Endocrinology

The silent epidemic of low testosterone: Why men are suffering in silence and what doctors can do about it

Conditions
December 19, 2024

The hidden health crisis

Low testosterone (low T) is one of the most underdiagnosed and misunderstood health conditions facing men today. Studies show that nearly 40 percent of men over age 45 and 50 percent of men over 80 have low testosterone levels. However, what’s more troubling is that only 20 percent of these men are ever diagnosed or treated.

The symptoms are often subtle but profound, affecting physical health, mental well-being, …

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Why endocrinologists need to rethink CME: the secret to a healthier conference

Physician
September 11, 2024

As endocrinologists, we spend our days balancing hormones and fine-tuning metabolism, but when it comes to our own continuing medical education (CME) conferences, it seems our ability to maintain equilibrium goes out the window. We advocate for healthy living, yet our CME events are a hormonal disaster, like a cortisol spike right after a sugar crash.

Picture the scene: you roll out of bed before the sun, which is already a …

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Why we need to stop blaming people for their diabetes

Conditions
August 27, 2024

“You brought this on yourself with poor eating habits and bad lifestyle choices.”

If you or someone you know has diabetes, you have likely heard this harmful misconception or even thought it yourself.

While the federal government’s proposed pharmacare legislation has spotlighted diabetes—with diabetes medications to be among the first prescriptions included in a new national pharmacare plan—erroneous assumptions and negative judgments about the condition persist.

It is time that we erased the …

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Bridging the health gap: Empowering Latino communities for a healthier future

Physician
August 11, 2024

As an endocrinologist, internal medicine physician, and public health leader, I have witnessed firsthand the health disparities that affect Latino communities. The COVID-19 pandemic has only magnified these issues, especially with chronic diseases, emphasizing the pressing need for culturally competent health care to address these inequities.

In Arizona and across the nation, my efforts have been dedicated to educating and protecting our communities through media outreach, training community health workers, and …

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A lesson in generosity: How one woman helped a stranger afford insulin

Conditions
June 14, 2024

I waited in line at the pharmacy, a familiar chain store. The man in front of me waited patiently for the technician to ring up his meds. I overheard her say to him, “$125.00. That includes your insulin.”

The man bowed his head and smiled politely, showing many missing teeth. He was dressed modestly. I did not know his name. I did not know him. I had never met him before. …

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It is time to change the conversation and eliminate the stigma attached to diabetes

Conditions
June 5, 2024

The Canadian federal government’s decision to cover diabetes medication and devices under its new pharmacare plan is a significant step forward in improving the quality of life for the millions of Canadians with diabetes, especially those who struggle to afford treatments.

However, access to medication and devices is not the only factor affecting the well-being of those living with diabetes. That title may be reserved for something we don’t …

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Growing up with diabetes

Conditions
May 9, 2024

An excerpt from Sugar Free.

“What do you want to do?” Ginny said.

“Chinese jump rope.”

“Tilly, you always want to play Chinese jump rope,” Renée said.

“So?” Tilly said.

Renée didn’t have an answer to that.

They let Tilly go first. Renée and Ginny faced each other, put the large elastic loop that was the jump rope around their ankles, and backed up until it was taut.

“What happened to you?” Tilly said to Ginny. …

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Beyond the workout: the hidden struggle of diabetic gastroparesis

Conditions
March 21, 2024

The final three minutes of my hour-long elliptical workout were not easy. Pain spread across my stomach, causing me to row in a half-sitting motion, and my chest vacillated between violent coughs and the sorts of deep breaths people take when they think they’ve seen a ghost. Perspiration fell from my shirtless torso to the garage floor. The amount of sweat was not the kind my body produces from exercise. …

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Beyond the headlines: the truth about weight loss drugs [PODCAST]

Podcast
January 6, 2024
YouTube video

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

We sit down with David Ahn, an endocrinologist. Join us as we delve into the impact of weight-loss drugs, the role of incretin medications, and their potential to reshape our approach to obesity and overall health.

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High-deductible health plans: a barrier to care for chronic conditions

Policy
December 31, 2023

At the peak of the coronavirus crisis in 2020, American policymakers were faced with the critical challenge of how to encourage as many Americans as possible to be tested for and vaccinated against the COVID-19 virus. Fortunately, Congress rose to this challenge by passing legislation that, in addition to providing these services to the uninsured, required private insurance plans to eliminate all out-of-pocket costs associated with getting vaccinated or tested. …

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Will GLP-1s allow our society to eschew its responsibility to create a healthy environment?

Meds
November 17, 2023

Since Ozempic entered the cultural zeitgeist, I have been overwhelmed with requests from my patients – both those who meet criteria to start the medication and those who do not – for this new class of “miracle” drug. While it does work like a miracle for some, there are also those for whom the promise rings hollow – those who are unable to tolerate the medications due to side effects, …

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What we have to gain from weight loss drugs

Conditions
November 9, 2023

Twenty years ago, the headlines were grim. It was common for studies to warn: “Rising childhood obesity will decrease life expectancy.” In large part, those predictions came true. The rise in obesity – both in children and adults – has correlated to a catastrophic rise in chronic disease that continues to affect life expectancy, cost of care, and quality of life.

But take a look at the health news headlines now, …

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A retired physician’s battle with moral injury

Physician
June 8, 2023

I retired early from the profession I loved because the devolution of the health care system had made it impossible for me to care for my patients in a manner that met my standards. It also left me with a wound of “moral injury” which makes me leery of re-engaging with our health care system.

My early career

My first post-training job (1989) as a physician was in a BCBS clinic. After …

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The hormone nomenclature debate: Is a name change the key to patient safety?

Conditions
February 22, 2023

In the latest issue of Clinical Endocrinology News, I found an interesting article reporting a proposal to change the name of a hormone. The rationale for the proposed change was “patient safety.”

In 2009, a patient with known panhypopituitarism was admitted to a U.K. hospital for elective surgery. Diagnosis included panhypopituitarism with diabetes insipidus. The patient developed hypernatremia and volume depletion, tragically leading to pronounced hypotension and death.

The author attributes this …

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A doctor’s journey: Navigating chronic disease and empowerment through life coaching

Conditions
February 8, 2023

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” …

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Lack of innovation is leading to disparities in diabetes care

Conditions
December 8, 2022

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 …

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Don’t blame Big Pharma for insulin’s problems

Policy
December 4, 2022

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 …

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We need to stop treating diabetes (without a prevention plan)

Conditions
October 30, 2022

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 …

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A personal mission to get obese patients on GLP-1 agonists

Conditions
October 19, 2022

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 …

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CME Spotlights