-- Robert Preidt
FRIDAY, Sept. 13 (HealthDay News) -- A simple scoring system can
predict whether an obese patient might achieve diabetes remission
within five years after weight-loss surgery, according to
The scoring system -- called DiaRem -- is based on four readily
available pre-surgery patient characteristics: insulin use, age,
hemoglobin A1c concentration (a measure of blood sugar) and type of
To develop their scoring system, the researchers analyzed the
outcomes of nearly 700 obese people with type 2 diabetes who
underwent weight-loss surgery between 2004 and 2011. Of those
patients, 63 percent achieved partial or complete diabetes
The researchers analyzed hundreds of factors in order to
identify those that were independent predictors of remission. They
eventually narrowed them down to the four used in the scoring
system. Patient scores were determined by assigning a certain
number of points to each of the four factors.
Patients with a low score had the highest chance of remission
within five years after surgery, while those with a higher score
were less likely to achieve remission. The scoring system's
performance was then tested in nearly 400 patients, according to
the study, which was published in the journal
The Lancet Diabetes & Endocrinology.
"[The new scoring system] will give patients and physicians a scientifically valid way of assessing the merits of gastric bypass surgery for treating diabetes and deciding whether additional measures should be taken to improve the odds of remission," lead author George Argyropoulos, from the Geisinger Health System in Danville, Penn., said in a journal news release.
The authors of an accompanying commentary agreed. "The DiaRem
score could help with selection of appropriate treatment and
management of expectations held by both the patient and the
multidisciplinary team involved in the patient's care," wrote
Dimitri Pournaras and Carel le Roux, from Imperial College London,
"Additionally, it could scientifically improve the comparison of different surgical procedures by allowing appropriate stratification of probability of remission," Pournaras and le Roux said.
"However, further prospective studies are needed to validate these potential uses," they said. "Future research in this area will increase the accuracy of outcome predictions in different populations, age groups and interventional approaches. This research could even challenge present guidelines for provision of weight-loss surgery, which mostly depends on [body-mass index]" -- a measurement of body fat based on height and weight.
The U.S. National Institute of Diabetes and Digestive and Kidney
Diseases has more about
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