ORIGINAL CONTRIBUTIONS Prediction of Long-Term Diabetes Remission After RYGB, Sleeve Gastrectomy, and Adjustable Gastric Banding Using DiaRem and Advanced-DiaRem Scores Dror Dicker 1,2 & Rachel Golan 3 & Judith Aron-Wisnewsky 4,5,6 & Jean-Daniel Zucker 7,8 & Natalyia Sokolowska 4,5,6 & Doron S. Comaneshter 9 & Rina Yahalom 9 & Shlomo Vinker 9 & Karine Clément 4,5,6 & Assaf Rudich 10 Published online: 22 November 2018 # Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Purpose DiaRem is a clinical scoring system designed to predict diabetes remission (DR) 1-year post-Roux-en-Y gastric bypass (RYGB). We examined long-term (2- and 5-year) postoperative DR prediction by DiaRem and an advanced-DiaRem (Ad- DiaRem) score following RYGB, sleeve gastrectomy (SG), and gastric banding (GB). Methods We accessed data from a computerized database of persons with type 2 diabetes and BMI ≥ 30 kg/m 2 who underwent RYGB, SG, or GB, and determined DR status 2- and 5-year postoperative according to preoperative DiaRem and the Ad-DiaRem calculated scores. Results Among 1459 patients with 5-year postoperative diabetes status data, 53.6% exhibited DR. For RYGB, Ad-DiaRem trended to exhibit mildly improved predictive capacity 5-year postoperatively compared to DiaRem: Areas under receiver operating characteristic [AUROC] curves were 0.85 (0.76–0.93) and 0.78 (0.69–0.88), respectively. The positive predictive values (PPVs) detecting > 80% of those achieving DR (i.e., sensitivity ≥ 0.8) were 78.2% and 73.2%, respectively, and higher Ad-DiaRem scores more consistently associated with decreased DR rates. Following SG, both scores had an AUROC of 0.82, but Ad-DiaRem still had a higher PPV for predicting > 80% of those with 5-year postoperative DR (76.2% and 71.0%). Predictive capacity parameters were comparatively lower, for both scores, when considering DR 5-year post-GB (AUROC: 0.73 for both scores, PPV: 66.3% and 64.3%, respectively). Conclusions Ad-DiaRem provides modest improvement compared to DiaRem in predicting long-term DR 5-years post-RYGB. Both scores similarly provide fair predictive capacity for 5-year postoperative DR after SG. Keywords Diabetes remission . Bariatric surgery . Prediction score Dror Dicker and Rachel Golan contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-018-3583-3) contains supplementary material, which is available to authorized users. * Dror Dicker daniel3@013.net 1 Department of Internal Medicine D, Hasharon Hospital, Rabin Medical Center, 7 Keren Kayemet St., 49100 Petah Tikva, Israel 2 Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel 3 Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Beer-Sheva, Israel 4 Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière hospital, Paris, France 5 INSERM, UMR S U1166, Nutriomics Team, Paris, France 6 Sorbonne Universités, UPMC University Paris, 06, UMR_S 1166 I, Nutriomics Team, Paris, France 7 Institute of Cardiometabolism and Nutrition, ICAN, Integromics team, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière hospital, Paris, France 8 Sorbonne Universités, UPMC Univ Paris 06, IHU ICAN, IRD, unité de modélisation mathématique et informatique des systèmes complexes (UMMISCO), F-93143 Bondy, France 9 Central Headquarters, Clalit Health Services, Tel Aviv, Israel 10 Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, and the National Institute of Biotechnology in the Negev, Ben-Gurion University of the Negev, 84105 Beer-Sheva, Israel Obesity Surgery (2019) 29:796–804 https://doi.org/10.1007/s11695-018-3583-3