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Original Article
- Lifestyle and Behavioral Interventions
- Risk Determinants of Type 2 Diabetes Mellitus with Severe Obesity and Prediction Model for Diabetes Remission after Bariatric Metabolic Surgery
- Zilong Wu, Yuxia Li, Dehui Wang, Bing Wu, Kaisheng Yuan, Yun Liu, Hao Zhu, Sijie Chen, Wah Yang, Ruixiang Hu, Cunchuan Wang
- Diabetes Metab J. 2026;50(2):368-384. Published online November 25, 2025
- DOI: https://doi.org/10.4093/dmj.2025.0337
- 2,818 View
- 128 Download
- 2 Web of Science
- 2 Crossref
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Abstract
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Supplementary Material
PubReader 
ePub - Background
Bariatric metabolic surgery (BMS) has been established as an effective intervention for obesity and type 2 diabetes mellitus (T2DM). However, systematic research addressing the onset of diabetes and post-surgical remission in severely obese populations remains scarce. This study aims to identify risk factors for T2DM in populations with severe obesity undergoing BMS and develop and validate a prediction model for the primary outcome of diabetes remission (DR) 1 year after BMS. This research provides a precise tool for managing T2DM in populations with severe obesity.
Methods
This research utilizes the China Obesity and Metabolic Surgery Database, retrospectively analyzing 3,670 severely obese populations who underwent BMS between January 2014 and January 2024. Differential analysis identified risk factors for T2DM onset, while univariate and multivariate regression analyses identified independent risk factors for DR post-surgery. A prediction model for DR was developed and internally validated.
Results
Factors associated with T2DM onset in severely obese populations included family history of diabetes, hypertension, hyperlipidemia, glycosylated hemoglobin (HbA1c) levels, and fasting plasma glucose. Independent factors influencing DR postsurgery included diabetes duration, surgical method, HbA1c, and insulin requirement. Subsequent model validation confirmed stable performance metrics (area under the curve values training, 0.71; validation, 0.72).
Conclusion
This study identifies risk factors for T2DM onset and a prediction model for DR following BMS in the Chinese severely obese population. It provides a more precise risk assessment tool for patients with severe obesity and T2DM, and lays the groundwork for future multicenter studies and international collaborations. -
Citations
Citations to this article as recorded by
- Validation Performance of Screening Tools for Predicting Obstructive Sleep Apnea Among Chinese Patients Undergoing Metabolic Bariatric Surgery: Insights from a Multicenter Database
Lizhen Liu, Pei Tang, Joyce Wai-Ting Chiu, Zhiyong Dong, Cunchuan Wang, Weixin Huang, Wenhui Chen
Obesity Surgery.2026; 36(6): 3117. CrossRef - Explainable Machine-Learning Model for Predicting Severe Obstructive Sleep Apnea in Patients Undergoing Metabolic Bariatric Surgery
Wenhui Chen, Lili Li, Junsen Peng, Cunchuan Wang, Guie Gao, Zhiyong Dong
Obesity Surgery.2026;[Epub] CrossRef
- Validation Performance of Screening Tools for Predicting Obstructive Sleep Apnea Among Chinese Patients Undergoing Metabolic Bariatric Surgery: Insights from a Multicenter Database
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