ArticleDiabetes, metabolic syndrome and obesity : targets and therapy2026
Predictive Accuracy of the Advanced-DiaRem Score for Type 2 Diabetes Remission After Sleeve Gastrectomy in a Persian Cohort.
Article in Diabetes, metabolic syndrome and obesity : targets and therapy, 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
Aims: This study evaluated the performance of the Advanced-DiaRem scoring system for predicting initial remission of type II diabetes mellitus (T2DM) after sleeve gastrectomy (SG) in the Persian population. Methods: A retrospective cohort study with cross-sectional telephone interviews was conducted, including adults with T2DM who underwent SG between 2016 and 2023. Baseline clinical, biochemical, and diabetes-related variables were collected, and Advanced-DiaRem scores were calculated. The primary outcome was initial T2DM remission, defined as initial physiological success rather than long-term, sustained remission. Receiver Operating Characteristic (ROC) curve analysis using Youden's Index evaluated model discrimination, and Decision Curve Analysis quantified clinical utility. Multivariable logistic regression identified independent predictors of initial remission. Results: Ninety-three patients (72.0% female) with a mean age of 49.1 ± 9.8 years were included, of whom 45.2% (95% CI: 34.9, 55.5) achieved initial remission. Remission was significantly associated with baseline HbA1c levels. The Advanced-DiaRem scoring system showed limited discriminatory performance (AUC 64.5%); the optimal cutoff <9 yielded 69% sensitivity, 59% specificity, 58% PPV, 70% NPV, 63% accuracy, LR+ of 1.68, and LR- of 0.53. Conclusion: The Advanced-DiaRem score showed limited accuracy in predicting initial T2DM remission after SG in this cohort. This study suggests that model recalibration or the development of population-specific prediction tools may improve predictive accuracy.
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