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Related Concept Videos

Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by the...

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Predictive Performance of Advanced-DiaRem for Diabetes Remission after Roux-en-Y Gastric Bypass Surgery.

Arash Abdollahi1, Maziar Afshar2, Yeganeh Karimi3

  • 1Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.

Obesity Surgery
|January 3, 2026
PubMed
Summary

The Advanced DiaRem score showed limited success in predicting diabetes remission after gastric bypass surgery in Iranian patients. Further research is needed to develop population-specific tools for better surgical outcome prediction.

Keywords:
Advanced-DiaRemDiagnostic performanceMetabolic bariatric surgeryRoux-en-Y gastric bypass

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Area of Science:

  • Bariatric surgery outcomes
  • Diabetes management and remission
  • Predictive scoring systems in medicine

Background:

  • Global obesity and type II diabetes epidemics necessitate reliable surgical outcome prediction tools.
  • The Advanced DiaRem (Ad-DiaRem) score's applicability in Iranian patients undergoing Roux-en-Y gastric bypass (RYGB) is unconfirmed due to population-specific factors.
  • This study aimed to validate the Ad-DiaRem score's predictive value in an Iranian cohort.

Purpose of the Study:

  • To validate the predictive performance of the Ad-DiaRem score for diabetes remission in Iranian patients post-RYGB.
  • To assess the accuracy, sensitivity, and specificity of the Ad-DiaRem score in this specific population.
  • To determine if the Ad-DiaRem score requires recalibration or if new population-specific models are needed.

Main Methods:

  • A mixed cohort study of 280 diabetic adults undergoing RYGB (2016-2023).
  • Preoperative Ad-DiaRem scores were calculated using clinical variables.
  • Diabetes remission defined as HbA1c < 6.5% or fasting blood glucose < 126 mg/dL at 3 months post-surgery without medication; performance assessed via ROC analysis.

Main Results:

  • Diabetes remission occurred in 57.9% of patients.
  • Patients achieving remission had significantly lower median Ad-DiaRem scores (6 vs. 9).
  • At a cut-off score of 7, Ad-DiaRem showed 62.9% accuracy, 51.9% sensitivity, 78.0% specificity, and an AUC of 66.7%.

Conclusions:

  • The Ad-DiaRem score demonstrated limited predictive performance for diabetes remission in Iranian RYGB patients, with lower accuracy than reported elsewhere.
  • Recalibration of the Ad-DiaRem score's components is suggested.
  • Development and validation of population-specific scoring systems in larger cohorts with extended follow-up are recommended.