A simple test can predict which patients with type 2 diabetes will benefit from weight loss surgery, British researchers have reported.
The University College London, UK, team say that the impact of gastric bypass and sleeve gastrectomy surgery on type 2 diabetes remission is unclear.
They compared the predictive value of the well-established DiaRem diabetes remission prediction score, which uses glycated haemoglobin (HbA1c), age and diabetes medications but not diabetes duration, against a test they developed called the DiaBetter score, which includes diabetes duration.
The study included 210 weight loss surgery patients. This showed that diabetes remission was highest for those with the lowest DiaBetter and DiaRem scores. Both tests were useful but the DiaBetter test has slightly superior predictive value.
Gastric bypass was more effective for weight loss after two years, and better for diabetes remission, a result that was accounted for by the greater weight loss.
The team write in Diabetic Medicine yesterday (21 November) that: "Two-year percentage weight loss plays a key role in determining diabetes remission."
"Over two million people in the UK are eligible for assessment for bariatric surgery, and yet only 6,000 undergo the procedure each year," says the lead author, Professor Rachel Batterham.
"Given the limited access to surgery it’s vital that we ensure it’s offered to those who will benefit the most, and that they’re well supported long after the surgery.
"Bariatric surgery can be highly beneficial, yet the results are highly variable, so we set out to devise a better way of identifying which people with type 2 diabetes will benefit most."
Pucci, A. et al. Type 2 diabetes remission 2 years post Roux-en-Y gastric bypass and sleeve gastrectomy: the role of the weight loss and comparison of DiaRem and DiaBetter scores. Diabetic Medicine 21 November 2017; doi: 10.1111/dme.13532 [abstract]
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