Search
Search titles only
By:
Search titles only
By:
Home
Forums
New posts
Search forums
What's new
New posts
New profile posts
Latest activity
Members
Current visitors
New profile posts
Search profile posts
Log in
Register
Search
Search titles only
By:
Search titles only
By:
New posts
Search forums
Menu
Install the app
Install
Reply to Thread
Guest, we'd love to know what you think about the forum! Take the
Diabetes Forum Survey 2024 »
Home
Forums
Diabetes Discussion
Diabetes Soapbox - Have Your Say
Great HbA1c, Very Disappointed!
JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding.
You are using an out of date browser. It may not display this or other websites correctly.
You should upgrade or use an
alternative browser
.
Message
<blockquote data-quote="Biggles2" data-source="post: 1646094" data-attributes="member: 406880"><p>Exactly [USER=6467]@LittleGreyCat[/USER]! The ADA consensus group was a group of physicians from various medical specialty areas. The group discussed and debated many of the semantics issues raised by [USER=459333]@AdamJames[/USER]. The challenges inherent in defining 'remission' and 'cure' was very much front and center to their discussions:</p><p></p><p style="margin-left: 20px">“However, defining remission or cure of diabetes is not as straightforward as it may seem. Unlike “dichotomous” diseases such as many malignancies, diabetes is defined by hyperglycemia, which exists on a continuum and may be impacted over a short time frame by everyday treatment or events (medications, diet, activity, intercurrent illness). <strong>The distinction between successful treatment and cure is blurred in the case of diabetes.</strong> Presumably improved or normalized glycemia must be part of the definition of remission or cure. Glycemic measures below diagnostic cut points for diabetes can occur with ongoing medications (e.g., antihyperglycemic drugs, immunosuppressive medications after a transplant), major efforts at lifestyle change, a history of bariatric/metabolic surgery, or ongoing procedures (such as repeated replacements of endoluminal devices). Do we use the terms remission or cure for all patients with normal glycemic measures, regardless of how this is achieved?”</p><p></p><p>The group addressed the issue of the need for a sustained remission in their definition:</p><p></p><p style="margin-left: 20px">“In a patient with type 2 diabetes, for example, improved or normal glycemia that occurs after only a few days of a stringent diet should certainly not be considered remission. <strong>Otherwise, patients could be in and out of remission constantly</strong>.”</p><p></p><p>And they addressed the challenge inherent in using the word ‘cure’:</p><p></p><p style="margin-left: 20px">“Additionally, if cure means remission that lasts for a lifetime, then by definition a patient could never be considered cured while still alive. Hence, it may make sense operationally to consider prolonged remission of diabetes essentially equivalent to cure.”</p> <p style="margin-left: 20px"><a href="http://care.diabetesjournals.org/content/32/11/2133" target="_blank">http://care.diabetesjournals.org/content/32/11/2133</a></p><p></p><p>It is really important from a policy perspective to have a standard definition for remission. Scarce NHS funds need to be directed to where they will do the most good.</p></blockquote><p></p>
[QUOTE="Biggles2, post: 1646094, member: 406880"] Exactly [USER=6467]@LittleGreyCat[/USER]! The ADA consensus group was a group of physicians from various medical specialty areas. The group discussed and debated many of the semantics issues raised by [USER=459333]@AdamJames[/USER]. The challenges inherent in defining 'remission' and 'cure' was very much front and center to their discussions: [INDENT]“However, defining remission or cure of diabetes is not as straightforward as it may seem. Unlike “dichotomous” diseases such as many malignancies, diabetes is defined by hyperglycemia, which exists on a continuum and may be impacted over a short time frame by everyday treatment or events (medications, diet, activity, intercurrent illness). [B]The distinction between successful treatment and cure is blurred in the case of diabetes.[/B] Presumably improved or normalized glycemia must be part of the definition of remission or cure. Glycemic measures below diagnostic cut points for diabetes can occur with ongoing medications (e.g., antihyperglycemic drugs, immunosuppressive medications after a transplant), major efforts at lifestyle change, a history of bariatric/metabolic surgery, or ongoing procedures (such as repeated replacements of endoluminal devices). Do we use the terms remission or cure for all patients with normal glycemic measures, regardless of how this is achieved?”[/INDENT] The group addressed the issue of the need for a sustained remission in their definition: [INDENT]“In a patient with type 2 diabetes, for example, improved or normal glycemia that occurs after only a few days of a stringent diet should certainly not be considered remission. [B]Otherwise, patients could be in and out of remission constantly[/B].”[/INDENT] And they addressed the challenge inherent in using the word ‘cure’: [INDENT]“Additionally, if cure means remission that lasts for a lifetime, then by definition a patient could never be considered cured while still alive. Hence, it may make sense operationally to consider prolonged remission of diabetes essentially equivalent to cure.” [URL]http://care.diabetesjournals.org/content/32/11/2133[/URL][/INDENT] It is really important from a policy perspective to have a standard definition for remission. Scarce NHS funds need to be directed to where they will do the most good. [/QUOTE]
Verification
Post Reply
Home
Forums
Diabetes Discussion
Diabetes Soapbox - Have Your Say
Great HbA1c, Very Disappointed!
Top
Bottom
Find support, ask questions and share your experiences. Ad free.
Join the community »
This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies.
Accept
Learn More.…