title: Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: predicting the success by ABCD score.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) is becoming a primary bariatric surgery for obesity and related diseases. This study presents the outcome of LSG with regard to the remission of type 2 diabetes mellitus (T2 DM) and the usefulness of a grading system to categorize and predict outcome of T2 DM remission.
  
  
  METHODS
  A total of 157 patients with T2 DM (82 women and 75 men) with morbid obesity (mean body mass index 39.0±7.4 kg/m(2)) who underwent LSG from 2006 to 2013 were selected for the present study. The ABCD score is composed of the patient's age, body mass index, C-peptide level, and duration of T2 DM (yr). The remission of T2 DM after LSG was evaluated using the ABCD score.
  
  
  RESULTS
  At 12 months after surgery, 85 of the patients had complete follow-up data. The weight loss was 26.5% and the mean HbA1c decreased from 8.1% to 6.1%. A significant number of patients had improvement in their glycemic control, including 45 (52.9%) patients who had complete remission (HbA1c<6.0%), another 18 (21.2%) who had partial remission (HbA1c<6.5%), and 9 (10.6%) who improved (HbA1c<7%). Patients who had T2 DM remission after surgery had a higher ABCD score than those who did not (7.3±1.7 versus 5.2±2.1, P<.05). Patients with a higher ABCD score were also at a higher rate of success in T2 DM remission (from 0% in score 0 to 100% in score 10).
  
  
  CONCLUSIONS
  LSG is an effective and well-tolerated procedure for achieving weight loss and T2 DM remission. The ABCD score, a simple multidimensional grading system, can predict the success of T2 DM treatment by LSG.
authors: Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan, Republic of China. Electronic address: wjlee_obessurg_tw@yahoo.com.tw.
authors: Wei-Jei
authors: WJ
authors: Lee
authors: Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan, Republic of China.
authors: Abdullah
authors: A
authors: Almulaifi
authors: Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan, Republic of China.
authors: Ju Juin
authors: JJ
authors: Tsou
authors: Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan, Republic of China.
authors: Kong-Han
authors: KH
authors: Ser
authors: Department of International Business, Chien Hsin University of Science and Technology, Taoyuan, Taiwan, Republic of China.
authors: Yi-Chih
authors: YC
authors: Lee
authors: Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan, Republic of China.
authors: Shu-Chun
authors: SC
authors: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D002096:C-Peptide
keywords: ABCD score; Sleeve gastrectomy; Type 2 diabetes mellitus