Aron-Wisnewsky J. auteur aut IRD Sokolovska N. auteur aut IRD Liu Y. J. auteur aut IRD Comaneshter D. S. auteur aut IRD Vinker S. auteur aut IRD Pecht T. auteur aut IRD Poitou C. auteur aut IRD Oppert J. M. auteur aut IRD Bouillot J. L. auteur aut IRD Genser L. auteur aut IRD Dicker D. auteur aut IRD Zucker Jean-Daniel auteur aut IRD Rudich A. auteur aut IRD Clement K. auteur aut IRD text journalArticle eng text/pdf born digital access Aims/hypothesis Not all people with type 2 diabetes who undergo bariatric surgery achieve diabetes remission. Thus it is critical to develop methods for predicting outcomes that are applicable for clinical practice. The DiaRem score is relevant for predicting diabetes remission post-Roux-en-Y gastric bypass (RYGB), but it is not accurate for all individuals across the entire spectrum of scores. We aimed to develop an improved scoring system for predicting diabetes remission following RYGB (the Advanced-DiaRem [Ad-DiaRem]). Methods We used a retrospective French cohort (n = 1866) that included 352 individuals with type 2 diabetes followed for 1 year post-RYGB. We developed the Ad-DiaRemin a test cohort (n = 213) and examined its accuracy in independent cohorts from France (n = 134) and Israel (n = 99). Results Adding two clinical variables (diabetes duration and number of glucose-lowering agents) to the original DiaRem and modifying the penalties for each category led to improved predictive performance for Ad-DiaRem. Ad-DiaRem displayed improved area under the receiver operating characteristic curve and predictive accuracy compared with DiaRem (0.911 vs 0.856 and 0.841 vs 0.789, respectively; p = 0.03); thus correcting classification for 8% of those initially misclassified with DiaRem. With Ad-DiaRem, there were also fewer misclassifications of individuals with mid-range scores. This improved predictive performance was confirmed in independent cohorts. Conclusions/interpretation We propose the Ad-DiaRem, which includes two additional clinical variables, as an optimised tool with improved accuracy to predict diabetes remission 1 year post-RYGB. This tool might be helpful for personalised management of individuals with diabetes when considering bariatric surgery in routine care, ultimately contributing to precision medicine. specialized Bariatric surgery Diabetes remission Obese Type 2 diabetesmellitus FRANCE 054 050 60 10 1892-1902 2017 0012-186X https://www.documentation.ird.fr/hor/fdi:010070956 10.1007/s00125-017-4371-7 0012-186X [F B010070956] https://www.documentation.ird.fr/hor/fdi:010070956 https://www.documentation.ird.fr/intranet/publi/2017/09/010070956.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2017-10-03 2023-07-11 fdi:010070956 fre