Abstract
Bariatric surgery has become an established evidence-based treatment option for diabetes associated with obesity . Numerous studies have demonstrated that bariatric surgery is superior to conventional medical treatment and is effective in achieving resolution of hyperglycaemia or improvement in glycaemic control in type 2 diabetes. However, diabetes remission after bariatric surgery does not occur universally in patients and surgical procedures are associated with the risks of complications. It is imperative to identify patients who are likely to gain the best possible metabolic benefit i.e. resolution of diabetes from bariatric surgery . Several clinical and biochemical factors have been studied to predict diabetes remission following bariatric surgery. This article provides a concise review within this area and describes the available scoring systems to predict diabetes remission.
Highlights
In 2008, the World Health Organisation described that 1.4 billion people were overweight and more than 0.5 billion were obese
A lower DiaRem score is associated with a greater likelihood of diabetes remission following Roux-en-Y gastric bypass (RYGB) surgery
Preoperative clinical and biochemical factors that could predict the outcome of T2DM following bariatric surgery would be useful for the bariatric multidisciplinary team
Summary
In 2008, the World Health Organisation described that 1.4 billion people were overweight and more than 0.5 billion were obese. Previous studies have shown that younger age is associated with both early and late remission of T2DM following surgery [10,11,12,13]. This may be debatable [7]. A German study found that increasing age was an independent significant predictor for postoperative metabolic failure [10] These observations were confirmed by a recently published metaanalysis of 13 studies (n=1149) which showed a significant negative association between preoperative age and T2DM remission (OR: -2.46 [-3.90 to -1.02], p< 0.01) [15]
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