Validated Scoring Systems for Predicting Diabetes Remission After Bariatric Surgery

• Background: Metabolic surgery is a new term used to emphasize the metabolic benefits of a variety of bariatric surgery procedures, particularly with relationship to the treatment of type 2 diabetes and its complications. Means by which the likely impact of metabolic surgery on diabetes could be assessed in individual patients would be of clinical value. Methods: Two main scoring systems (ABCD and DiaRem) have been proposed to predict remission of diabetes after metabolic surgery. We present a description of these systems, discuss the sources of differences in their predictive power, and suggest means by which to improve predictive power. Results: ABCD is more predictive in patients with intermediate and poorer scores. Neither score is validated as a means of predicting, which patients will benefit most from the repercussions of improved glycemic control in terms of complications. Conclusion: A composite scoring system derived from ABCD and DiaRem may improve prediction of postoperative remission rates. Such a system should be considered principally as an aid to decision-making. Excessive focus on prediction of long-term remission of type 2 diabetes mellitus should be avoided in favor of identifying which patients may stand to benefit most, even if full clinical remission is not achieved.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

Nyckelord

scoring system

diabetes

bariatric surgery

roux-en-y

gastric bypass-surgery

body-mass index

intensive medical

therapy

morbidly obese-patients

randomized controlled-trial

beta-cell

function

weight-loss

metabolic surgery

microvascular complications

Nursing

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)