Diabetes
A doctor’s journey: Navigating chronic disease and empowerment through life coaching
On January 2020, I got the dreaded call: You have Type 1 diabetes. The rest is a blur. I went into a global pandemic, one of the highest risk categories, a red lab value that stared at me “HgbA1c > 15.”
As a family physician, I was supposed to manage patients and ease their fears. I was supposed to know all about the disease management of a “bread and butter condition” …
Lack of innovation is leading to disparities in diabetes care
Having spent over 30 years of my career in diabetes, first as a practicing diabetologist and later as a diabetes researcher, I’ve met many people with diabetes. And while diabetes care has evolved significantly over my career, I’m amazed to see that daily insulin management is just as complex and manual for many people, particularly those with type 2 diabetes (T2D) — daily insulin management is just as complex and …
Don’t blame Big Pharma for insulin’s problems
For diabetics, insulin matters as much as H2O. Unfortunately, insulin’s a hell of a lot more expensive than bottled water. High insulin prices force approximately nine million Americans to balance their wallet and well-being.
The American Action Forum reported that a type-one diabetic’s average yearly expense for insulin was $~6000 (i.e., $500/month). It’s easy to lambast Big Pharma companies for the current state of insulin’s affairs, but history and market behavior …
The environmental impact of the diabetes epidemic
The superior doctor prevents sickness. The mediocre doctor attends to impending sickness. The inferior doctor treats actual sickness.”
– Chinese Proverb
The management of diabetes today requires an understanding of the concept of the circular economy in eliminating waste and pollution, circulating products and materials at their highest level, and regenerating nature.
Today, we saw a 64-year-old woman for her follow-up visit to the diabetes clinic. She is our typical Oklahoma patient with …
How people of faith can respond to our broken health system
An excerpt from Care: How People of Faith Can Respond to Our Broken Health System.
“Why do you have to be such an asshole?”
Roger was visibly angry with me and ready to get up to leave. Forty-five years old, he worked long hours repairing cars and had very poor control of …
We need to stop treating diabetes (without a prevention plan)
The recent report from the National Center for Health Statistics on declining U.S. life expectancy painted a bleak picture, fueled in large part by the impact of Covid-19, but not exclusively. Many of the contributing factors are deeply systemic – poverty and health disparities among them — but other longstanding health issues, including high rates of obesity and Type 2 diabetes, are contributing factors.
More than 34 million people – one …
A personal mission to get obese patients on GLP-1 agonists
Admittedly, this comes to you from a place of concussion-inducing-head-banging-against-brick-walls-level frustration.
For the past year, I have made it a personal mission to get people suffering from obesity on GLP-1 agonists. These drugs are all in the same class, have identical mechanisms, and three are the same generics. (Ozempic, Wegovy, and Rybelsus are all semaglutide.)
They are advertised as Wegovy, Ozempic, Rybelsus, Saxenda, Trulicity, and Mounjaro.
To say these are life savers is …
Direct care with a podiatry twist
A patient, let’s call him Jay, came to me refusing a leg amputation. He had open sores that were necrotic, foul-smelling as if he had been neglected for a long time. At his consultation, he fought with every cell of his being, refusing to lose his leg as his uncle did. He wanted a second opinion on whether or not his foot could be saved.
Traditional insurance-based medicine has …
Combining personalized education and digital technology to improve glucose monitors [PODCAST]
“Diabetes uniquely requires patients be experts in their own care and demands 24/7/365 vigilance. Close communication with a health care team eases the burden and improves outcomes.
Glucose management revolves around numbers. Unfortunately, numbers are just noise unless translated into actions. Innovations, such as color for people with low numeracy, are essential …
How long will it take to address clinical inertia in T2DM? [PODCAST]
This article is sponsored by the Academy for Continued Healthcare Learning. Visit the CME activity and Clinical Inertia Assessment Tool. This activity is supported by an educational grant from Lilly.
It’s been over …
20 years and counting. How long will it take to address clinical inertia in T2DM?
This article is sponsored by the Academy for Continued Healthcare Learning, an independently owned and operated full-service medical education company that has been developing certified health care education for nearly twenty years.
Visit the CME activity and Clinical Inertia Assessment Tool. This activity is …
If we better manage diabetes, can we better manage COVID?
Over their lifetimes, adults in the United States have a 40% chance of developing type 2 diabetes. And the likelihood for Latino adults is 25% higher. Even worse, Latinos develop type 2 diabetes when younger, and experience more severe complications and higher hospitalizations.
The stark disparities of type 2 diabetes reveal how cultural and social factors affect disadvantaged populations. As a case in point, managing diabetes is more difficult for patients …
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Diabetes impacts the whole body, but the foot can’t be forgotten
Diabetes is a complex yet common disease that impacts over 34 million Americans. Blood glucose is just the tip of the iceberg; related complications include neuropathy, eye disease, ketoacidosis, kidney disease, cardiovascular disease and more. In fact, it could be said that diabetes is a “whole body” disease, in the sense that it spirals out to cause devastating problems that impact many regions of the body, including …
Type 1 diabetes in transgender children and adults
In the face of genetically engineered therapies for many cancers and the incredibly rapid development of effective vaccines for COVID-19, it’s easy to lose sight of the breadth and depth of unsolved puzzles in medical science. Many of these remaining mysteries may be at least partially resolved as we overcome the mind/body dichotomy. A fascinating example of this issue has emerged with recent evidence of the excessive prevalence of Type …
No wonder patients detest our health care system, and doctors are leaving medicine in droves
My patient is a brilliant, 30-something-year-old highly educated woman with type 1 diabetes. I’ve known her for many years, since she was a teenager. She is sweet and fun, even though she can be fierce and fiery at times. She has type 1 diabetes.
She has been living with this life-altering, life-threatening disease for many years. Even as a child, she always took charge of her life and consistently maintained her …
Minorities and medical research: Who is still excluded?
In the United States, there is clear evidence that minority populations continue to be underrepresented in clinical research related to new therapies for common and serious long-term medical conditions such as type 2 diabetes (T2D). This is despite these same populations facing a continuing and disproportionate burden of T2D, which shows no signs of abating.
Black people have one of the highest rates of T2D (13.2 percent), a rate almost twice …
Why direct primary care is the future
I recently wrote about my new type 1 diabetes diagnosis, the quest for affordable meds and supplies, and the subsequent financial savings found through transparent pricing outside of my insurance plan. I summarized that health care “coverage” is very expensive, whereas medical services may be found much more affordably.
My next step was to establish an ongoing primary care physician relationship.
I contacted one of the large medical …
A patient’s tale of type 2 diabetes
Samuel was an English gentleman hailing from London. Close to 10 percent of the U.S. population, over 30 million people, lives with diabetes. Five years ago, Samuel was diagnosed with type 2 diabetes. Taking lisinopril and glipizide, he also goes on hour-long walks every morning at 6:30 a.m. to keep his A1c at his comfort number of 5.5. It has not always been this way for Samuel as he was …
Endocrinologists are needed more than ever. Why are they being devalued?
I chose endocrinology to be my lifelong profession out of love for the complex interactions of endocrine glands and intricate feedback loops. I take pride in preventing medical complications, prolonging life expectancy, and providing complex care to type 1 and type 2 diabetics. At times, this field of work requires spending hours — either with the patient or before or after patient visits — counseling, examining blood glucose data and …
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Past Week
-
Is primary care becoming a triage station?
-
Psychiatrists are physicians: a key distinction
-
The blind men and the elephant: a parable for modern pain management
-
Gender bias in medicine: Who deserves to be saved?
-
How to handle medical gaslighting
-
Catching type 1 diabetes before it becomes life-threatening [PODCAST]
-
Past 6 Months
Recent Posts
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Catching type 1 diabetes before it becomes life-threatening [PODCAST]
-
The consequences of adopting AI in medicine
-
Pediatrician vs. grandmother: Choosing love over medical advice
-
How I got Dr. Luis Torres Díaz on Wikipedia: a grandson’s journey
-
Direct primary care vs psychotherapy models: Why they aren’t interchangeable
-
The hidden depth of the rural primary care shortage
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