Eat healthy, exercise, limit alcohol and processed foods, don’t smoke, keep blood pressure under control.

There are lots of ways to reduce your risk of developing type 2 diabetes. But there may be another couple added to that list soon: Increase vitamin D levels and prevent gum disease.

Researchers don’t yet know for sure how vitamin D, gum disease, and type 2 diabetes are connected, but several studies have concluded that there appears to be a connection.

A new study, published earlier this summer, found more evidence of that.

By examining health survey data from people in the United States over the age of 30, Aleksandra Zuk said she discovered that people with gum disease and low levels of vitamin D-3, the most important D vitamin, had increased odds of developing type 2 diabetes.

Zuk, a Ph.D. candidate in epidemiology at the Dalla Lana School of Public Health at the University of Toronto, said that doesn’t mean vitamin D deficiency causes the diseases, though.

But getting sufficient vitamin D may help ward off at least gum disease, also known as periodontitis.

“Periodontitis is a chronic inflammatory condition caused by oral microbes that, if left untreated, affects teeth-supporting tissues, and over time could lead to bone loss,” Zuk told Healthline. “Vitamin D is not only important for bone health, but research shows that it may have anti-inflammatory and/or antimicrobial effects.”

It’s possible it may help ward off diabetes, too, although that has yet to be confirmed.

Zuk said clinical trials are underway in several countries to look into that.

For now, she said, “the current research regarding just vitamin D-3 or D on reducing diabetes risk is conflicting, and whether vitamin D supplementation can reduce the risk of diabetes in high-risk individuals is still to be confirmed.”

A growing problem

The risk of developing type 2 diabetes increases as you age, although it’s increasingly being seen in younger and younger patients.

A 2012 study predicted the number of people under 20 with type 2 diabetes will jump by nearly 50 percent by 2050.

There are some risk factors — family history, age, ethnic background — that can’t be changed. But the disease can often be prevented, or at least delayed, by ensuring you live a healthy lifestyle.

Nearly 90 percent of adults with type 2 diabetes are overweight or obese, according to the Centers for Disease Control and Prevention (CDC).

That agency notes that losing weight can lower your risk of developing the disease. Getting enough vitamin D can be part of a healthy lifestyle, especially because, to get enough, you usually need to be outside.

You can get vitamin D from foods such as fish, but unlike vitamins A or C, it’s difficult to get all the vitamin D your body needs from food. Instead, most of it usually comes from sunlight.

Vitamin D helps your body absorb calcium and other important substances that are critical to maintaining healthy bones and teeth.

The gum disease connection

The vitamin also has anti-inflammatory properties that have been shown to likely reduce inflammation in the gums. Periodontitis starts out as the minor inflammation gingivitis, which you might have if you’ve noticed your gums bleed when you brush your teeth.

But that inflammation can spiral into receding gums, bacteria buildup in the gums, bone loss, and eventually tooth loss. Zuk isn’t the first to note that there appears to be a connection between these three conditions.

A 2015 study in the Indian state of Kerala found that periodontitis patients, both with and without type 2 diabetes, had low vitamin D levels. But, the authors conjectured, those low levels “may be due to the diseases’ processes rather than low vitamin D acting as a cause for the disease.”

The authors of that paper also said, however, that the patients they studied who just had periodontitis “showed a tendency” toward prediabetes.

They concluded that the body-wide inflammatory response to the gum disease may lead to insulin resistance and prediabetes, meaning gum disease may increase the risk of diabetes.

Don’t jump to conclusions

If gum disease increases the risk of diabetes, and higher vitamin D levels reduce the risk of gum disease, then would it stand to reason that getting more vitamin D could reduce the risk of diabetes?

Not so fast, Zuk warned. “Whether vitamin D supplementation can reduce the risk of diabetes in high-risk individuals is still to be confirmed,” she said.

And as for reversing diabetes, that was a firm no. “Vitamin D cannot reverse diabetes once type 2 diabetes has developed,” Zuk said. “The pathophysiology of type 2 diabetes is complex.”

There are plans for more studies, though, including those trials in various countries. They’ll just take time since they’ll need to follow people over a number of years.