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INTRODUCTION: A growing body of evidence links vitamin D deficiency to obesity as well as metabolic syndrome and insulin resistance. Vitamin D deficiency and insufficiency is common in patients after gastric bypass surgery, though little is known about its relationship to glycemic control in this population.
METHODS: Between January 2005 and December 2011, 203 patients with type 2 diabetes mellitus (T2DM) underwent laparoscopic roux-en-y gastric bypass (LRYGBP) at our institution. We retrospectively evaluated demographics, hemoglobin A1C levels, 25-hydroxy vitamin D levels, and medication lists.
RESULTS: Average age was 49.8, average duration of T2DM was 7.9 years, 74.5% were women, and 89.2% of the patients were caucasian. Average length of follow-up was 2.8 years. Postoperative pharmacologic therapy for T2DM and/or hemoglobin A1c levels above 6.9 were seen in 24.7% of patients at last follow-up. Postoperative vitamin D levels consistently under 30 ng/mL were seen in 13.0% of patients. These patients were more than twice as likely to have persistent T2DM at last follow-up (RR 2.24, CI 1.31 to 3.88, p<0.01).
CONCLUSION: Postoperative vitamin D insufficiency and deficiency is associated with persistence of T2DM after gastric bypass surgery. Aggressive supplementation with vitamin D may improve outcomes in these patients.