DRAMS — the new system for predicting type 2 diabetes mellitus remission after baritaric surgery

Abstract

BACKGROUND: Bariatric surgery has proven effective as a treatment for the metabolic complications of obesity, including type 2 diabetes mellitus (T2DM). Nowadays it is important to develop a personalized approach for bariatric patients generally, and for those with T2DM.AIM: Development of a scale for preoperative prediction of remission of T2DM in obese patients Russian population undergoing bariatric surgery (sleeve gastrectomy or gastric bypass).MATERIALS AND METHODS: A retrospective multicenter cohort study was conducted. The study included 112 patients (75 women and 37 men), mean age 46.25±9.29 years, mean BMI 48.71±7.66 kg/m2. A mathematical analysis of 17 preoperative clinical criteria was carried out to search for independent predictors of T2DM remission.RESULTS: A remission of T2DM was verified in 85 subjects, (75.9%), absence of remission of T2DM — in 27 subjects (24.1%). The most important prognostic factors were T2DM experience, age, HOMA-IR insulin resistance index, HbA1c, BMI, metformin therapy, SUs, insulin intake, increased levels of liver transaminases, and total cholesterol levels. The relative importance coefficient of each parameter was calculated. A formula has been developed to predict the high or low probability of T2DM remission after bariatric treatment. An online DRAMS (Diabetes Remission After Metabolic Surgery) calculator was proposed based on this formula so it is easy to use in clinical practice.CONCLUSION: An online calculator has been developed to predict the probability of T2DM remission after bariatric surgery. The received data allow us to construct a qualitative “high risk”/“low risk” scale. A number of identified predictors require further study in larger samples of patients.

Keywords

• bariatric surgery
• metabolic surgery
• remission of type 2 diabetes mellitus
• obesity
• diarem
• аd-diarem
• ims
• abcd
• diabetter