A464 Diabetes Remission Rates after Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: An Individualized Metabolic Surgery Score for Koreans

An, Jee Hyun; Park, Dae Gun; Park, Kyong Min; Huh, Yeon-Ju; Han, Sun-Hee; Lee, Joo-Ho; Kim, Yong Jin

doi:10.1016/j.soard.2019.08.402

Cited by 3 publications

(3 citation statements)

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“…Patients with medical therapy alone were assumed to not achieve remission. The probability of experiencing T2D remission after bariatric surgery was calculated as the weighted average of published T2D remission rates by baseline T2D severity using the IMS scoring system . We assumed remission occurred at 3 months on the basis of the change in HbA1 c levels observed in the STAMPEDE trial .…”

Section: Methodsmentioning

confidence: 99%

“…Every month of the simulation, patients could transition among health states defined by BMI status (normal, 18-24.9; overweight, 25-29.9; mild obesity, 30-34.9; moderate obesity, 35-39.9; and severe obesity, Ն40), T2D status (baseline severity, remission, and relapse to baseline severity), surgery complications, and mortality (Figure 1). Model inputs were derived from clinical trials, large cohort studies, national databases, and published literature 4,6,7,11,[15][16][17][18][19][20][21][22][23][24][25] (Table 1).…”

Section: Model Overviewmentioning

confidence: 99%

“…The probability of experiencing T2D remission after bariatric surgery was calculated as the weighted average of published T2D remission rates by baseline T2D severity using the IMS scoring system. 11,[15][16][17] We assumed remission occurred at 3 months on the basis of the change in HbA1 c levels observed in the STAMPEDE trial. 5 Patients who experienced T2D remission could subsequently experience a relapse, derived from the PCORNet Bariatric Study.…”

Section: Jama Network Open | Surgerymentioning

confidence: 99%

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Estimated Cost-effectiveness of Medical Therapy, Sleeve Gastrectomy, and Gastric Bypass in Patients With Severe Obesity and Type 2 Diabetes

et al. 2022

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IMPORTANCE Bariatric surgery is recommended for patients with severe obesity (body mass index Ն40) and type 2 diabetes (T2D). However, the most cost-effective treatment remains unclear and may depend on the patient's T2D severity. OBJECTIVETo estimate the cost-effectiveness of medical therapy, sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) among patients with severe obesity and T2D, stratified by T2D severity. DESIGN, SETTING, AND PARTICIPANTS This economic evaluation used a microsimulation model to project health and cost outcomes of medical therapy, SG, and RYGB over 5 years. Time horizons varied between 10 and 30 years in sensitivity analyses. Model inputs were derived from clinical trials, large cohort studies, national databases, and published literature. Probabilistic sampling of model inputs accounted for parameter uncertainty. Estimates of US adults with severe obesity and T2D were derived from the National Health and Nutrition Examination Survey. Data analysis was performed from January 2020 to August 2021. EXPOSURES Medical therapy, SG, and RYGB. MAIN OUTCOMES AND MEASURESQuality-adjusted life-years (QALYs), costs (in 2020 US dollars), and incremental cost-effectiveness ratios (ICERs) were projected, with future cost and QALYs discounted 3.0% annually. A strategy was deemed cost-effective if the ICER was less than $100 000 per QALY. The preferred strategy resulted in the greatest number of QALYs gained while being costeffective. RESULTSThe model simulated 1000 cohorts of 10 000 patients, of whom 16% had mild T2D, 56% had moderate T2D, and 28% had severe T2D at baseline. The mean age of simulated patients was 54.6 years (95% CI, 54.2-55.0 years), 61.6% (95% CI, 60.1%-63.4%) were female, and 65.1% (95% CI, 63.6%-66.7%) were non-Hispanic White.

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Section: Methodsmentioning

confidence: 99%