Recognised causes of VDD susceptibility in South Asians include 1) skin complexion, 2) lack of sunlight exposure, 3) vegetarianism, and 4) adipose tissue vitamin sequestration, although surprisingly there is lack of evidence supporting a specific dosing regime in this Vitamin D deplete population. Consensus algorithms for replacement based predominantly on bone-related outcomes in Caucasians are unlikely to adequately address VDD in South Asians, nor indeed associated cardio-metabolic effects based upon the currently available trial evidence. The prospect of vitamin D supplementation as a potential intervention for both diabetes and other cardiovascular risk factors carries considerable public health implication. Far from an ethnic minority niche, VDD prevalence is set to rise in line with Western obesity trends. It is therefore imperative the investigators determine the potential of this most simple of treatments in the prevention of cardio-metabolic diseases.