Role of DiaRem Score in Preoperative Prediction of Type 2 Diabetes Mellitus Remission After Laparoscopic Roux-en-Y Gastr
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ORIGINAL CONTRIBUTIONS
Role of DiaRem Score in Preoperative Prediction of Type 2 Diabetes Mellitus Remission After Laparoscopic Roux-en-Y Gastric Bypass: Indian Perspective Pradeep Chowbey 1 & Rajat Kelkar 1
&
Vandana Soni 1 & Rajesh Khullar 1 & Anil Sharma 1 & Manish Baijal 1
Received: 30 July 2020 / Revised: 11 November 2020 / Accepted: 11 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Roux-en-Y gastric bypass (RYGB) has emerged as the most effective treatment in reversing insulin resistance in patients with type 2 diabetes mellitus (T2DM). A number of models and statistical tools have been proposed to predict patients likely to experience diabetes remission post-RYGB. The purpose of our study was to evaluate the preoperative accuracy of DiaRem score in predicting T2DM remission at 1 year of follow-up in a retrospective analysis of diabetic morbidly obese patients who underwent RYGB. Methods One hundred and forty-three patients underwent RYGB between January 2018 and December 2018. We conducted a retrospective analysis in 55 patients (38.46%) with T2DM with 1 year of follow-up. DiaRem score was calculated, and patients were stratified in five groups. Result At a 1-year follow-up, we found a higher proportion of patients with T2DM remission in the lower score group compared to a lower proportion of patients with remission in the higher score group. We derived a DiaRem cut-off score of 6.5 that had high sensitivity and specificity to predict T2DM remission preoperatively. We found a significant decrease in BMI and HbA1C values post-operatively at 1 year following RYGB. Conclusion DiaRem score is an easy to determine score based on basic clinical parameters that could identify patients with T2DM who would achieve maximal benefit in terms of remission after bariatric surgery. The development of a suitable scoring tool would be clinically useful as it would enable clinicians to better triage patients for RYGB. Keywords DiaRem score . Roux-en-Y gastric bypass . Type 2 DM remission
* Rajat Kelkar [email protected] Pradeep Chowbey [email protected] Vandana Soni [email protected] Rajesh Khullar [email protected] Anil Sharma [email protected] Manish Baijal [email protected] 1
Minimal Access, Metabolic & Bariatric Surgery (MAMBS) Department, Max Superspeciality Hospital, 1 & 2, Press Enclave Marg, Saket, New Delhi 110017, India
Introduction Bariatric surgery has emerged as the most effective treatment in reversing insulin resistance in patients with type 2 diabetes [1]. Roux-en-Y gastric bypass (RYGB) surgery, most commonly performed in patients with a BMI of 35 kg/m2 or greater, is a particularly effective intervention, with about 60% of patients achieving remission of type 2 diabetes [2, 3]. RYGB surgery has also been proposed as a way to achieve remission of type 2 diabetes in individuals for whom the primary objective might not be weight loss, such as those with a BMI of 25–35 kg/m2 [4, 5].
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