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Research Letter |

Association of DiaRem Score With Cure of Type 2 Diabetes Following Bariatric Surgery

G. Craig Wood, MS1; Tooraj Mirshahi, PhD2; Christopher D. Still, DO1; Annemarie G. Hirsch, PhD, MPH3
[+] Author Affiliations
1Obesity Institute, Geisinger Health System, Danville, Pennsylvania
2Weis Center for Research, Geisinger Health System, Danville, Pennsylvania
3Center for Health Research, Geisinger Health System, Danville, Pennsylvania
JAMA Surg. 2016;151(8):779-781. doi:10.1001/jamasurg.2016.0251.
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This cohort study examines whether the DiaRem score is associated with cure of type 2 diabetes following bariatric surgery.

There is great anticipation for the predicted impact that the Precision Medicine Initiative will have on health outcomes.1 However, we do not need to wait to sequence the DNA of the proposed 1 million–person cohort for this initiative; we can make significant strides in improving the precision of care delivery now. There are sufficient data in existing electronic health record systems that can be used to facilitate tailored treatment decisions. For example, the DiaRem score, a validated score generated from data readily available in the medical record, can be used for patients with type 2 diabetes to predict whether bariatric surgery will lead to short-term remission of diabetes.24 Herein, we examine whether this score can be used to predict patients for whom bariatric surgery will result in cure of type 2 diabetes.5

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Figure.
Proportion of Patients With Remission and Cure of Type 2 Diabetes Following Roux-en-Y Gastric Bypass by DiaRem Score

Partial remission indicates no medications, hemoglobin A1c (HbA1c) level less than 6.5% of total hemoglobin (to convert to proportion of total hemoglobin, multiply by 0.01), fasting glucose level less than 125 mg/dL (to convert to millimoles per liter, multiply by 0.0555), and no active treatment or procedures for at least 1 year. Prolonged partial remission indicates no medications, HbA1c level less than 6.5% of total hemoglobin, fasting glucose level less than 125 mg/dL, and no active treatment or procedures for at least 5 years. Complete remission indicates no medications, HbA1c level less than 5.7% of total hemoglobin, fasting glucose level less than 100 mg/dL, and no active treatment or procedures for at least 1 year. Diabetes cure indicates no medications, HbA1c level less than 5.7% of total hemoglobin, fasting glucose level less than 100 mg/dL, and no active treatment or procedures for at least 5 years.

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