Limitations of the DiaRem Score in Predicting Remission of Diabetes Following Roux-En-Y Gastric Bypass (RYGB) in an ethnically Diverse Population from a Single Institution in the UK.
This study aimed to determine the predictive power of the DiaRem score following Roux-en-Y gastric bypass to identify patients who would have diabetes remission at 1 year in an ethnically diverse population.



We performed a retrospective review of 262 patients with type 2 diabetes mellitus who underwent RYGB at the Imperial Weight Centre, UK, from 2007 to 2014. Data was collected on the parameters required to calculate the DiaRem score as well as pre- and post-surgical weight and the ethnicity of the subjects.



The studied cohort was ethnically diverse (61.3 % Caucasian, 10.3 % Asian, 5.3 % black, 2.6 % mixed and 20.6 % other). At 1-year post-surgery, there were significant reductions in mean weight (133.4 to 94.3 kg) and BMI (46.7 to 33.3 kg/m2). The mean HbA1c decreased from 8.2 to 6.1 %, and 32.5 % of the cohort underwent either partial or complete remission. 67.8 % of the patients that were classified in group 1 of the DiaRem score (most likely to have remission) had complete remission. However, 22.9 % of the patients predicted to have the least chance of remission had either partial or complete remission.



In this ethnically diverse cohort, the DiaRem score remains a useful tool to predict diabetes remission in those that have a low DiaRem score (high chance for remission) but was more limited in its predictive power in those with a high DiaRem score (least likely to have remission). Caution must be used in the application of this model in populations other than the US white Caucasian population used to derive the score.
Department of Medicine, Imperial College London, London, UK.|Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
George
G
Tharakan
Department of Medicine, Imperial College London, London, UK.|Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
Rebecca
R
Scott
Department of Medicine, Imperial College London, London, UK.|Department of Life Sciences, Brunel University, London, UK.
Olivia
O
Szepietowski
Department of Medicine, Imperial College London, London, UK.|Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
Alexander D
AD
Miras
Department of Medicine, Imperial College London, London, UK.|Department of Life Sciences, Brunel University, London, UK.
Alexandra I
AI
Blakemore
Department of Surgery, Imperial College Healthcare NHS Trust, London, UK.
Sanjay
S
Purkayastha
Department of Surgery, Imperial College Healthcare NHS Trust, London, UK.
Ahmed
A
Ahmed
Department of Medicine, Imperial College London, London, UK.|Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
Harvinder
H
Chahal
Department of Medicine, Imperial College London, London, UK. t.tan@imperial.ac.uk.|Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK. t.tan@imperial.ac.uk.
Tricia
T
Tan
D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000208:ethnology / Q000601:surgery*; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data
Bariatric surgery; DiaRem; Diabetes; Diabetes remission; RYGB