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Surg Obes Relat Dis. 2018 May;14(5):640-645. doi: 10.1016/j.soard.2018.01.027. Epub 2018 Jan 31.

Prediction of type 2 diabetes remission after metabolic surgery: a comparison of the individualized metabolic surgery score and the ABCD score.

Author information

1
Ph.D. Program for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei, Taiwan, R.O.C.; Department of Surgery, Min-Sheng General Hospital, Taipei, Taiwan, R.O.C.
2
Ph.D. Program for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei, Taiwan, R.O.C.. Electronic address: h440506@tmu.edu.tw.
3
Department of Surgery, Min-Sheng General Hospital, Taipei, Taiwan, R.O.C. Electronic address: wjlee_obessurg_tw@yahoo.com.tw.
4
Department of Surgery, Min-Sheng General Hospital, Taipei, Taiwan, R.O.C.
5
Department of International Business, Chien Hsin University of Science and Technology, Taipei, Taiwan, R.O.C.

Abstract

BACKGROUND:

Metabolic surgery has become increasingly accepted for the treatment of type 2 diabetes (T2D). However, there is limited evidence regarding the optimal candidate and surgical procedure. Although a new individualized metabolic surgery (IMS) score was recently proposed for procedure selection, it has yet to be validated.

OBJECTIVE:

To validate the IMS score with regard to remission of T2D after metabolic surgery and compare it with the age, body mass index, C-peptide level, and duration of T2D (ABCD) score.

SETTING:

Hospital-based bariatric center.

METHODS:

A total of 310 T2D patients who underwent gastric bypass and sleeve gastrectomy at an academic center in Taiwan and had a minimum 5-year follow-up (2004-2012) were examined for the predictive power of complete remission using the IMS and the ABCD scoring systems.

RESULTS:

At the 5-year follow-up, weight loss was 27.5%, with mean body mass index decreasing from 37.8 to 27.9 kg/m2, mean glycated hemoglobin decreased from 8.6% to 6.1%, and prolonged remission of T2D achieved in 224 (72.3%) T2D patients. Remission rates were higher in patients who underwent gastric bypass than in those who underwent sleeve gastrectomy (73.6% versus 66.1%; P = .04), regardless of T2D severity, and were 96%, 68%, and 16% in patients with IMS mild, moderate, and severe scores, respectively. Although both scores predicted the success of surgery, the ABCD was better in patients with IMS moderate scores.

CONCLUSION:

Metabolic surgery is an option for T2D patients with obesity. The ABCD score may be better at predicting T2D remission after metabolic surgery compared with the IMS score.

KEYWORDS:

ABCD score; Gastric bypass; IMS score; Obesity; Sleeve gastrectomy; T2D

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