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WIG Score of Shantha for Predicting Dose Reduction in Antidiabetes Medications with Weight Loss

Description

Shantha et al developed a score which can predict a reduction in antidiabetic medications after weight loss. The authors are from the University of Iowa, Johns Hopkins University, Wright Center for Graduate Medical Education, LV Prasad Eye Institute (India) and Washington University.


Patient selection: obese diabetic on medications

 

Parameters:

(1) weight loss (W) within 3 months of attempting weight loss

(2) insulin resistance at baseline indicated by triglyceride to HDL ratio

(3) glycosylated hemoglobin (G)

 

Parameter

Finding

Points

weight loss

< 5%

0

 

>= 5%

1

triglyceride to HDL ratio

<= 3

1

 

> 3

0

glycosylated hemoglobin

<= 8.5%

1

 

> 8.5%

0

 

where:

• Point assignment for I and G differ between abstract and body of the text.

• The HDL measurement is for the lipoprotein concentration, not HDL-C.

• Determination of I and G can be done at baseline and after 3 months.

 

total score =

= SUM(points for all 3 items)

 

Interpretation:

• minimum score: 0

• maximum score: 3

• A patient with a score of 0 may be a candidate for bariatric surgery.

• The presence of I or G at baseline had an AUC of 0.79 for antidiabetic dose reduction.


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