2 thoughts on “Diabetes Australia Will Embrace Remission”

  1. Hi, Good news you are mentioning. Actually, I am interested in a different and recent Twitter comment you posted on body measurements, particularly RFM. (there was no option to DM you so seeking your view on your blog). There you posted an interesting paper where the authors lay out the methodology for prioritizing RFM (based on correlation with DXA scans) as measure of obesity. I think this is very practical and cost effective and do believe physical measurements are under-rated in diagnosis (particularly visceral fat). this paper highlighted (for men) a threshold >22.8% as a relevant measure of obesity [“These findings are consistent with those from previous studies, regardless the DXA body fat cut-points used to define obesity9,28,29. An RFM ≥33.9 for women and ≥22.8 for men showed a high sensitivity to identify individuals with obesity, 95.0% and 96.2%, respectively. “]. Subsequently you referred to another paper which, also based on RFM, seeks to determine a relevant threshold and establishes at >30% (again, for men) [“Conclusions: We suggest rounded RFM cutoffs of 40% for women and 30% for men to diagnose obesity and identify individuals at higher risk of death.”]. Did you notice this discrepancy? What do you make of it? I noticed Gary replied to you on Twitter with interest and said he would look into thresholds, but he did not share his finings. Of course, one may note that the second paper mentions the threshold as a reference for both obesity + all cause mortality. But that becomes a bit confusing, particularly since the same authors in their first paper speak about obesity (but not all cause mortality) at a much much lower threshold value. Not sure resolving this is imperative, since sustaining personal progress over time is where I believe the empowerment lies. But thresholds do offer a goal post. On a separate note, the paper is also a bit confusing in that it concludes that the RFM is an all-fat measure. This is puzzling because later on in the paper it says its very good as a trunk fat measure (which I take as visceral fat, and which would make more sense given that RFM is derived from comparing it with DXA scans on visceral fat). I wonder why they did not conclude it was a visceral fat measure, rather than an overall fat measure. (Maybe just better for some specific subgroups). Cheers and thanks for sharing your first-hand knowledge !

    1. Hi Vladamir,

      Thanks for your comment. I am very interested in the RFM measurement but don’t have experience with it. Apologies for the slow reply. If you tag me in a comment on Twitter I will follow back so we can chat there.

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