Observational studyObesity surgery2026
A Simple Scoring Model for Mid-term Remission of Type 2 Diabetes Mellitus After Sleeve Gastrectomy in Chinese Patients.
Observational study in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMetabolic bariatric surgery is the most effective treatment for obesity and related type 2 diabetes mellitus (T2DM), but T2DM remission post-surgery is heterogeneous. Existing prediction models were developed largely in Western populations, often for gastric bypass and short-term outcomes, limiting applicability to Chinese patients undergoing laparoscopic sleeve gastrectomy (LSG). We aimed to develop a preoperative model for predicting mid-term T2DM remission after LSG.
methodsWe performed a retrospective cohort study of Chinese patients with obesity and T2DM who underwent primary LSG between 2017 and 2023. Mid-term remission was assessed over 2-7 years of follow-up. Candidate preoperative variables were screened by univariate analysis and LASSO regression, followed by multivariable logistic regression and 2,000-bootstrap internal validation. The final model was simplified into a scoring system.
resultsAmong 221 patients included (median baseline HbA1c 7.20%), 81.4% achieved T2DM remission at a mean follow-up of 3.60 ± 1.49 years, with median HbA1c decreasing to 5.60%. The final model retained three predictors: number of hypoglycemic agents, insulin use, and 2-hour plasma C-peptide, and showed strong discrimination (AUC 0.876). Bootstrap validation confirmed robust performance (mean AUC 0.878, 95% CI 0.809-0.935). The simplified score (2-hour plasma C-peptide-5 × number of hypoglycemic agents - insulin use score [11/0]) showed the same AUC, and higher scores indicated greater remission probability.
conclusionsWe developed and internally validated a preoperative model for predicting mid-term T2DM remission after LSG in Chinese patients with obesity and T2DM. The model was translated into a simple scoring system that may support individualized management and decision-making.
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