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04.01.2022 | Original Contributions

Validation of Ad-DiaRem and ABCD Diabetes Remission Prediction Scores at 1-Year After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in the Randomized Controlled Oseberg Trial

verfasst von: Farhat Fatima, Jøran Hjelmesæth, Jens Kristoffer Hertel, Marius Svanevik, Rune Sandbu, Milada Cvancarova Småstuen, Dag Hofsø

Erschienen in: Obesity Surgery | Ausgabe 3/2022

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Abstract

Background

Prediction of type 2 diabetes (T2DM) remission is an important part of risk-benefit assessment before bariatric surgery.

Study Design

Advanced-DiaRem (Ad-DiaRem) and ABCD diabetes remission scores for sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) were calculated using baseline data. Differences in model discrimination using area under the curve of receiver operating curve (AUC-ROC) and model calibration were tested for complete remission (HbA1c ≤ 6.0% without antidiabetic medications) in the two groups. Optimal cutoff scores were calculated using the Youden index.

Results

We randomized 109 patients to either SG or RYGB. With one patient lost to follow-up in each group, the scores were calculated for 54 patients in the SG group and 53 patients in the RYGB group. Both models showed moderate predictive power without any significant difference between the groups: AUC-ROCs (95% CI) for the Ad-DiaRem score (SG versus RYGB) were 0.872 (0.780–0.964) versus 0.843 (0.733–0.954), p = 0.69, and for the ABCD score 0.849 (0.752–0.946) versus 0.750 (0.580–0.920), p = 0.32, respectively. Using optimal cutoff points derived from the whole study population, the actual proportion of diabetes remission was significantly higher than predicted for both the Ad-DiaRem and ABCD scores in the RYGB group. Diabetes duration and glycated haemoglobin predicted diabetes remission in the entire Oseberg population.

Conclusion

Both the Ad-DiaRem and ABCD scores showed moderate ability to discriminate between those who achieved remission of T2DM and those who did not after SG and RYGB. Larger studies are needed for the identification of procedure-specific optimal cutoffs.

Trial Registration

ClinicalTrials.gov Identifier: NCT01778738

Graphical abstract

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Titel: Validation of Ad-DiaRem and ABCD Diabetes Remission Prediction Scores at 1-Year After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in the Randomized Controlled Oseberg Trial
verfasst von: Farhat Fatima
Jøran Hjelmesæth
Jens Kristoffer Hertel
Marius Svanevik
Rune Sandbu
Milada Cvancarova Småstuen
Dag Hofsø
Publikationsdatum: 04.01.2022
Verlag: Springer US
Erschienen in: Obesity Surgery / Ausgabe 3/2022
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-021-05856-2

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Validation of Ad-DiaRem and ABCD Diabetes Remission Prediction Scores at 1-Year After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in the Randomized Controlled Oseberg Trial