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Endo News Roundup: Diabetes Prevention and Remission

June 13, 2017
Mark L. Fuerst

Three new diabetes-related studies include these highlights: for those at risk of developing diabetes, long-term use of metformin does not worsen cognitive performance; a score from a validated nomogram predicts diabetes remission with either sleeve gastrectomy or gastric bypass surgery; and another scoring system predicts type 2 diabetes mellitus (DM) remission at 1 year following bariatric surgery.References Long-term Metformin Does Not Affect Cognitive Function Luchsinger JA, et al. Metformin, Lifestyle Intervention, and Cognition in the Diabetes Prevention Program Outcomes Study. Diabetes Care 2017 May; dc162376. https://doi.org/10.2337/dc16-2376Score Predicts Best Surgery for Diabetes Remission Aminian A, et al. Individualized Metabolic Surgery Score: Procedure Selection Based on Diabetes Severity. American Surgical Association 2017 Annual Meeting. April 22, 2017; Philadelphia, Pennsylvania. Scientific Session V, Presentation 27.Validation of Bariatric Surgery Score for Type 2 DM Khowaja A, et. al. Predictability Of Diabetes Mellitus Type 2 Remission And Changes In Metabolic Profile After Bariatric Surgery Using Diarem Scoring System. American Association of Clinical Endocrinologists (AACE) 2017 Annual Scientific & Clinical Congress. May 6, 2017; Austin, Texas. Abstract 1158.

Endo News Roundup for June 2017: Diabetes Prevention and Remission

Effect of Long-term Metformin on Cognitive Function

Observational follow-up to the Diabetes Prevention Program study found use of metformin for more than 8 years does not lead to cognitive impairment in persons at risk for diabetes.

Clinical implications:

Contrary to reports from other studies, long-term use of metformin did not impact cognitive function in Diabetes Prevention Program study participants.

Score Predicts Best Surgery for Diabetes Remission

An Individualized Metabolic Surgery (IMS) Score can help determine for which patients gastric bypass (GB) or sleeve gastrectomy (SG) is the better procedure for long-term diabetes remission.

Mild diabetes: both GB and SG were highly effective; however, GB was slightly better than SG for long-term diabetes remission and reduction in diabetes medications. Moderate diabetes: GB was significantly more effective than SG.

Clinical implications:

Individualized Metabolic Score may help guide evidence-based procedure selection for obese patients with type 2 diabetes who are candidates for bariatric surgery.

Validation of Roux-en-Y Bariatric Surgery Score for T2DM

DiaRem score based on 4 preoperative clinical variables to determine which patients have greatest chance of remission 1 year post-Roux-en-Y gastric bypass surgery.

Those with higher DiaRem scores were less likely to achieve diabetes remission; score was significantly predictive of both partial and complete remission.

Clinical implications:

The DiaRem score appears to be an easy-to-use tool in clinical practice to predict which patients will have remission of T2DM after Roux-en-Y GB surgery.

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