A new scoring system will allow doctors to identify patients that are more likely to have diabetes remission after gastric bypass surgery. The system is based on four different variables, age, types of antidiabetic drugs, insulin use and HbA1C concentration. A patient can score up to 22 points. The study was released by the Geisinger Health System and the National Institutes of Health.*
The study found that 88% of patients had scores of 0 to 2 while just 2% of patients had scores 18 to 22, at the high end of the scoring system. The study believes that diabetes remission is influenced by insulin use, one’s age, glycated hemoglobin as well as combination therapy with insulin sensitizers.
The researchers found that baseline insulin use was the strongest predictor of remission in patients, as those who did not use insulin before the surgery had a remission rate of 70.6% compared to 10.3% of those who did take insulin before gastric bypass surgery.
Future of Diabetes Scoring System for Gastric Bypass Patients
“The DiaRem score is the first pre-operative way to predict diabetes remission after RYGB surgery and is calculated with four readily obtainable clinical variables,” the researchers said. For example, an individual with a body mass index (BMI) of 39 kg/m2 and a DiaRem score of 22 could benefit from RYGB in terms of weight loss, but would have low probability of diabetes remission and could therefore opt to make intensive lifestyle changes or use incretion mimetics before surgery, which appears to improve the odds of remission for individuals taking insulin.”
The study also reports that nearly 60% of obese diabetic patients experience a remission of diabetes after weight loss surgery. Many believe this statistic means that surgery should be used as a means to achieve diabetes remission in patients who have dangerous cases of diabetes as a result of their morbid obesity.
About the Study
The authors of the study agree that patients and their doctors can benefit from a system that allows them to predict their likelihood for remission before enduring weight loss surgery (gastric bypass). The researchers were determined to find an effective and easy to understand way to predict diabetes remission. They achieved this by studying nearly 2,300 patients who understand gastric bypass at their health system (Geisinger Health System) from 2004 to 2011. They identified the patients studied by ensuring that they met the American Diabetes Association criteria for type 2 diabetes before enduring surgery. They also used the American Diabetes Association definition of remission to define it in this study.
Researchers separated patients into two groups according to their individual insulin use at the time of surgery. From there, patients were divided into groups further by studying when remission occurred (if at all), whether within 2 months before surgery or 2 months after surgery. The study looked at 2,300 patients with 690 of the patients having type 2 diabetes prior to surgery and 436 achieving partial remission and 340 achieving complete remission. According to the study, patients were separated into five categories – 0 to 2, 3 to 7, 8 to 12, 13 to 17 and 18 to 22. The study highlighted the fact that gastric bypass surgery had a profound impact of type 2 diabetes remission.
More Information & Links