Dr. Shaw has announced her departure from TD&E effective 9/4/20

Dear Patients:

It is with mixed emotions that I am announcing my departure from Texas Diabetes & Endocrinology, P.A. on September 4th, 2020. It has been a great pleasure helping you with your health care needs over the years. I want to personally thank you for trusting me and allowing me to participate in your medical journey. My number one goal is for you to continue to receive excellent personalized medical care. I know that all the Physicians and Advanced Practice Providers at Texas Diabetes & Endocrinology, P.A. are going to continue to provide exception medical care to you in my absence.
As of October 5th, 2020, I will be joining Seton Family of Doctors and practicing at Ascension Medical Group. My new practice information is located at the bottom of this letter.
Your medical records will remain with Texas Diabetes & Endocrinology, P.A. If you require a copy of your medical records, you may contact their offices at (512)458-8400, option 5 or email medicalrecords@texasdiabetes.com.
I have greatly valued our relationship, and thank you for your friendship over the years. Best wishes for your future health.

Sincerely,

Stephanie Shaw, M.D.

Ascension Medical Group
1905 HK Dodgen Loop
Temple, TX 76505
(254)298-2400

New Private Pay Policy

To Our Patients: 

We have implemented a policy requiring a credit card on file for all Self-Pay (Private Pay) patients. Effective July 15, 2020, we now kindly require a credit card to be on file with our office so that your payment can be automatically drafted the day of or after your appointment. If you decline to place a credit card on file, you may pre-pay your visit in full prior to the appointment date. Please call our billing office to receive your estimate for services at (512)458-8400, option 6.

When do I give you my credit card?
We prefer that you enter your credit card information while confirming/pre-registering for your appointment through our secure platform, Phreesia. Please pay close attention to your appointment reminders sent via text & email to complete pre-registration.You can also deliver your credit card information over the phone, by mail, or in person, but the most secure way is online during pre-registration. 

But wait, I’m nervous about leaving you my credit card information. 
Phreesia’s secure PCI-DSS compliant system never stores sensitive credit card information in our office system or Phreesia’s, it is stored with the merchant. 

What is PCI-DSS compliant?
Payment Card Industry (PCI) Security Standards Council offers robust and comprehensive standards to enhance payment card data security and reduce exposure to credit card fraud. PCI Data Security Standard (DSS) provides an actionable framework for developing a robust payment card data security process, including prevention, detection, and appropriate reaction to security incidents. 

How will I know how much you are going to charge me?
Upon storing your credit card information in Phreesia, you will sign the card-on-file policy, including the maximum amount we can charge to your card. You will never be charged more than the agreed-upon maximum amount. On the day of or after your appointment, your card will be automatically drafted for the amount due and a receipt will be emailed to you. 

What if I have more questions?
Our staff is happy to speak with you about your account at any time. Please call our billing department at (512)458-8400, option 6. 

Sincerely,
Texas Diabetes & Endocrinology, P.A. 

Update on Diabetes and Covid-19 Studies show the impact of diabetes control on Covid 19 outcomes

Two studies, one from China and one from England, offer similar messages to people with diabetes.

The first study, from Hubei Province, China, evaluated nearly 1000 patients with Covid 19 and pre-existing diabetes (published in Cell Metabolism). The patients who were better controlled upon entry to the hospital (average A1c 7.3%) had a significantly higher survival rate than those who had an average A1c of 8.1%.

The second study, from England, noted that one in four people who have died of Covid 19 also had diabetes. Weight and higher A1c correlated to a higher death rate.

Overall, the data shows that people who go to the hospital for Coronavirus and also have poorly managed diabetes, have a higher risk of dying.

What does this mean for people with diabetes?

First, there is no evidence that people with diabetes have a higher risk of contracting Coronavirus, and most people with the infection will not need hospital care at all.

Secondly, the best approach to reducing the risk of complications due to Coronavirus is to manage diabetes carefully and keep blood sugars controlled.

Prevention of Coronavirus by wearing masks and social distancing is the best approach for everyone.

If you have diabetes, be sure to monitor your blood sugars and keep all medical appointments. If your blood sugars are not well controlled, please seek medical care. Our endocrinologists and mid-level practitioners are here to help.

This update is brought to you by the doctors and mid levels at Texas Diabetes and Endocrinology, where helping you be successful in managing your diabetes is our priority.

Austin TypeOneNation Summit

Dr. Tira Chaicha-Brom, MD ECNU, of Texas Diabetes and Endocrinology, has joined a panel of experts who will be discussing Type 1 diabetes (T1D) and pregnancy at the upcoming Austin TypeOneNation Summit on Sunday, March 1, 2020.  

This educational conference is a great opportunity for those living with T1D, parents, caregivers, siblings and anyone interested in learning more about T1D. Topics include advancements in the treatment of T1D,  T1D and pregnancy and will showcase learning tracks for children and teens as well. Please join Dr. Chaicha-Brom at this important event.

Learn more and register today at bit.ly/TON2020

Diabetes

When a diagnosis of Diabetes is given it can be scary and overwhelming for most people. At Texas Diabetes and Endocrinology we are here to help you navigate a path to achieving a healthier life. We will work alongside you and your family members to gain a better understanding of both the disease as well as the treatment options.

  • In the last 20 years, the number of people diagnosed with diabetes has doubled
  • Diabetes is the 7th leading cause of death in the US
  • Diabetes is the #1 cause of kidney failure, lower-limb amputations as well as adult blindness
  • There are many types of diabetes: Type 1, Type 2, gestational diabetes and prediabetes

Risk Factors For Diabetes:

  • For Type 2 Diabetes:
    • if you have a parent or sibling with diabetes,
    • are overweight,
    • > 45 y.o,
    • history of gestational diabetes,
    • history of prediabetes,
    • and African Americans and Latinos are at a higher risk
  • For Type 1 Diabetes:
    • family history with a parent or sibling with Type 1 diabetes

What is the difference between Type 1 and Type 2 Diabetes?

Type 1 diabetes is an autoimmune disease where the pancreas is not functioning and treatment requires insulin. Type 2 diabetes is due to insufficient insulin production from beta cells in the setting of insulin resistance. The risk of type 2 diabetes is both a combination of lifestyle and genetic factors. Studies show that type 2 diabetes can be delayed or prevented with exercise and weight loss.

Treatment options:

There are many treatment options available and each person needs a plan specific to them and their needs. There are multiple options with oral medication, non-insulin injectables, as well as insulin and lifestyle modification to aid in treatment. Treatment options also include a variety of insulin pumps and we can help you in deciding the one that would be the best fit for you.

There are also numerous options available on how to monitor your blood sugars including continuous glucose monitors, traditional finger stick glucometers and even implantable monitors.

We are fortunate to have multiple treatment options for diabetes and recommend you schedule a visit so we can come up with an INDIVIDUALIZED plan for you or your loved ones.

At any given time we also have multiple research trials going on for weight loss, type 1 and type 2 diabetes. Please refer to our research page(https://texasdiabetes.com/sponsors-and-cro/currently-enrolling-trials/) for ongoing studies.

We look forward to working with you. Please do not hesitate to contact the office with any questions or concerns.

POLYCYSTIC OVARIAN SYNDROME

Do you have irregular periods? There are several reasons for missing periods, but one of the most common reasons is PCOS, polycystic ovarian syndrome.  

Symptoms of PCOS include:

  • Missing periods (usually having less than 9 periods per year)
  • Excess testosterone on blood work or on exam (excess hair growth, acne)
  • Ovarian cysts

PCOS is a diagnosis of exclusion so other diseases like thyroid or other hormone problems should be ruled out before making the diagnosis of PCOS.  The diagnosis is based on symptoms, laboratory findings, and sometimes imaging studies.

The risk of having PCOS is that it can be associated with diabetes or insulin resistance, sleep apnea, cardiovascular disease, weight issues, uterine cancer, infertility, and sleep apnea.

The cause of PCOS is unknown and treatment involves controlling the symptoms.  A healthy lifestyle with weight loss can oftentimes improve symptoms and prevent associated medical complications.  Birth control pills are typically used to help regulate periods and can sometimes decrease facial hair or acne. Metformin is another medication that is typically used to help control the blood sugar.

When a woman has regular periods, this is a good indication that her hormones are appropriate. 

You should let your healthcare provider know if you have irregular periods or excess hair growth or acne in order to do a proper evaluation.

The following references:

https://www.hormone.org/diseases-and-conditions/polycystic-ovary-syndrome

PCOSChallenge.com

Obesity

Obesity (defined as a body mass index (BMI) >30kg/m2) is a chronic disease that is increasing in prevalence in adults, adolescents, and children and is now considered to be a global epidemic. The National Health and Nutrition Examination Survey (NHANES) in 2016 showed the prevalence of obesity in the United States to be 39.6% (37.9% in men and 41.1% of women), up from 22.9% in 1994.

At Texas Diabetes and Endocrinology we investigate many aspects of this disease. We rule out any possible secondary causes (such as pituitary, thyroid, adrenal or ovarian abnormalities) as clinically indicated, discuss contributing medications, and obtain a thorough weight gain/weight loss history. Obesity is associated with a significant increase in morbidity (including diabetes mellitus, hypertension, dyslipidemia, heart disease, stroke, sleep apnea, and cancer) and we assess these and come up with a comprehensive plan to manage them.

Weight loss itself is associated with a reduction in obesity-associated morbidity and we are committed to helping our patients achieve these benefits. We counsel all patients on lifestyle and behavioral modification. We also offer medically supervised programs to assist with individual goals. Ideal Protein is one program we utilize: it provides structure and one-on-one coaching that can help achieve not only weight loss but also reduction in comorbidities and often medications. We also use FDA-approved weight loss medications as needed to help our patients achieve their goals.

Finally we conduct clinical trials at all of our locations and these often involve obesity treatments. Currently at the south office we are conducting a study on a medication (semaglutide) to evaluate weight loss and long-term cardiovascular outcomes.