Type 2 diabetes remission rates 1‐year post‐Roux‐en‐Y gastric bypass and validation of the <scp>DiaRem</scp> score: the Ontario Bariatric Network experience

Honarmand, Kimia; Chetty, Kota G.; Vanniyasingam, Thuva; Anvari, Mehran; Chetty, V. Tony

doi:10.1111/cob.12189

Cited by 20 publications

(15 citation statements)

References 16 publications

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“…The calculation of DiaRem score stratifies individuals within 5 categories of ascending score, providing a probability of remission achievement [77]. The DiaRem score is a practical clinical tool and has undergone external validation [80,81,82]. Although its application cannot be directly extrapolated to types of surgery other than RYGB, there is limited data supporting its applicability to VSG and possibly also to AGB [83,84].…”

Section: Factors That Predict T2dm Remission After Bariatric Surgerymentioning

confidence: 99%

Remission of Type 2 Diabetes Mellitus after Bariatric Surgery: Fact or Fiction?

Tsilingiris

Koliaki

Kokkinos

2019

IJERPH

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Although type 2 diabetes mellitus (T2DM) has been traditionally viewed as an intractable chronic medical condition, accumulating evidence points towards the notion that a complete remission of T2DM is feasible following a choice of medical and/or surgical interventions. This has been paralleled by increasing interest in the establishment of a universal definition for T2DM remission which, under given circumstances, could be considered equivalent to a “cure”. The efficacy of bariatric surgery in particular for achieving glycemic control has highlighted surgery as a candidate curative intervention for T2DM. Herein, available evidence regarding available surgical modalities and the mechanisms that drive metabolic amelioration after bariatric surgery are reviewed. Furthermore, reports from observational and randomized studies with regard to T2DM remission are reviewed, along with concepts relevant to the variety of definitions used for T2DM remission and other potential sources of discrepancy in success rates among different studies.

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Section: Factors That Predict T2dm Remission After Bariatric Surgerymentioning

confidence: 99%

Remission of Type 2 Diabetes Mellitus after Bariatric Surgery: Fact or Fiction?

Tsilingiris

Koliaki

Kokkinos

2019

IJERPH

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“…The findings showed that at one-year follow-up after RYGB, 37% of individuals had remitted, and the clinical factors within the DiaRem score were associated with this remission. A helpful DiaRem cutoff score of <5 (71.8% sensitivity, 71.3% specificity) was established by this study, and they concluded that this scoring system had a moderate predictive value at best [ 1 ].…”

Section: Reviewmentioning

confidence: 99%

“…Obesity is one of the leading global causes of preventable deaths and has rapidly become a health issue of epidemic proportions, impacting people of all ages, from children and adolescents to adults [ 1 , 2 , 3 ]. The connection between obesity and diabetes has been well researched and documented [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Bariatric Surgery and Type 2 Diabetes Mellitus: Assessing Factors Leading to Remission. A Systematic Review

Ilyas

Al-Refai

Maharjan

et al. 2020

Cureus

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Type 2 Diabetes Mellitus (T2DM) is a health problem of paramount proportions and is associated with significant morbidity and mortality. Our study aims to review data published on the effects of different types of bariatric surgeries on T2DM remission, compared to lifestyle and medical intervention (LMI) exclusively, along with a comprehensive finding of numerous preoperative factors that lead to remission. We used PubMed, PubMed Central (PMC), and MEDLINE to search for literature. Our criteria included peer-reviewed, English language articles published in 2010 and onwards, consisting of adults with T2DM and a body mass index (BMI) of >30 kg/m 2 as the population of interest. Twenty-four articles with 5,411 patients were selected for this systematic review, which included nine randomized controlled trials (RCTs) and 15 observational studies. The primary endpoint was T2DM remission. Based on the review, bariatric surgery is superior to LMI in inducing remission in T2DM, especially when employing the Roux-en-Y Gastric Bypass (RYGB) technique. Lower age of onset and shorter duration of T2DM, along with a high BMI are some of the factors that can lead to greater remission rates. Further research in RCTs is needed by incorporating double/triple-blind protocols, a standard definition of T2DM remission, long follow-up periods to evaluate for relapses in remission and any side effects, with a focus on inflammatory markers (eg, osteopontin), scoring systems (eg, DiaRem), and benefits of One-Anastomosis Gastric Bypass (OAGB) over other modalities, to advance our understanding of T2DM remission.

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“…Using retrospective data, preoperative scoring models (DiaRem, Ad-DiaRem, DiaBetter) have been developed and validated to accurately predict T2D remission up to 5 years after gastric bypass surgery [4][5][6][7][8][9][10]. However, preoperative prediction of T2D relapse after initial remission seems more challenging and it has been suggested that in addition to preoperative Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04763-2) contains supplementary material, which is available to authorized users.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Prediction Models for Type 2 Diabetes Relapse After Post-bariatric Surgery Remission: a Post hoc Analysis of 15-Year Follow-up Data from the Swedish Obese Subjects (SOS) Study

et al. 2020

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Purpose Many patients achieve type 2 diabetes (T2D) remission after bariatric surgery, but relapse after post-surgery remission is common. Scoring models accurately predict remission up to 5 years after surgery but have not been tested for prediction of longterm T2D relapse. The aim of this work was to test the ability of prediction models and single predictors to identify patients at risk of long-term relapse (10-15 years) after post-surgery T2D remission. Methods We identified 222 individuals with T2D from the surgically treated group in the prospective Swedish Obese Subjects study, who were in remission at the 2-year follow-up and had data available for prediction of long-term T2D relapse. T2D remission/relapse was assessed after 10 and 15 years. Model performance (discrimination) was evaluated by the area under the receiver operating characteristic (AUROC) curves. Results Preoperative prediction of relapse using scores DiaRem, Ad-DiaRem, and DiaBetter and T2D duration alone was poor, as indicated by AUROC curves between 0.61-0.64 at 10 years and 0.62-0.66 at 15 years. Likewise, the 5y-Ad-DiaRem score, which includes early postoperative measures, resulted in AUROC curves of 0.65 and 0.70 for relapse at 10 and 15 years, respectively. Two-year weight change alone had higher discriminatory capacity than the 5y-Ad-DiaRem model at 10 years (AUROC = 0.70; p = 0.036) and similar capacity at 15 years (AUROC = 0.78; p = 0.188). Conclusions Predictive performance of all tested models is low for T2D relapse. By contrast, a single measure of 2-year weight change after surgery was associated with relapse, supporting a key role for initial weight reduction in long-term T2D control.

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Type 2 diabetes remission rates 1‐year post‐Roux‐en‐Y gastric bypass and validation of the DiaRem score: the Ontario Bariatric Network experience

Cited by 20 publications

References 16 publications

Remission of Type 2 Diabetes Mellitus after Bariatric Surgery: Fact or Fiction?

Remission of Type 2 Diabetes Mellitus after Bariatric Surgery: Fact or Fiction?

Bariatric Surgery and Type 2 Diabetes Mellitus: Assessing Factors Leading to Remission. A Systematic Review

Evaluation of Prediction Models for Type 2 Diabetes Relapse After Post-bariatric Surgery Remission: a Post hoc Analysis of 15-Year Follow-up Data from the Swedish Obese Subjects (SOS) Study

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