1. Limitations of the DiaRem Score in Predicting Remission of Diabetes Following Roux-En-Y Gastric Bypass (RYGB) in an ethnically Diverse Population from a Single Institution in the UK.
- Author
-
Tharakan G, Scott R, Szepietowski O, Miras AD, Blakemore AI, Purkayastha S, Ahmed A, Chahal H, and Tan T
- Subjects
- Adult, Asian People statistics & numerical data, Black People statistics & numerical data, Diabetes Mellitus, Type 2 ethnology, Female, Humans, Male, Middle Aged, Obesity, Morbid ethnology, Prognosis, Remission Induction, Retrospective Studies, White People statistics & numerical data, Diabetes Mellitus, Type 2 surgery, Gastric Bypass methods, Health Status Indicators, Obesity, Morbid surgery
- Abstract
Purpose: This study aimed to determine the predictive power of the DiaRem score following Roux-en-Y gastric bypass to identify patients who would have diabetes remission at 1 year in an ethnically diverse population., Methods: We performed a retrospective review of 262 patients with type 2 diabetes mellitus who underwent RYGB at the Imperial Weight Centre, UK, from 2007 to 2014. Data was collected on the parameters required to calculate the DiaRem score as well as pre- and post-surgical weight and the ethnicity of the subjects., Results: The studied cohort was ethnically diverse (61.3 % Caucasian, 10.3 % Asian, 5.3 % black, 2.6 % mixed and 20.6 % other). At 1-year post-surgery, there were significant reductions in mean weight (133.4 to 94.3 kg) and BMI (46.7 to 33.3 kg/m
2 ). The mean HbA1c decreased from 8.2 to 6.1 %, and 32.5 % of the cohort underwent either partial or complete remission. 67.8 % of the patients that were classified in group 1 of the DiaRem score (most likely to have remission) had complete remission. However, 22.9 % of the patients predicted to have the least chance of remission had either partial or complete remission., Conclusions: In this ethnically diverse cohort, the DiaRem score remains a useful tool to predict diabetes remission in those that have a low DiaRem score (high chance for remission) but was more limited in its predictive power in those with a high DiaRem score (least likely to have remission). Caution must be used in the application of this model in populations other than the US white Caucasian population used to derive the score., Competing Interests: The authors declare that they have no conflict of interest. Ethical Approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed Consent Informed consent for the surgical procedures undertaken was obtained from all individual participants included in the study.- Published
- 2017
- Full Text
- View/download PDF