Prognostic factors and a new preliminary scoring system for remission of type 2 diabetes mellitus after laparoscopic sleeve gastrectomy

Akira Umemura, Akira Sasaki, Hiroyuki Nitta, Haruka Nikai, Shigeaki Baba, Takeshi Takahara, Yasushi Hasegawa, Hirokatsu Katagiri, Shoji Kanno, Yasushi Ishigaki

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the early remission rate of type 2 diabetes mellitus (T2DM) after laparoscopic sleeve gastrectomy (LSG) and establish a preliminary scoring system that predicts T2DM remission. Methods: We assessed the outcomes of 49 morbidly obese patients with T2DM who underwent LSG between 2008 and 2018. The prognostic factors for T2DM remission 1 year post-LSG were identified and an original scoring system was established. We validated our scoring system by comparing it with the individualized metabolic surgery score and the ABCD score. Results: The patients’ mean body weight loss and percentage of excess weight loss were 34.4 kg and 59.4%, respectively, while the T2DM remission rate was 77.5%. The serum insulin level and the T2DM duration were independent predictive factors, the receiver-operating characteristic (ROC) curves for which revealed cutoff values of 12.7 ng/mL and 72 months, respectively. We set our system’s score range at 0–2, whereby patients with higher scores have a good T2DM remission prognosis, as higher insulin levels, and/or shorter T2DM duration. Our scoring system had accuracy levels similar to those of the ABCD score with a simple stratification. Conclusion: Our preliminary scoring system attains a good level of accuracy for predicting T2DM remission.

Original languageEnglish
JournalSurgery today
DOIs
Publication statusAccepted/In press - 2020 Jan 1
Externally publishedYes

Keywords

  • Bariatric surgery
  • Complete remission
  • Diabetes mellitus
  • Laparoscopic sleeve gastrectomy
  • Metabolic surgery

ASJC Scopus subject areas

  • Surgery

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    Umemura, A., Sasaki, A., Nitta, H., Nikai, H., Baba, S., Takahara, T., Hasegawa, Y., Katagiri, H., Kanno, S., & Ishigaki, Y. (Accepted/In press). Prognostic factors and a new preliminary scoring system for remission of type 2 diabetes mellitus after laparoscopic sleeve gastrectomy. Surgery today. https://doi.org/10.1007/s00595-020-01990-z