The advanced-DiaRem score improves prediction of diabetes remission One year post-Roux-en-Y gastric bypass - Sorbonne Université Accéder directement au contenu
Article Dans Une Revue Diabetologia Année : 2017

The advanced-DiaRem score improves prediction of diabetes remission One year post-Roux-en-Y gastric bypass

Doron S Comaneshter
  • Fonction : Auteur
Shlomo Vinker
  • Fonction : Auteur
Tal Pecht
  • Fonction : Auteur
Jean-Luc Bouillot
  • Fonction : Auteur
Dror Dicker
Assaf Rudich
  • Fonction : Auteur

Résumé

Aims/hypothesis Not all people with type 2 diabetes who undergo bariatric surgery achieve diabetes remission. Thus it is critical to develop methods for predicting outcomes that are applicable for clinical practice. The DiaRem score is relevant for predicting diabetes remission post-Roux-en-Y gastric bypass (RYGB), but it is not accurate for all individuals across the entire spectrum of scores. We aimed to develop an improved scoring system for predicting diabetes remission following RYGB (the Advanced-DiaRem [Ad-DiaRem]). Methods We used a retrospective French cohort (n = 1866) that included 352 individuals with type 2 diabetes followed for 1 year post-RYGB. We developed the Ad-DiaRem in a test cohort (n = 213) and examined its accuracy in independent cohorts from France (n = 134) and Israel (n = 99). Results Adding two clinical variables (diabetes duration and number of glucose-lowering agents) to the original DiaRem and modifying the penalties for each category led to improved predictive performance for Ad-DiaRem. Ad-DiaRem displayed improved area under the receiver operating characteristic curve and predictive accuracy compared with DiaRem (0.911 vs 0.856 and 0.841 vs 0.789, respectively; p = 0.03); thus correcting classification for 8% of those initially misclassified with DiaRem. With Ad-DiaRem, there were also fewer misclassifications of individuals with mid-range scores. This improved predictive performance was confirmed in independent cohorts. Conclusions/interpretation We propose the Ad-DiaRem, which includes two additional clinical variables, as an optimised tool with improved accuracy to predict diabetes remission 1 year post-RYGB. This tool might be helpful for personalised management of individuals with diabetes when considering bariatric surgery in routine care, ultimately contributing to precision medicine.
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Dates et versions

hal-01684017 , version 1 (15-01-2018)

Identifiants

Citer

Judith Aron-Wisnewsky, Nataliya Sokolovska, Yuejun Liu, Doron S Comaneshter, Shlomo Vinker, et al.. The advanced-DiaRem score improves prediction of diabetes remission One year post-Roux-en-Y gastric bypass. Diabetologia, 2017, 60 (10), pp.1892 - 1902. ⟨10.1007/s00125-017-4371-7⟩. ⟨hal-01684017⟩
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