Applicability of individualized metabolic surgery score for prediction of diabetes remission after endoscopic sleeve gastroplasty

Khushboo Gala; Wissam Ghusn; Vitor Brunaldi; Eric J Vargas; Andrew C Storm; Andres Acosta; Barham K Abu Dayyeh

doi:10.1177/26317745241247175

Applicability of individualized metabolic surgery score for prediction of diabetes remission after endoscopic sleeve gastroplasty

Ther Adv Gastrointest Endosc. 2024 Apr 25:17:26317745241247175. doi: 10.1177/26317745241247175. eCollection 2024 Jan-Dec.

Authors

Khushboo Gala¹, Wissam Ghusn², Vitor Brunaldi¹, Eric J Vargas¹, Andrew C Storm¹, Andres Acosta¹, Barham K Abu Dayyeh³

Affiliations

¹ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
² Department of Internal Medicine, Boston University Medical Center, Boston, MA, USA.
³ Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.

Abstract

Background: Endoscopic sleeve gastroplasty (ESG) is a safe and effective obesity treatment. The individualized metabolic score (IMS) is a validated score that uses preoperative variables predicting T2D remission (DR) in bariatric surgery.

Objectives: We evaluated the applicability of using the IMS score to predict DR in patients after ESG.

Design/methods: We performed a retrospective review of patients with obesity and T2D who underwent ESG. We calculated DR, IMS score, and severity, and divided patients based on IMS category.

Results: The cohort comprised 20 patients: 25% (5) mild, 55% (11) moderate, and 20% (4) severe IMS stages. DR was achieved in 60%, 45.5%, and 0% of patients with mild, moderate, and severe IMS scores (p = 0.08), respectively. IMS score was significantly associated with DR (p = 0.03), with the area under the curve of the receiver operating characteristic for predicting DR 0.85.

Conclusion: These pilot data demonstrate that the IMS score appears to be useful in predicting DR after ESG.

Keywords: diabetes mellitus; diabetes remission; endoscopic sleeve gastroplasty; individualized metabolic surgery score; metabolic score; obesity.

Plain language summary

Use of individualized metabolic surgery score in endoscopic sleeve gastroplasty Why was the study done? Endoscopic sleeve gastroplasty (ESG) is effective and safe as a treatment for obesity and has also shown improvement in diabetes in previous studies. However, there is no data showing the rates of diabetes remission after this procedure and no measures to predict this outcome. This study uses the individualized metabolic score (IMS) to predict diabetes remission after ESG. What did the researchers do? They analyzed a sample of patients who had undergone ESG, and evaluated the change in their diabetes parameters at 1 year compared to baseline, and then correlated this with their calculated baseline IMS score. What did the researchers find? Patients with a higher IMS score, representing more severe disease, were less likely to have an improvement in their diabetes after ESG. What do the findings mean? ESG can be an effective treatment option for patients with obesity and early-stage diabetes.