Author: Leslie Branon

women taking menopause pills
PCOS and Menopause: What You Should Know This PCOS Awareness Month
Posted on by Leslie Branon

Polycystic Ovary Syndrome (PCOS) is often thought of as a condition that primarily affects younger women, but its impact doesn’t end there. As more people with PCOS enter perimenopause and menopause, research is shedding light on how symptoms and risks change, and what steps you can take to protect your health during this important stage of life.

What Is PCOS?

PCOS is a hormonal disorder that affects how the ovaries work. It often leads to irregular or missed periods, higher levels of male-type hormones (androgens), and insulin resistance. Many women experience symptoms such as acne, increased facial or body hair, fertility challenges, and weight gain. Importantly, PCOS is a lifelong condition—it does not simply go away with age or once menstruation stops.

What Happens During Perimenopause and Menopause

Perimenopause is the transitional period before menopause when estrogen and progesterone levels begin to fluctuate. This stage can last for several years and is often marked by irregular cycles, hot flashes, and mood changes. Menopause, on the other hand, is defined as 12 consecutive months without a menstrual period and signals the end of natural ovarian hormone production.

Research shows that women with PCOS often reach menopause a little later than average—sometimes one to two years later. Because symptoms like irregular periods, weight gain, and changes in skin or mood can occur with both PCOS and perimenopause, it can be difficult to tell which condition is driving the changes you may be experiencing.

How PCOS Changes with Menopause

While menstrual irregularities resolve once menopause begins, PCOS does not disappear. In fact, the focus shifts toward long-term health risks. Women with PCOS continue to face a higher risk of insulin resistance, type 2 diabetes, high cholesterol, and cardiovascular disease. Some symptoms of androgen excess, such as acne or hair growth, may improve, but for many women, they persist even after menopause.

Managing PCOS Through Menopause

Here are practical steps for managing PCOS and menopause together, especially to reduce risks and improve quality of life:

  1. Lifestyle
    • Maintain a healthy weight through balanced nutrition (with whole foods, lean protein, plenty of fiber) and regular physical activity.
    • Focus on good sleep hygiene and stress management—both affect hormones.
    • Avoid smoking; alcohol in moderation.
  2. Hormonal & Medical Treatments
    • Hormone therapy (if appropriate) to address menopausal symptoms.
    • Medications to manage insulin resistance (e.g. metformin) or regulate androgen levels.
    • Regular monitoring of lipids, blood sugar, and blood pressure.
  3. Regular Check-ups
    • See your endocrinologist or health provider to review labs and symptoms at least annually.
    • Screen for diabetes, heart disease, and other metabolic complications.
  4. Be Proactive
    • Work with your care team (endocrinologist, gynecologist, primary care) to tailor a plan based on how PCOS has affected you through your life.

Contact Texas Diabetes

If you have PCOS and are approaching perimenopause or already navigating menopause, Texas Diabetes is here to help. Our endocrinologists specialize in managing hormone changes, metabolic health, and long-term risks to ensure you receive the comprehensive care you deserve. 

If you’d like to schedule an appointment with one of our endocrinologists at Texas Diabetes & Endocrinology, please contact us at (512) 458-8400 or request an appointment online.  

rows of soft drinks
A Closer Look at Liquid Sugar and Diabetes 
Posted on by Leslie Branon

Recent research has shed new light on the risks associated with sugary beverages. A study from Brigham Young University (BYU) has revealed that consuming sugar in liquid form—such as in sodas, sweetened teas, and fruit juices—may increase the risk of developing type 2 diabetes more significantly than consuming sugar in solid foods.

What Is Liquid Sugar?

Liquid sugar refers to added sugars found in beverages, including sodas, sweetened teas, energy drinks, and fruit juices. Unlike sugars found in whole fruits, which are accompanied by fiber and nutrients, liquid sugars are absorbed quickly into the bloodstream. This rapid absorption can lead to spikes in blood sugar and insulin levels, placing added stress on the body over time.

Understanding Type 2 Diabetes

Type 2 diabetes occurs when your body doesn’t respond normally to insulin. Over time, insulin resistance causes your body to require even more insulin, resulting in high blood sugar and increasing the risk of complications such as heart disease, kidney damage, and nerve problems. Factors contributing to type 2 diabetes include genetics, lifestyle choices, and dietary habits.

The Link Between Liquid Sugar and Health Risks

The BYU study found that each 12-ounce serving of sugar-sweetened beverages consumed daily was associated with a 25% increased risk of developing type 2 diabetes. This heightened risk is thought to be due to the rapid absorption of liquid sugars, which can lead to increased fat storage, insulin resistance, and inflammation.

Excessive consumption of sugary drinks has also been linked to heart disease. High sugar intake can lead to obesity, high blood pressure, and elevated triglyceride levels—all risk factors for cardiovascular disease.

Reducing the intake of sugary beverages is a proactive step toward better health. Consider the following tips:

  • Choose Water or Unsweetened Beverages: Opt for water, herbal teas, or beverages without added sugars.
  • Read Labels Carefully: Be aware of hidden sugars in drinks labeled as “natural” or “healthy.”
  • Gradual Reduction: If you’re accustomed to sugary drinks, try gradually reducing your intake to allow your taste buds to adjust.

Reduce Your Type 2 Diabetes Risk

Additional steps you can take to protect your health and prevent type 2 diabetes include:

  • Maintain a Healthy Weight: Even modest weight loss can improve insulin sensitivity.
  • Stay Active: Aim for at least 150 minutes of moderate physical activity per week, such as brisk walking, swimming, or cycling.
  • Choose Whole Foods: Emphasize vegetables, fruits, whole grains, lean proteins, and healthy fats.
  • Limit Processed Foods: Reduce consumption of refined carbohydrates and foods high in added sugars.
  • Monitor Blood Sugar: Regular screenings can help detect early changes and allow for timely lifestyle adjustments.
  • Prioritize Sleep: Poor sleep can affect metabolism and insulin resistance. Aim for 7–9 hours of quality sleep per night.

Partnering with Experts for Better Health

At Texas Diabetes & Endocrinology, our team of specialists is dedicated to helping you achieve and maintain a healthy weight, a crucial factor in preventing type 2 diabetes and its complications. Through our comprehensive weight management program, we offer personalized guidance to help you achieve your health goals. Our approach includes nutrition education, customized exercise plans, and, when appropriate, a discussion of FDA-approved medications. We focus on supporting you in making sustainable lifestyle changes that lead to improved health and well-being.

Consult with an Endocrinologist in Austin, TX

If you’d like to schedule an appointment with one of our endocrinologists at Texas Diabetes & Endocrinology and discover how our diabetes services and other endocrinology therapies can help you lead a full and active life, please contact us at (512) 458-8400 or request an appointment online.  

women with apple watch on wrist looking at screen
Wearable Devices and Your Health: Insights from Dr. Lucy Esteve
Posted on by Leslie Branon

Wearable technology is becoming an increasingly popular way to monitor health — and for good reason. These devices offer valuable information that can help you better understand your body and make changes to support your overall health. 

We asked endocrinologist Dr. Lucy Esteve to share everything you need to know about using wearable devices to help achieve your metabolic health goals. 

Why are wearables important in the fight against diabetes?

Over one-third of the U.S. population has prediabetes, and 9 out of 10 people remain undiagnosed. That’s why there’s a pressing need for more widespread screening in the community to help prevent progression to diabetes and the complications that come with it. Wearable devices give us an opportunity to engage patients in their own health and help them make informed changes.

What types of wearable devices are available, and what do they track?

Wearables are non-invasive biometric sensors worn on the body and used worldwide for personalized health monitoring. Think of devices like the Apple Watch, Fitbit, Garmin, and Oura Ring. They generate objective data such as step count, calories burned, sleep patterns, and physiological stress. That immediate feedback can be leveraged to improve glycemic control, encourage self-care, and boost self-efficacy.

Can wearables measure blood sugar?

It’s important to know that, as of yet, smartwatches in the U.S. are not FDA-approved for detecting glycemic dysfunction and don’t provide reliable, real-time glucose levels. However, continuous glucose monitors (CGMs) are minimally invasive wearables that are FDA-approved for managing diabetes and they’ve truly revolutionized how we detect and address blood sugar issues.

What’s new in CGM technology?

We now have over-the-counter CGMs like Abbott’s Lingo and Dexcom’s Stelo. These are designed for people who want to track their metabolic health even without a diabetes diagnosis and do not require a prescription. They allow users to monitor trends in blood glucose rather than single data points like a lab draw, and data can even be shared with healthcare professionals via apps like Dexcom Clarity.

Are there limitations to these devices?

OTC CGMs can be costly, and they only measure glucose levels (they don’t provide additional biometric data). They also don’t have high or low glucose alerts, and accuracy can vary within an acceptable range. Finally, not all of them are integrated into electronic health record systems, which can make clinical workflow more challenging.”

Can you share an example of when CGM technology made a difference for a patient?

A patient in her 40s came to see me for evaluation of intermittent episodes of anxiety, shakiness, palpitations, dizziness, fatigue, and weight gain despite a healthy lifestyle. Her extensive cardiac work-up (EKG, stress testing and echocardiogram) and psychiatric evaluation (for anxiety disorder) were normal, and even her fingerstick glucose checks looked fine. We decided to try a CGM for two weeks, and she carefully logged her meals, symptoms, and exercise. When we reviewed the data together, we found she was having rapid blood sugar spikes after higher-carb meals, followed by quick drops — typical of reactive hypoglycemia. By simply adjusting her diet and adding more frequent high-protein snacks every 2–3 hours, her symptoms improved dramatically.

The Bottom Line

Wearable devices are powerful tools that can help patients and healthcare providers work together toward better health outcomes. As Dr. Esteve explains, they are not a replacement for medical evaluation, but when used correctly, they can be a game-changer in understanding and managing your health.

Consult with an Endocrinologist in Austin, TX

If you’d like to schedule an appointment with one of our endocrinologists at Texas Diabetes & Endocrinology and discover how our diabetes services and other endocrinology therapies can help you lead a full and active life, please contact us at (512) 458-8400 or request an appointment online.  

How Stress Impacts Your Blood Sugar
Posted on by Leslie Branon

Keeping up with your diabetes care can be stressful. But did you know that mental stress can raise your blood sugar levels?

If it feels like your numbers are difficult to control when you’re anxious or overwhelmed, you’re not imagining things. Stress and blood sugar are closely linked, and for people with diabetes, understanding that connection is an important step toward feeling better and staying healthy.

How Stress Affects Blood Sugar

When you’re stressed, your body releases hormones like cortisol and adrenaline. These are part of your natural “fight or flight” response, designed to help you handle a threat. But along with increasing your heart rate and energy, these hormones also raise blood glucose levels, making it harder to manage blood sugar.

A study published in Frontiers in Psychology found that people with diabetes who experienced high levels of stress often had higher A1C levels (a marker of average blood glucose). 

Dealing with the daily tasks of diabetes management can also become a source of stress, making it a cycle that can feel tough to break.

Signs Stress May Be Affecting You

Stress doesn’t always show up in obvious ways. You may notice:

  • Higher-than-usual blood sugar readings
  • Trouble sleeping or fatigue
  • Mood changes like irritability or feeling down
  • Difficulty concentrating
  • Feeling overwhelmed with your diabetes care

If any of this sounds familiar, it may be time to take a closer look at your stress levels and explore tools to manage them.

Simple Ways to Lower Stress and Support Better Blood Sugar

The American Diabetes Association recommends a few simple, effective techniques that can help lower stress:

Get moving. Exercise is a natural stress reliever. Even a walk around the block can improve your mood and your glucose levels. Activity can boost your insulin sensitivity, too.

Talk it out. Whether it’s a support group, a friend, or a therapist, talking about what’s on your mind can lighten the load. You don’t have to manage diabetes alone.

Prioritize rest. Sleep plays a major role in both blood sugar and emotional resilience. Aim for 7–8 hours each night.

Take a break. A few deep breaths, a short meditation, or even 10 minutes without your phone can calm your nervous system and lower cortisol levels.

Try something new. A new hobby, a good book, or a creative project can help shift your focus and reduce daily stress.

You’re Not Alone

At Texas Diabetes, we understand that managing diabetes isn’t just about medication and numbers—it’s about your whole well-being. If stress is making your diabetes harder to manage, talk to your care team. Together, we can explore what’s going on and find solutions that work for your lifestyle.

Consult with an Endocrinologist in Austin, TX 

If you’d like to schedule an appointment with one of our endocrinologists at Texas Diabetes & Endocrinology and discover how our diabetes services and other endocrinology therapies can help you lead a full and active life, please contact us at (512) 458-8400 or request an appointment online.  

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