Sensitivity of DiaRem Scoring System in Predicting Type Two Diabetes Mellitus Resolution After Bariatric Surgery in Qassim Region

Bandar Saad Assakran; Mansur S Alqunai; Abdullah Homood Alromaih; Laila M Almutairi; Fai M Alharbi; Leen M Almaghyuli

doi:10.7759/cureus.20064

Sensitivity of DiaRem Scoring System in Predicting Type Two Diabetes Mellitus Resolution After Bariatric Surgery in Qassim Region

Cureus. 2021 Nov 30;13(11):e20064. doi: 10.7759/cureus.20064. eCollection 2021 Nov.

Authors

Bandar Saad Assakran¹, Mansur S Alqunai^{2

1}, Abdullah Homood Alromaih¹, Laila M Almutairi³, Fai M Alharbi³, Leen M Almaghyuli³

Affiliations

¹ Department of Surgery, King Fahad Specialist Hospital, Buraydah, SAU.
² Department of Surgery, College of Medicine, Jouf University, Sakaka, SAU.
³ General Surgery, Qassim University, Buraydah, SAU.

Abstract

Introduction: Type two diabetes mellitus (T2DM) remission has been observed as an additional benefit of bariatric surgery for morbidly obese diabetic patients. There are many scoring systems for identifying factors that predict diabetes remission; however, there is as yet no universally applicable scoring system.

Aim: This study aims to test the sensitivity of the DiaRem scoring system for predicting the resolution of T2DM in morbidly obese patients who underwent bariatric surgery at King Fahad Specialist Hospital in Buraydah, Saudi Arabia.

Methods: This was a non-randomized controlled trial conducted at King Fahd Specialist Hospital in Buraydah, Saudi Arabia. Visiting patients at first screening were enrolled based on eligibility criteria. Data were collected according to the given parameters such as gender, age, body mass index (BMI), duration of diabetes mellitus (DM), medications (insulin, oral antihyperglycemic agents, number of tablets if used, or no medications use), presence of comorbidities, such as hypertension and dyslipidemia, HbA1c level (before surgery and at third, sixth, and 12th months after surgery), and fasting blood glucose (FBG) level (before and after surgery).

Results: A total of 96 diabetic patients were enrolled (35 males vs 61 females) with a mean age of 46.5 years. Laparoscopic sleeve gastrectomy was the most commonly performed surgery. The most common associated comorbidities were hypertension (50%) and hypothyroidism (14.6%). Results of the DiaRem scoring system showed 0-2 points in 15.6% patients, 3-7 points in 39.6% patients, 8-12 in 26% patients, 13-17 in 9.4% patients, and 18-22 in 9.4% patients. The lowest DiaRem score was associated with a higher value of BMI, shorter DM duration, and lower mean values of HbA1c and FBG post-surgery.

Conclusion: Consistent with the literature, our results indicated that those with an increased BMI, shorter duration of DM, and lower values of HbA1c post-FBG had a greater chance of diabetes remission postoperatively.

Keywords: bariatric surgery; diabetes remission; diabetic patients; diarem; type two diabets mellitus.