I picked these up from an excellent free recent Audio Digest program entitled "The Role of Primary Care in the Surgical Management of Obese Patients with Type 2 Diabetes". You can check it out at their website, it's a great overview, with more detail than I need to supply here.
And, the terms ~
We all are familiar with the benefits of Weight Loss Surgery for the Diabetic patient (both weight dependent and weight independent), but I wanted to clarify the terms in which we describe the effects in more specific terms. I believe it was Dr. Gerardus Jameson, a noted Schenectady Endocrinologist, who a while ago stated, "Those guys are the only ones with the possibility right now of a cure...They're trying to put me out of business!"
*Remission
As per the ADA, achievement of HbA1C <6% and FBG <100 for 1+years after cessation of pharmacotherapy
*Resolution
Widely defined as achieving normoglycemia without hypoglycemic meds
*Improvement
Dramatic reduction in need for medications with accompanying improved control overall
*Cure Rates
Really a wastebasket term, for a mixture of the above variations in improved glycemic control. This is what accounts for the "7% - 41%" cure rates as occasionally referred to after surgery. A bit misleading.
To follow in future posts I'll put up some patient profiles to exemplify some of the variations and give you better insight into this amazing Endocrine benefit of Bariatric Surgery, as well as the mechanisms of this effectiveness , and also remind you to continue to check these patients as a small percentage of them can recur with their hyperglycemia down the road, with or without associated weight regain.
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