Prediction of type 2 diabetes remission after metabolic surgery: a comparison of the individualized metabolic surgery score and the ABCD score
Metabolic surgery has become increasingly accepted for the treatment of type 2 diabetes (T2D). However, there is limited evidence regarding the optimal candidate and surgical procedure. Although a new individualized metabolic surgery (IMS) score was recently proposed for procedure selection, it has...
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Published in | Surgery for obesity and related diseases Vol. 14; no. 5; pp. 640 - 645 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Elsevier Inc
01.05.2018
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Abstract | Metabolic surgery has become increasingly accepted for the treatment of type 2 diabetes (T2D). However, there is limited evidence regarding the optimal candidate and surgical procedure. Although a new individualized metabolic surgery (IMS) score was recently proposed for procedure selection, it has yet to be validated.
To validate the IMS score with regard to remission of T2D after metabolic surgery and compare it with the age, body mass index, C-peptide level, and duration of T2D (ABCD) score.
Hospital-based bariatric center.
A total of 310 T2D patients who underwent gastric bypass and sleeve gastrectomy at an academic center in Taiwan and had a minimum 5-year follow-up (2004–2012) were examined for the predictive power of complete remission using the IMS and the ABCD scoring systems.
At the 5-year follow-up, weight loss was 27.5%, with mean body mass index decreasing from 37.8 to 27.9 kg/m2, mean glycated hemoglobin decreased from 8.6% to 6.1%, and prolonged remission of T2D achieved in 224 (72.3%) T2D patients. Remission rates were higher in patients who underwent gastric bypass than in those who underwent sleeve gastrectomy (73.6% versus 66.1%; P = .04), regardless of T2D severity, and were 96%, 68%, and 16% in patients with IMS mild, moderate, and severe scores, respectively. Although both scores predicted the success of surgery, the ABCD was better in patients with IMS moderate scores.
Metabolic surgery is an option for T2D patients with obesity. The ABCD score may be better at predicting T2D remission after metabolic surgery compared with the IMS score. |
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AbstractList | BACKGROUNDMetabolic surgery has become increasingly accepted for the treatment of type 2 diabetes (T2D). However, there is limited evidence regarding the optimal candidate and surgical procedure. Although a new individualized metabolic surgery (IMS) score was recently proposed for procedure selection, it has yet to be validated.OBJECTIVETo validate the IMS score with regard to remission of T2D after metabolic surgery and compare it with the age, body mass index, C-peptide level, and duration of T2D (ABCD) score.SETTINGHospital-based bariatric center.METHODSA total of 310 T2D patients who underwent gastric bypass and sleeve gastrectomy at an academic center in Taiwan and had a minimum 5-year follow-up (2004-2012) were examined for the predictive power of complete remission using the IMS and the ABCD scoring systems.RESULTSAt the 5-year follow-up, weight loss was 27.5%, with mean body mass index decreasing from 37.8 to 27.9 kg/m2, mean glycated hemoglobin decreased from 8.6% to 6.1%, and prolonged remission of T2D achieved in 224 (72.3%) T2D patients. Remission rates were higher in patients who underwent gastric bypass than in those who underwent sleeve gastrectomy (73.6% versus 66.1%; P = .04), regardless of T2D severity, and were 96%, 68%, and 16% in patients with IMS mild, moderate, and severe scores, respectively. Although both scores predicted the success of surgery, the ABCD was better in patients with IMS moderate scores.CONCLUSIONMetabolic surgery is an option for T2D patients with obesity. The ABCD score may be better at predicting T2D remission after metabolic surgery compared with the IMS score. Metabolic surgery has become increasingly accepted for the treatment of type 2 diabetes (T2D). However, there is limited evidence regarding the optimal candidate and surgical procedure. Although a new individualized metabolic surgery (IMS) score was recently proposed for procedure selection, it has yet to be validated. To validate the IMS score with regard to remission of T2D after metabolic surgery and compare it with the age, body mass index, C-peptide level, and duration of T2D (ABCD) score. Hospital-based bariatric center. A total of 310 T2D patients who underwent gastric bypass and sleeve gastrectomy at an academic center in Taiwan and had a minimum 5-year follow-up (2004-2012) were examined for the predictive power of complete remission using the IMS and the ABCD scoring systems. At the 5-year follow-up, weight loss was 27.5%, with mean body mass index decreasing from 37.8 to 27.9 kg/m , mean glycated hemoglobin decreased from 8.6% to 6.1%, and prolonged remission of T2D achieved in 224 (72.3%) T2D patients. Remission rates were higher in patients who underwent gastric bypass than in those who underwent sleeve gastrectomy (73.6% versus 66.1%; P = .04), regardless of T2D severity, and were 96%, 68%, and 16% in patients with IMS mild, moderate, and severe scores, respectively. Although both scores predicted the success of surgery, the ABCD was better in patients with IMS moderate scores. Metabolic surgery is an option for T2D patients with obesity. The ABCD score may be better at predicting T2D remission after metabolic surgery compared with the IMS score. Metabolic surgery has become increasingly accepted for the treatment of type 2 diabetes (T2D). However, there is limited evidence regarding the optimal candidate and surgical procedure. Although a new individualized metabolic surgery (IMS) score was recently proposed for procedure selection, it has yet to be validated. To validate the IMS score with regard to remission of T2D after metabolic surgery and compare it with the age, body mass index, C-peptide level, and duration of T2D (ABCD) score. Hospital-based bariatric center. A total of 310 T2D patients who underwent gastric bypass and sleeve gastrectomy at an academic center in Taiwan and had a minimum 5-year follow-up (2004–2012) were examined for the predictive power of complete remission using the IMS and the ABCD scoring systems. At the 5-year follow-up, weight loss was 27.5%, with mean body mass index decreasing from 37.8 to 27.9 kg/m2, mean glycated hemoglobin decreased from 8.6% to 6.1%, and prolonged remission of T2D achieved in 224 (72.3%) T2D patients. Remission rates were higher in patients who underwent gastric bypass than in those who underwent sleeve gastrectomy (73.6% versus 66.1%; P = .04), regardless of T2D severity, and were 96%, 68%, and 16% in patients with IMS mild, moderate, and severe scores, respectively. Although both scores predicted the success of surgery, the ABCD was better in patients with IMS moderate scores. Metabolic surgery is an option for T2D patients with obesity. The ABCD score may be better at predicting T2D remission after metabolic surgery compared with the IMS score. |
Author | Ser, Kong-Han Lee, Wei-Jei Lee, Yi-Chih Chen, Shu-Chun Chen, Jung-Chien Hsu, Nan-Yung |
Author_xml | – sequence: 1 givenname: Jung-Chien surname: Chen fullname: Chen, Jung-Chien organization: Ph.D. Program for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei, Taiwan, R.O.C – sequence: 2 givenname: Nan-Yung surname: Hsu fullname: Hsu, Nan-Yung email: h440506@tmu.edu.tw organization: Ph.D. Program for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei, Taiwan, R.O.C – sequence: 3 givenname: Wei-Jei surname: Lee fullname: Lee, Wei-Jei email: wjlee_obessurg_tw@yahoo.com.tw organization: Department of Surgery, Min-Sheng General Hospital, Taipei, Taiwan, R.O.C – sequence: 4 givenname: Shu-Chun surname: Chen fullname: Chen, Shu-Chun organization: Department of Surgery, Min-Sheng General Hospital, Taipei, Taiwan, R.O.C – sequence: 5 givenname: Kong-Han surname: Ser fullname: Ser, Kong-Han organization: Department of Surgery, Min-Sheng General Hospital, Taipei, Taiwan, R.O.C – sequence: 6 givenname: Yi-Chih surname: Lee fullname: Lee, Yi-Chih organization: Department of International Business, Chien Hsin University of Science and Technology, Taipei, Taiwan, R.O.C |
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Keywords | IMS score Obesity ABCD score T2D Gastric bypass Sleeve gastrectomy |
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Snippet | Metabolic surgery has become increasingly accepted for the treatment of type 2 diabetes (T2D). However, there is limited evidence regarding the optimal... BACKGROUNDMetabolic surgery has become increasingly accepted for the treatment of type 2 diabetes (T2D). However, there is limited evidence regarding the... |
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SubjectTerms | ABCD score Adult Aged Bariatric Surgery - methods Body Mass Index Diabetes Mellitus, Type 2 - surgery Female Follow-Up Studies Gastrectomy - methods Gastric bypass Gastric Bypass - methods Health Status Indicators Humans IMS score Laparoscopy - methods Male Middle Aged Obesity Precision Medicine - methods Remission Induction Sleeve gastrectomy T2D Treatment Outcome Young Adult |
Title | Prediction of type 2 diabetes remission after metabolic surgery: a comparison of the individualized metabolic surgery score and the ABCD score |
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