The relationship between ABCD and DiaRem scores and the OS-MRS score in patients with type 2 diabetes mellitus undergoing sleeve gastrectomy and gastric bypass

Objective: This study retrospectively analyzed 400 patients, including 206 who underwent Laparoscopic Sleeve Gastrectomy (LSG) and 194 who underwent Laparoscopic Roux-en-Y Gastric Bypass (LRYGB), to comprehensively evaluate the relationship between the ABCD and DiaRem scores—commonly used to predict diabetes remission—and the OS-MRS score, which is widely utilized for surgical risk assessment. Methods: Patients diagnosed with Type 2 Diabetes Mellitus (T2DM) who underwent metabolic surgery (LSG or LRYGB) at the Department of General Surgery, Istanbul Cerrahpaşa University School of Medicine, between January 2016 and January 2025 were included. Demographic characteristics and preoperative biochemical parameters were examined. The associations between ABCD, DiaRem, and OS-MRS scores were analyzed statistically. Results: Increasing age was significantly associated with lower ABCD scores and higher DiaRem and OS-MRS scores. Male patients demonstrated notably higher DiaRem and OS-MRS scores compared with female patients. The LRYGB group exhibited significantly higher DiaRem and OS-MRS scores, alongside lower ABCD scores, compared with the LSG group. Additionally, the risk of postoperative surgical complications was observed to be 32% higher in males than in females. Patients aged over 55 years had a 1.8-fold higher rate of OS-MRS ≥3 compared with younger individuals. Conclusion: The combination of high DiaRem and high OS-MRS scores was strongly associated with reduced diabetes remission potential and increased mortality risk. Elevated OS-MRS scores and diminished remission likelihood, particularly in male patients, highlight the importance of routine OS-MRS assessment. For high-risk males, prioritizing safer procedures such as sleeve gastrectomy is recommended. Given the tendency for higher OS-MRS scores in patients planned for RYGB, a more detailed preoperative risk evaluation is advised for this group.