>(25<jats:styled-content style=\"fixed-case\">OHD<\/jats:styled-content>) levels. We performed an electronic literature search to identify articles that examined associations between sun exposure and<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>and\/or glucose metabolism. A best evidence synthesis was then conducted using outcomes from analyses deemed to have high methodological quality. Ten eligible full\u2010text articles were identified, yielding 19<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\u2010related outcomes. The best evidence analysis considered 11 outcomes which were grouped into six outcome types:<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>, fasting glucose, glucose tolerance, fasting insulin, insulin secretion and insulin sensitivity. There was moderate evidence to support a role of recreational sun exposure in reducing odds of<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>incidence. High\u2010level evidence was lacking; evidence presented for other outcomes was of low or insufficient level. This review highlights significant gaps in research pertaining to sun exposure and<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\u2010related outcomes. Further research is encouraged as we aim to identify novel preventative strategies for T2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/cen.12567","type":"journal-article","created":{"date-parts":[[2014,7,26]],"date-time":"2014-07-26T08:55:19Z","timestamp":1406364919000},"page":"799-811","source":"Crossref","is-referenced-by-count":22,"title":["<scp>S<\/scp>hining the<scp>L<\/scp>ight on<scp>S<\/scp>unshine: a systematic review of the influence of sun exposure on type 2 diabetes mellitus\u2010related outcomes"],"prefix":"10.1111","volume":"81","author":[{"given":"Catherine","family":"Shore\u2010Lorenti","sequence":"first","affiliation":[{"name":"NorthWest Academic Centre Department of Medicine Western Health The University of Melbourne Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon L.","family":"Brennan","sequence":"additional","affiliation":[{"name":"NorthWest Academic Centre Department of Medicine Western Health The University of Melbourne Melbourne Vic. Australia"},{"name":"School of Medicine Deakin University Barwon Health Geelong Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerrie M.","family":"Sanders","sequence":"additional","affiliation":[{"name":"NorthWest Academic Centre Department of Medicine Western Health The University of Melbourne Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel E.","family":"Neale","sequence":"additional","affiliation":[{"name":"Cancer and Population Studies QIMR Berghofer Medical Research Institute Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn M.","family":"Lucas","sequence":"additional","affiliation":[{"name":"National Centre for Epidemiology and Population Health Australian National University Canberra ACT Australia"},{"name":"Telethon Kids Institute University of Western Australia Perth WA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter R.","family":"Ebeling","sequence":"additional","affiliation":[{"name":"NorthWest Academic Centre Department of Medicine Western Health The University of Melbourne Melbourne Vic. Australia"},{"name":"Department of Medicine School of Clinical Sciences Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,9,9]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"32","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2013"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2011.118"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0962"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2012.193003"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(13)70165-7"},{"key":"e_1_2_8_7_1","first-page":"1","volume-title":"Global Solar UV Index: A Practical Guide","author":"World Health Organisation","year":"2002"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8227(95)01040-K"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.05.008"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009734.2011.628422"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00276970"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365513.2011.575235"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1286310"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001721-200107000-00004"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2010.32"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.03.009"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2010.06.007"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2008.03.005"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp166"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2006.02.013"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00281300"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00429838"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/40.6.1352"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1042\/cs0410453"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1726-4901(09)70004-8"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0059063"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0026-0495(00)90613-9"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-2167"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature09253"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2004.06.001"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1108750"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0032670"},{"key":"e_1_2_8_34_1","doi-asserted-by":"crossref","first-page":"E41","DOI":"10.1152\/ajpendo.1988.255.1.E41","article-title":"Circadian rhythm in sensitivity of glucose metabolism to insulin in rat soleus muscle","volume":"255","author":"Leighton B.","year":"1988","journal-title":"American Journal of Physiology \u2013 Endocrinology and Metabolism"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-079X.2010.00798.x"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-079X.2007.00519.x"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2009-0425"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-065X.1984.tb00496.x"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-1097.2007.00239.x"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri3045"},{"key":"e_1_2_8_41_1","first-page":"3","article-title":"Exposure to UV wavelengths in sunlight suppresses immunity. To what extent is UV\u2010induced vitamin D3 the mediator responsible?","volume":"34","author":"Hart P.H.","year":"2013","journal-title":"The Clinical Biochemist Reviews"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1039\/b418378a"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcb.2010.09.011"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.191.3.561"},{"key":"e_1_2_8_45_1","first-page":"394","article-title":"The effect of ultraviolet B irradiation and urocanic acid isomers on dendritic cell migration","volume":"77","author":"Moodycliffe A.M.","year":"1992","journal-title":"Immunology"},{"key":"e_1_2_8_46_1","doi-asserted-by":"crossref","first-page":"445","DOI":"10.4049\/jimmunol.124.1.445","article-title":"Epidermal Langerhans cell density determines whether contact hypersensitivity or unresponsiveness follows skin painting with DNFB","volume":"124","author":"Toews G.B.","year":"1980","journal-title":"The Journal of Immunology"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1993.tb03330.x"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.76.12.6591"},{"key":"e_1_2_8_49_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/j.1751-1097.2007.00223.x","article-title":"25\u00a0years of UV\u2010induced immunosuppression mediated by T cells \u2013 from disregarded T suppressor cells to highly respected regulatory T cells","volume":"84","author":"Schwarz T.","year":"2008","journal-title":"Photochemistry & Photobiology"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1053\/meta.2001.25654"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e328349666d"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1009178"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.92.8.3124"},{"key":"e_1_2_8_54_1","unstructured":"W.J. Olds 2010 Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane 181 192"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.2337\/db08-1070"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909163411216"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.51.4.1102"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwi071"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00691.2006"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI62308"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.2337\/db09-0833"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature12642"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpi.12089"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2009-0647"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2008.01789.x"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.6250216"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcen.12567","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.12567","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T12:54:12Z","timestamp":1717160052000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.12567"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,9]]},"references-count":65,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2014,12]]}},"alternative-id":["10.1111\/cen.12567"],"URL":"https:\/\/doi.org\/10.1111\/cen.12567","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9,9]]}}}