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The following is a summary of “A Novel Prognostic Calculator Model Predicting Diabetes Remission Before and After Metabolic Procedures,” published in the February 2025 issue of Surgery by Ghusn et al. 

Metabolic and bariatric surgery (MBS) with Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) effectively achieved type 2 diabetes (T2D) remission, but predicting individual outcomes, especially considering weight loss, remained a challenge. 

Researchers conducted a retrospective study to develop and validate 2 predictive models, the Diabetes Remission Index (DRI) and the Weight Loss-Adjusted DRI (W-DRI), for assessing T2D remission after MBS. 

They assessed patients with T2D and overweight/obesity (BMI ≥27 kg/m²) who underwent RYGB or SG between 2008 and 2018. Data from Institution 1 (I-1; n=503) was used to develop and validate the models internally, while Institution 2 (I-2; n=409) provided external validation. The DRI model used preoperative variables, while the W-DRI model added post-surgical weight loss. Predictive accuracy was evaluated through AUC, calibration plots, and stratified analyses. 

The results showed that 44.7% of patients in I-1 achieved T2D remission, with a DRI model AUC of 0.80. In I-2, 52.6% achieved remission, with an AUC of 0.78. Including weight loss improved W-DRI accuracy, with AUCs of 0.82 in I-1 and 0.79 in I-2. Calibration plots showed strong agreement between predicted and observed remission rates.

Investigators concluded that the DRI and W-DRI models accurately predicted T2D remission after MBS, facilitating personalized care. 

Source: journals.lww.com/annalsofsurgery/abstract/9900/the_diabetes_remission_index__dri___a_novel.1185.aspx