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Abstract
Introduction:Roux-en-Y Gastric Bypass (RYGB) is a bariatric surgery procedure, associated with substantial and sustained weight loss, as well as significant improvement or resolution of obesity-associated comorbidities, such as Type 2 Diabetes (T2D). The probability of short-term T2D remission can be predicted with the aid of several mathematical models (DiaBetter, DiaRem, Ad-DiaRem and 5y-Ad-DiaRem). However, these models’ accuracy for predicting long-term T2D remission has not yet been assessed.
Objective:This study aim was to evaluate the accuracy of DiaBetter, DiaRem, Ad-DiaRem and 5y-Ad-DiaRem scores’ at predicting T2D remission 10 or more years after surgery.
Methods:Patients with obesity and T2D (n=126) submitted to RYGB for the primary treatment of obesity and obesity-associated comorbidities, with 10 or more years of followup. It was a unicentric trial. Pre-operative anthropometric and clinical data was retrieved to calculate DiaRem, DiaBetter, Ad-DiaRem and 5y-Ad-DiaRem scores, while a hospital visit was conducted to assess current diabetes status. The area under the receiver operating characteristic (AUROC) curve was calculated as estimate of the scores’ accuracy to predict long-term T2D remission.
Results:Among the entire cohort (n=126), 70 subjects (55.6%) achieved and maintained T2D remission 10 or more years after RYGB. The 5y-Ad-DiaRem score was the one that depicted the highest discriminative power (AUROC=0.838) to predict long-term T2D remission when compared to DiaBetter (AUROC=0.735), DiaRem (AUROC=0.721) and AdDiaRem (AUROC=0.720).
Conclusion:RYGB was associated with a high rate of long-term T2D remission. The score with highest accuracy to predict long-term T2D remission after RYGB surgery was the 5yAd-DiaRem. Yet, the available scores accuracy to predict T2D remission in the long term is still suboptimal, highlighting the unmet need for a better scoring system.
