Prediction of remission after metabolic surgery using a novel scoring system in type 2 diabetes -a retrospective cohort study

被引：44

作者：

Ugale S. ^{[1
]}

Gupta N. ^{[1
]}

Modi K.D. ^{[2
]}

Kota S.K. ^{[3
]}

Satwalekar V. ^{[1
]}

Naik V. ^{[1
]}

Swapna M. ^{[1
]}

Kumar K.V.S.H. ^{[4
]}

机构：

[1] Department of Advanced Laparoscopy and Metabolic Surgery, Kirloskar Hospital, Hyderabad, Andhra Pradesh

[2] Department of Endocrinology, Medwin Hospital, Hyderabad, AP

[3] Department of Endocrinology, Endocare Hospital, Vijayawada, AP

[4] Department of Endocrinology, Command Hospital, Chandimandir, Haryana

来源：

Journal of Diabetes & Metabolic Disorders | / 13卷 / 1期

关键词：

Diabetes remission; Ileal interposition; Metabolic surgery; Sleeve gastrectomy; Type; 2; Diabetes;

D O I：

10.1186/s40200-014-0089-y

中图分类号：

学科分类号：

摘要：

Background: Remission of diabetes is seen in more than 60% of patients after bariatric surgery. There is extensive variability in the remission rates between different surgical procedures. We analyzed our database and aimed to develop an easy scoring system to predict the probability of diabetes remission after two surgical procedures i.e. Ileal Interposition coupled with Sleeve Gastrectomy (IISG) or Diverted Sleeve Gastrectomy (IIDSG).Methods: In this retrospective study, we analyzed records pertaining to patients who underwent IISG (n = 46) and IIDSG (n = 29). The primary outcome measure was diabetes remission (A1c <6.5% and not requiring hypoglycemic drugs). We identified seven preoperative clinical variables (age, duration of diabetes, body mass index, micro and macrovascular complications, use of insulin and stimulated C-peptide) based on our previous reports to be included in the diabetes remission score (DRS). The DRS score (7 -14) was compared between the patients with and without remission in both the surgery groups.Results: Mean DRS in patients who underwent IISG was 9.2 ± 1.4. Twenty one (46%) had a remission in diabetes. DRS was significantly lower in patients with remission than patients without remission (8.1 ± 0.8 versus 10.2 ± 0.9, p < 0.0001). Mean DRS in patients who underwent IIDSG was 10.4 ± 1.3. Twenty one (72%) had a remission in diabetes. DRS was significantly lower in patients with remission than patients without remission (9.7 ± 0.8 versus 12.0 ± 0.5, p < 0.0001). Patients with a DRS ≥ 10 in IISG group and more than 12 in IIDSG group did not get into remission.Conclusion: Preoperative DRS can be a useful tool to select the type of surgical procedure and to predict the postoperative diabetes remission.Trial registration: NCT00834626. © 2014 Ugale et al.; licensee BioMed Central Ltd.

引用

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