Scores, Weight Loss Predict Type 2 Diabetes Remission After Bariatric Surgery

Two-year percent weight loss as well as DiaBetter and DiaRem scores are significant predictors of type 2 diabetes remission in patients who undergo Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy, according to a recent study.

Little is known about the comparable efficacy of RYGB and sleeve gastrectomy on type 2 diabetes remission, and the role of weight loss.
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For their study, the researchers assessed patients with obesity with type 2 diabetes at a single center who underwent RYGB (n = 107) or sleeve gastrectomy (n = 103). A separate validation cohort study (n = 173) was also performed.

The researchers determined type 2 diabetes remission, percent weight loss, DiaRem scores, DiaBetter scores, and areas under receiving operator characteristic curves. Logistic regression with multivariate adjustments was used to analyze the association between percent weight loss and type 2 diabetes remission.

Results indicated that more patients with lower DiaBetter and DiaRem scores had achieved type 2 diabetes remission, compared with those with higher scores. Areas under the curve were similar for DiaBetter (0.867) and DiaRem (0.865).

Patients who had undergone RYGB had a higher 2-year percent weight loss (26.6) vs those who had undergone sleeve gastrectomy (20.6). Furthermore, those who had received RYGB had a 151% higher chance of achieving type 2 diabetes complete remission vs those who had received sleeve gastrectomy. However, following adjustment for percent weight loss, this association became nonsignificant.

“DiaBetter and DiaRem scores predict type 2 diabetes remission following RYGB and sleeve gastrectomy,” the researchers concluded. “Two-year percent weight loss plays a key role in determining type 2 diabetes remission.”

—Christina Vogt

Reference:

Pucci A, Tymoszuk U, Cheung WH, et al. Type 2 diabetes remission 2 years post Roux-en-Y gastric bypass and sleeve gastrectomy: the role of the weight loss and comparison of DiaRem and DiaBetter scores [Published online October 21, 2017]. Diabetic Med. doi:10.1111/dme.13532.