Predicting success of metabolic surgery: age,body mass index,C-peptide,and duration score |
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Authors: | Wei-Jei Lee Kyung Yul Hur Muffazal Lakadawala Kazunori Kasama Simon KH Wong Shu-Chun Chen Yi-Chih Lee Kong-Han Ser |
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Institution: | 1. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan;2. Department of Surgery, Soonchunhyang University Hospital, Seoul, Korea;3. Department of Surgery, Saifee Hospital, Mumbai, India;4. Department of Surgery, Yotsuya Medical Cube, Tokyo, Japan;5. Department of Surgery, Prince of Wales Hospital, Hong Kong, China |
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Abstract: | BackgroundSurgery is the most effective treatment of morbid obesity and leads to dramatic improvements in type 2 diabetes mellitus (T2DM). Gastrointestinal metabolic surgery has been proposed as a treatment option for T2DM. However, a grading system to categorize and predict the outcome of metabolic surgery is lacking. The study setting was a tertiary referral hospital (Taoyuan City, Taoyuan County, Taiwan).MethodsWe first evaluated 63 patients and identified 4 factors that predicted the success of T2DM remission after bariatric surgery in this cohort: body mass index, C-peptide level, T2DM duration, and patient age. We used these variables to construct the Diabetes Surgery Score, a multidimensional 10-point scale along which greater scores indicate a better chance of T2DM remission. We then validated the index in a prospective collected cohort of 176 patients, using remission of T2DM at 1 year after surgery as the outcome variable.ResultsA total of 48 T2DM remissions occurred among the 63 patients and 115 remissions (65.3%) in the validation cohort. Patients with T2DM remission after surgery had a greater Diabetes Surgery Score than those without (8 ± 4 versus 4 ± 4, P < .05). Patients with a greater Diabetes Surgery Score also had a greater rate of success with T2DM remission (from 33% at score 0 to 100% at score 10); A 1-point increase in the Diabetes Surgery Score translated to an absolute 6.7% in the success rate.ConclusionThe Diabetes Surgery Score is a simple multidimensional grading system that can predict the success of T2DM treatment using bariatric surgery among patients with inadequately controlled T2DM. |
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