Novel Predictive Models for Assessing T2D Risk After Gastric Surgery Prove Accurate

A group of researchers developed and validated two predictive models for assessing type 2 diabetes (T2D) remission after metabolic and bariatric surgery: the Diabetes Remission Index (DRI) and the Weight Loss-Adjusted Diabetes Remission Index (W-DRI).

The multicenter, retrospective cohort study was published in Annals of Surgery and included patients with T2D and overweight or obesity (body mass index ≥27) who underwent Roux-en-Y gastric bypass and sleeve gastrectomy between 2008 and 2018.

Institution 1 data (n=503) were used to develop and internally validate the models, whereas Institution 2 data (n=409) were used for external validation. The DRI model incorporated preoperative variables; the W-DRI additionally included postsurgical weight loss. Predictive accuracy was assessed using area under the curve (AUC) variables, calibration plots, and stratified analyses.

In Institution 1, 44.7% of patients reached T2D remission, with a DRI model AUC of 0.80. In Institution 2, 52.6% achieved remission with an AUC of 0.78. Incorporating weight loss improved W-DRI predictive accuracy (Institution 1 AUC, 0.82; Institution 2 AUC, 0.79), and calibration plots demonstrated strong agreement between predicted and observed remission rates.

Based on these results, the researchers concluded that the DRI and W-DRI models accurately predicted postsurgical T2D remission.

Source

Annals of Surgery