Researchers studied nearly 28 million people with diabetes to understand how two conditions—high uric acid levels and severe vitamin D deficiency—affect how long people live. They found that having both problems at the same time makes the risk of dying from heart disease or any cause much higher than having just one problem. The study suggests that doctors should pay attention to both of these conditions in diabetic patients, as treating them together might help people with diabetes live longer and healthier lives.

The Quick Take

  • What they studied: Whether two health problems—high uric acid in the blood and very low vitamin D—increase the risk of death in people with diabetes, especially when both problems happen at the same time.
  • Who participated: About 7,869 people with diabetes aged 20 and older from a large U.S. health survey conducted between 2001 and 2018. The group represented about 27.5 million Americans with diabetes.
  • Key finding: People with diabetes who had both high uric acid AND severe vitamin D deficiency had nearly double the risk of dying from any cause and 2.6 times higher risk of dying from heart disease compared to those without these problems.
  • What it means for you: If you have diabetes, getting your uric acid and vitamin D levels checked may be important. Having both problems at once appears to be especially dangerous, so managing both together could potentially help you live longer. Talk to your doctor about testing for these conditions.

The Research Details

This study used information from a large national health survey that tracked Americans’ health over many years. Researchers looked at people with diabetes and followed them for an average of about 7 years to see who died and from what causes. They used special statistical methods to figure out whether high uric acid levels and low vitamin D were connected to higher death rates, while accounting for other health factors that might affect the results. The researchers also tested their findings in different ways to make sure the results were reliable and not due to chance.

This research approach is important because it looks at real-world data from actual people rather than just laboratory experiments. By following people over time and tracking who died, researchers can see which health problems are truly connected to longer life or shorter life. The study also looked at what happens when two problems occur together, which is important because people often have multiple health issues at the same time.

This study is fairly strong because it included a large number of people and followed them for several years. The researchers adjusted their analysis to account for many other health factors that could affect the results. They also repeated their analysis in different ways to confirm their findings were stable and reliable. However, the study is based on observations rather than a controlled experiment, so it shows connection but not definite proof of cause-and-effect.

What the Results Show

Among people with diabetes, those with high uric acid had a 28% higher risk of dying from any cause, and those with severe vitamin D deficiency had a 44% higher risk. For heart disease deaths specifically, high uric acid increased risk by 54% and severe vitamin D deficiency increased it by 98%. When people had both problems together, the risks were much worse: they had a 90% higher risk of dying from any cause and 160% higher risk of dying from heart disease. This means the two problems together were more dangerous than just adding their individual risks—they appeared to work together to increase danger. Over the study period, about 28 deaths per 1,000 people with diabetes occurred per year, with about 9 of those being from heart disease.

The researchers also found that the connection between uric acid and death risk was partly explained by a measure of insulin resistance (how well the body uses insulin), accounting for about 11% of the effect. The connection between vitamin D deficiency and death risk was partly explained by blood sugar control, accounting for about 2% of the effect. These findings suggest that these two conditions may harm health through slightly different pathways in the body.

Previous research has shown that both high uric acid and vitamin D deficiency are individually linked to worse health outcomes in people with diabetes. This study adds important new information by showing that having both problems together creates an especially dangerous situation. The findings support the idea that doctors should screen for and manage both conditions in diabetic patients, rather than focusing on just one.

This study shows connections between these health problems and death, but cannot prove that the problems directly cause death—other unmeasured factors could be involved. The study included mostly data from the United States, so results may not apply equally to other countries or populations. The researchers relied on measurements taken at one point in time, so they couldn’t track how changes in uric acid or vitamin D levels over time affected outcomes. Additionally, the study couldn’t determine the best ways to treat these conditions or how much improvement in these levels would reduce death risk.

The Bottom Line

If you have diabetes, ask your doctor to check your uric acid and vitamin D levels. If either is abnormal, work with your doctor on a treatment plan. This might include dietary changes, supplements, or medications. The evidence suggests this could be particularly important if you have both problems. (Confidence level: Moderate—this is based on observational data, not controlled experiments)

Anyone with diabetes should pay attention to these findings. This is especially important for people who are overweight, have high blood pressure, or have a family history of heart disease. People with kidney disease should also be aware, as both uric acid and vitamin D are related to kidney health. However, these findings don’t necessarily apply to people without diabetes.

Changes in uric acid and vitamin D levels can take weeks to months to improve with treatment. Benefits to overall health and survival would likely take much longer to see—probably months to years. This is why consistent, long-term management is important.

Want to Apply This Research?

  • Track your uric acid and vitamin D test results every 3-6 months. Record the actual numbers and dates to see if your levels are improving with treatment. Also track any dietary changes you make to help manage these levels.
  • Set a reminder to take vitamin D supplements if prescribed, and track your intake. If you’re working to lower uric acid, log foods high in purines (like red meat and certain seafood) to help identify patterns. Share these logs with your doctor at each visit.
  • Create a simple chart showing your uric acid and vitamin D levels over time. Set goals with your doctor for target ranges. Check in monthly to see progress, and adjust your diet or supplements based on results. Alert your doctor if levels aren’t improving after 2-3 months of effort.

This research shows a connection between high uric acid, vitamin D deficiency, and death risk in people with diabetes, but does not prove these conditions directly cause death. This information is for educational purposes and should not replace medical advice from your doctor. If you have diabetes, consult with your healthcare provider before making any changes to your treatment plan, starting supplements, or making major dietary changes. Your doctor can assess your individual risk factors and recommend appropriate testing and treatment based on your specific health situation.