Bariatric surgery results in improved glycemic control in individuals with type 2 diabetes. Single and clusters of clinical determinants have been identified as presurgery predictors of postsurgery diabetes remission. Our goal was to assess whether the addition of measured preoperative β-cell function would improve established clinical models of prediction of diabetes remission.

Presurgery clinical characteristics, metabolic markers, and β-cell function after oral and intravenous (IV) glucose challenges were assessed in 73 individuals with severe obesity and type 2 diabetes and again 1 year after gastric bypass surgery. Single and multivariate analyses were conducted with preoperative variables to determine the best predictive models of remission.

Presurgery β-cell glucose sensitivity, a surrogate of β-cell function, was negatively correlated with known diabetes duration, HbA_1c, insulin use, and the diabetes remission scores DiaRem and advanced (Ad)-DiaRem (all P < 0.001). Measured β-cell function after oral glucose was 1.6-fold greater than after the IV glucose challenge and more strongly correlated with preoperative clinical and metabolic characteristics. The addition of preoperative β-cell function to clinical models containing well-defined diabetes remission scores did not improve the model’s ability to predict diabetes remission after Roux-en-Y gastric bypass.

The addition of measured β-cell function does not add predictive value to defined clinical models of diabetes remission 1 year after surgical weight loss.

减肥手术可改善 2 型糖尿病患者的血糖控制。单个和一组临床决定因素已被确定为术后糖尿病缓解的术前预测因素。我们的目标是评估增加术前测量的 β 细胞功能是否会改善已建立的预测糖尿病缓解的临床模型。

对 73 名严重肥胖和 2 型糖尿病患者进行了口服和静脉 (IV) 葡萄糖激发后的术前临床特征、代谢标志物和 β 细胞功能评估，并在胃绕道手术后 1 年后再次进行了评估。对术前变量进行单变量和多变量分析，以确定缓解的最佳预测模型。

术前 β 细胞葡萄糖敏感性（β 细胞功能的替代指标）与已知糖尿病病程、HbA _1c 、胰岛素使用以及糖尿病缓解评分 DiaRem 和晚期 (Ad)-DiaRem 呈负相关（所有P < 0.001）。口服葡萄糖后测得的 β 细胞功能是静脉注射葡萄糖激发后的 1.6 倍，并且与术前临床和代谢特征的相关性更强。将术前 β 细胞功能添加到包含明确糖尿病缓解评分的临床模型中，并没有提高模型预测 Roux-en-Y 胃绕道手术后糖尿病缓解的能力。

添加测量的 β 细胞功能并不会增加手术减肥后 1 年后糖尿病缓解的定义临床模型的预测价值。