DOES VITAMIN D DEFICIENCY NEGATIVELY IMPACT TYPE 2 DIABETES REMISSION AFTER BARIATRIC SURGERY?

Mehran Anvari, PhD, FRCSC, FACS¹, Rodrigo Lemus, MD¹, Olivia Lovrics, Bsc², Ruth Breau, BA¹. ¹McMaster University, ²Mcgill University

Introduction: Studies have suggested that vitamin D plays a role in glucose homeostasis and vitamin D deficiency (VDD) may be associated with lower rates of resolution of T2DM after surgery. This study aims to compare nutritional variables in both sleeve (SG) and bypass surgery (RYGB) in type 2 diabetes mellitus (T2DM) patients, and analyze the relationship between vitamin D levels and T2DM remission post-operatively.

Methods and procedures: Data from the Ontario Bariatric Registry was used for this retrospective study to determine the prevalence of VDD and T2DM remission after Bariatric surgery, followed by analysis of the relationship between these outcomes and other variables during a 3-year follow-up after SG or RYGB.

Results: 6,433 Bariatric Registry T2DM patients underwent surgery (RYGB: 5,419 and SG: 1,014) from Jan 2010 to Sept 2017 in Ontario. RYGB was more effective than SG at eliciting complete remission, 69.45% vs. 57.99% at 1-year, and 70.77% vs. 57.04% at 2-year. However at 3-year, rates were similar (RYGB 66.13% and SG 69.23%) but the groups were smaller. The post-operative management reduced the prevalence of VDD (25-hydroxyvitamin D levels <50 nmol/L) from 46.6% at baseline to 9.3% at 3-year visit. Only 20.13% of patients had sufficient vitamin D levels (≥75 nmol/L) at baseline vs. 60% at 3-year. Those who underwent T2DM remission were less likely to be VDD at all time points. The rates of VDD appear to be slightly higher in RYGB at each time points. The rates of macrocytic anemia, microcytic anemia and hypoalbuminemia were low and varied depending on surgical procedure, with no relevant increase following surgery (see figure 1).

Conclusions: Vitamin D deficiency is prevalent among diabetic patients with obesity presenting for bariatric surgery. The postoperative management was successful in addressing VDD following surgery; those who experienced T2DM remission after surgery were less likely to be VDD. Further prospective studies are needed to explore this relationship.

Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87070

Program Number: P589

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster