A groundbreaking study has introduced the Diabetes Remission Index (DRI) and Weight Loss-Adjusted Diabetes Remission Index (W-DRI), innovative tools designed to predict whether individuals with type 2 diabetes (T2D) are likely to achieve remission following weight loss surgery. These tools incorporate key patient-specific factors, such as the type of metabolic or bariatric procedure, the presence of diabetes-related complications, and the degree of weight loss after surgery, to provide tailored predictions for remission. Diabetes remission, defined as normal blood sugar levels without the need for diabetes medications, can significantly improve the quality of life and reduce the risk of long-term complications. However, not all patients achieve remission after surgery, and predicting who will benefit has been challenging—until now. The DRI and W-DRI offer a transformative solution. By providing a personalized assessment, these tools empower doctors and patients to make more informed decisions. For patients, this means understanding their individual likelihood of remission, setting realistic expectations, and emphasizing the importance of sustained weight loss for long-term success. For healthcare providers, these indices enable more precise counseling, better tailoring of surgical options, and improved post-operative care plans.
One of the key strengths of the DRI and W-DRI is their basis in real-world data, making them highly relevant and applicable to diverse patient populations. Unlike many predictive models that are confined to experimental settings, these tools reflect the outcomes of patients from multiple institutions and real clinical practice. This ensures they can be broadly utilized and trusted by both clinicians and patients. The utility of these tools goes beyond prediction. By including weight loss in the W-DRI, the index encourages post-surgical commitment to lifestyle changes. It highlights the direct link between maintaining weight loss and improving the chances of diabetes remission, reinforcing the value of long-term follow-up care. With diabetes being one of the most prevalent chronic diseases worldwide, affecting millions of people, the development of the DRI and W-DRI represents a major advance in personalized medicine. These tools not only support decision-making at the time of surgery but also promote healthier outcomes by fostering patient engagement and adherence to post-surgical goals. To make this innovation widely accessible, the study team has developed an online version of the DRI and W-DRI. This user-friendly resource allows both clinicians and patients to access these tools and integrate them into their care journey. The study marks a critical step forward in diabetes treatment, offering a practical and evidence-based approach to enhance the effectiveness of metabolic and bariatric surgery for patients with type 2 diabetes.
The findings of the study were internally validated at the mother institution, Mayo Clinic, and externally validated at Fresno Heart & Surgical Hospital.
Calculator Link:
Reference:
Ghusn W, Ma P, Vierkant RA, Mundi M, Fehervari M, Ikemiya K, Hage K, Acosta A, Camilleri M, Abu Dayyeh B, Higa K, Ghanem OM. The Diabetes Remission Index (DRI): A Novel Prognostic Calculator Model Predicting Diabetes Remission Before and After Metabolic Procedures. Ann Surg. 2025 Feb 4. doi: 10.1097/SLA.0000000000006656. Epub ahead of print. PMID: 39902562.
Disclaimer:
This calculator was developed and internally validated at Mayo Clinic, and was externally validated at Fresno Heart & Surgical Hospital.
Excellent overview of expected metabolic outcomes from bariatric surgery.