A Simple Scoring Model for Mid-term Remission of Type 2 Diabetes Mellitus After Sleeve Gastrectomy in Chinese Patients
In brief
More than 80% of Chinese patients achieve diabetes remission after sleeve gastrectomy
In a retrospective cohort of 221 obese Chinese adults, 81% achieved mid-term type 2 diabetes remission (average 3.6 years) following laparoscopic sleeve gastrectomy. A new three-factor pre-operative score-based on number of oral agents, insulin use, and 2-hour C-peptide-predicted remission with an AUC of 0.88, offering a practical tool for personalized surgical counseling.
- Journal
- Obesity surgery (Q1)
- Published
- 12 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Shun Lu, Mengcheng He, Qiyuan Yao, Rong Hua, Bo Xu, Qiwei Shen, et al.
- PMID
- 42732032
- DOI
- 10.1007/s11695-026-08925-6
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 14 September 2026): Prediction model for T2DM remission after LSG
Abstract
BACKGROUND: Metabolic 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. METHODS: We 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. RESULTS: Among 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. CONCLUSIONS: We 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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.