Researchers have developed a scoring system, called DiaRem, based on four readily available preoperative patient characteristics that can predict which candidates for gastric bypass surgery are likely to achieve type 2 diabetes remission within five years. A predictive model is likely to help patients and clinicians better manage the disease and could even save lives, the researchers said.
“Our novel DiaRem score will give patients and physicians a scientifically valid way of assessing the merits of gastric bypass surgery for treating diabetes and deciding whether additional measures should be tak PhDen to improve the odds of remission”, said lead author George Argyropoulos, PhD, from Geisinger’s Sigfried and Janet Weis Center for Research, in The Lancet Diabetes & Endocrinology.
Roux-en-Y gastric bypass (RYGB) is used to help people who are morbidly obese lose weight. As a side effect, it has been shown to resolve or improve type 2 diabetes in roughly 60% of patients. It may also be useful to treat diabetes in people who are not morbidly obese. But, currently there is no accurate method to determine which patients have the greatest likelihood of remission after surgery.
To create the scoring system, researchers from the Weis Center for Research, the Center for Health Research, the Center for Nutrition and Weight Management, and the Department of Surgery combed through Geisinger's electronic health records to retrospectively analyze the outcomes of 690 obese patients with type 2 diabetes who underwent RYGB between 2004 and 2011. Of these patients, 463 (63%) achieved partial or complete type 2 remission of type 2 diabetes.
The researchers found that obesity surgery success in reducing/reversing type 2 diabetes could be effectively predicted based on four standard clinical measures—insulin use, age, hemoglobin A1c concentration (HbA1c; a measure of blood sugar), and type of anti-diabetic drugs. DiaRem scores were derived by assigning a certain number of points to each of the four factors.
“The DiaRem score will help guide patients and their clinicians in their selection of appropriate treatment and management of type 2 diabetes,” noted Christopher D. Still, DO, director of Geisinger’s Obesity Institute.
Nationwide, about 160,000 people undergo various types of obesity surgery each year. RYGB surgery, the type studied, involves stapling the stomach to create a small pouch and attaching it to the lower intestine.