Wednesday, March 30, 2011

Why everyone has to learn about QALY

This is ridiculous - to not consider the cost of a medication, but then demand that other types of care be subjected to "cost effectiveness" tests... We need a level playing field for what value taxpayers and patients are getting - Quality Adjusted Life Years, or QALY is the way to do that.

Please see the quote from Dr David Flum at University of Washington in the article from day 1 of the NYC Diabetes Conference.

A billion dollars for less than 2 more months of life?

The data is Here... more NYC Summit

Nobel Laureates speaking as keynotes, Swedish long term data

I think we can say definitively that the science is in! There is always more to learn for exact mechanisms, and refining techniques. Insurers and the government may hedge because of perceived costs, but for most individuals the question is answered. Your life and health are better with surgical control of Diabetes and Obesity. To deny this is to simply put money ahead of people...

even the American Heart Association recognizes the benefit

News from NYC Diabetes Summit

Cost effectiveness of surgery for Diabetes

Monday, March 28, 2011

Profound Emotional Suffering - worldwide now

It is inspiring to see a researcher who is so sensitive to the impact of society's dysfunctional judgements. So many of us internalize that incredibly demeaning and disempowering hatred. I guess the only upside is what going through hell can teach you about compassion...

Traditionally tolerant societies showing intolerance, anti-obesity attitudes

Sunday, March 27, 2011

Brain response article

There are a lot of related links to older articles on the sidebar, too.

enhanced reward response in vulnerable children with family history of obesity

Science is just beginning to appreciate individual genetic neural and behavioral variability - we are all similar, but not the same!

Tuesday, March 22, 2011

Mortality of medications

I get asked about the mortality of surgery quite often, but will your diabetes doc tell you the mortality rate of their treatment?

Turns out some meds increase the death rate

excess DEATHS with popular Diabetes meds

Here are some selected quotes from the link----

"431 excess deaths for every 100,000 patients who receive rosiglitazone rather than pioglitazone"

"Given that there are about 3.8 million prescriptions for rosiglitazone dispensed annually in the United States, "the effect on public health may be considerable," they warn."

In an accompanying editorial, Victor Montori and Nilay Shah from the Mayo Clinic in the US argue that the rosiglitazone story "says much about how healthcare has become less about promoting patients' interests, alleviating illness, promoting function and independence, and curing disease, and much more about promoting other interests, including those of the drug industry."

Somebody correct my math - that gives 16,378 deaths from this med....

NOW - if we do the math for DEATH from gastric bypass, that is 0.003, or 3 per thousand. if 3.8 million diabetics all had surgery, the mortality would be 11,400 - BUT the diabetes resolution rate is almost 90%! So at the end of a year (using a conservative 80%) then over 3 million people would be off ALL diabetic meds.


Of course, to get that done, a thousand surgeons would have to operate on almost 400 diabetic patients a year, every year for a decade - which is about double the current rate of bariatric surgery for obesity.

Monday, March 21, 2011

Good update on technology

No magic bullets in the pipeline

This is an article from the New York Times that summarizes the limitations of many promising advanced innovations. What we have is actually pretty great with gastric bypass and related operations, and it will be pretty hard to actually "beat" them in the long term.

Toughest study yet on Gastric Banding problems

This may have some of the limitations pointed out by the Allergan rep, but still, there are more problems with Bands than we were hoping for. While Gastric Bypass has its very real risks, the weight loss and Diabetes control are far superior..

I think the perspective of most surgeons is that the average person greatly overestimates the short term risks, but underestimates the long term consequences of the choice. This doesn't mean "be afraid", it means "be prepared".

Sunday, March 06, 2011

self compassion

worth living as your own best friend

This perfectly echos the "take Responsibility, but don't need Blame and Shame" message we have been saying for years

Very nice to see it validated!