Author: Leslie Branon

CGM
FDA Approves New OTC Continuous Glucose Monitor (CGM) 
Posted on by Leslie Branon

A continuous glucose monitor (CGM) has typically only been available via prescription, until now. 

Recently, the Food and Drug Administration (FDA) approved over-the-counter (OTC) sales of a CGM known as Dexcom’s Stelo Glucose Biosensor System.

This is good news not only for those with diabetes, but also for those who want to support a healthier lifestyle and make smart food choices by monitoring their blood sugar (glucose) levels. 

At Texas Diabetes & Endocrinology, our team of endocrinology experts often include CGMs as part of the treatment plan for our patients with diabetes.

What is a CGM?

A CGM is a small device that adheres directly onto the skin and uses sensors to track real-time glucose readings.  Having this important information at your fingertips can help you better plan food intake goals and medication or insulin doses throughout the day.  The CGM affords patients the opportunity to live more independently without stopping for multiple tests (finger pricks) every few hours. Additionally, the sensor can send an alarm to the patient or their caretaker if their blood sugar is dangerously low or high to alert them to take action.

Under the direction of your endocrinologist, a CGM can be an effective glucose monitoring tool for patients with either Type 1 or Type 2 Diabetes. 

Our endocrinologists can also access these real-time readings so that guidance on adjusting medications can be made swiftly and with as little interruption to your daily routine as possible. 

The introduction of CGMs has changed the way endocrinologist determine how well controlled a person’s diabetes is by looking at the amount of time the blood sugars stay in a target range. “We now understand that keeping blood sugars controlled all day long, instead of just parts of the day, are better for patient outcomes,” explains endocrinologist Dr. Tira Chaicha-Brom. “We still routinely check hemoglobin A1c but this is a three month average of one’s blood sugars.” 

CGMs for Non-Diabetics 

There is a growing number of people who are not diabetic opting to use CGMs in order to monitor their blood sugar levels. Without a confirmed diabetes diagnosis, it has previously been challenging to obtain a CGM.

“As more and more people are wanting to take control of their health and make smart choices, using a CGM can be a proactive way to use data that supports these goals”, says Dr. Tira Chaicha-Brom. 

The benefits of maintaining healthy blood sugar levels include:

  • Boosting energy and circulation
  • Preventing heart and kidney disease
  • Protecting against vision loss and the development of diabetes

The Dexcom Stelo device is a wearable CGM system that provides glucose readings every 15 minutes and delivers them to an app on your phone. It will be available for widespread purchase this summer. 

For questions about CGMs and successful diabetes management, please contact us here. 

Contact Us to Help Manage your Diabetes and Thyroid Conditions 

If you’d like to schedule an appointment with one of our specialists 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.  

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

What are the benefits of weight loss and weight loss management?
Posted on by Leslie Branon

The benefits of weight loss and then maintaining a healthy weight are countless. 

Your circulation and blood pressure will improve, muscles and joints will be more flexible, cholesterol levels will stabilize, better sleep is possible, blood sugar levels will become more balanced, and the list goes on…

The CDC estimates that if you lose just 5-10% of your body weight, you will benefit from it in so many ways. 

At Texas Diabetes & Endocrinology, our team of endocrinology experts treat diabetes, thyroid issues, osteoporosis, and promote heart disease prevention.

We are highly invested in helping our diabetes patients to lose any excess body weight to better manage their blood sugar levels and their overall health. Lowering your body weight will encourage the pancreas to work more efficiently to keep up with insulin production and help sustain healthy blood sugar levels. 

One of our advanced practice providers, Brandy Wellmon PA-C, CDCES, contributed to an article about weight loss and blood sugars. 

Wellmon says that “the most important aspect of a successful weight loss program is that it must be tolerable to the patient so that the changes are lifelong.”

Experts and research suggest that making adjustments to your diet and adding regular exercise to your daily routine are the main factors that contribute to successful weight loss.

Wellmon shares that she tells patients not to expect significant weight loss until they have sustained the changes for at least three months. 

Ways to help with your dieting and weight loss goals include:

  • Seeking professional guidance from a nutritionist and/or physical trainer
  • Setting realistic goals that you can achieve and sustain over the long term
  • Staying positive, working consistently, and trying not to compare your weight loss journey to someone else’s

Research does show that weight loss medications can help in extreme cases when diet and exercise have failed, but these should be taken strictly under the supervision of your physician and as directed. 

Wellmon warns that there could be risk in losing weight too fast as well if not done safely.  

“Losing too much weight can lead to excessive or rapid bone loss, increasing risk of osteoporosis,” she says. “Also, extreme weight loss or losing it too quickly can have an adverse effect on hormones.”

In the race to lose weight, remember that a slow and steady pace often wins. Make smart choices to facilitate your unique weight loss goals that you will be able to stick to and sustain. Your body will thank you for the many benefits associated with these efforts to maintain a healthy weight for years to come.  

Contact Us to Help Manage your Diabetes and Thyroid Conditions 

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

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

Welcome Dr. Mauli Shah
Posted on by Leslie Branon

Texas Diabetes & Endocrinology is pleased to welcome Dr. Mauli Shah to our team of endocrinology experts. 

Dr. Shah is board-certified in Internal Medicine and will be treating the full scope of endocrine disorders including diabetes, thyroid issues, osteoporosis, and promoting heart disease prevention out of our Round Rock clinic.

She joins us most recently from working as a hospitalist and completing her fellowship in Endocrinology at Baylor Scott and White in Temple, TX. 

Dr. Shah loves practicing endocrinology as she says “it allows me to meet all different kinds of people and help them understand complex hormonal issues.”

“It’s a very satisfying field because we can see immediate results after starting treatment,” she adds. 

Dr. Shah was born and raised in southern California and earned her undergraduate degree from Rensselaer Polytechnic Institute in New York. She remained in New York to attend medical school at Albany Medical College and then returned to California for her Internal Medicine residency training at Kaiser Permanente Los Angeles Medical Center. 

When asked why she was excited to join our practice, Dr. Shah shares that “everyone I have met from the staff to the other providers are very personable and great to work with.”

She describes her patient care philosophy as follows:

Every patient should have control over their own medical care with the advice of their physician. Care should be tailored to every individual and their own unique needs and lifestyle. Doctors should be seen as advocates for their patients. 

Dr. Shah likes to emphasize to her patients that they should always be comfortable, open, and honest with her and other physicians, as they are only here to help heal and never to judge. 

Outside of work, Dr. Shah enjoys spending time with her children and husband and also enjoys yoga, watching movies, and traveling. She loves that Austin shares the same warm and sunny climate as her home state of California, where all of her sisters and parents are practicing physicians as well.  

Contact Us to Help Manage your Diabetes and Thyroid Conditions 

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

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

How ChatGPT helped one patient correct his diabetes misdiagnosis
Posted on by Leslie Branon

Artificial Intelligence (AI) is infiltrating everything these days, even medical diagnoses. One young patient of ours was misdiagnosed with Type 1 diabetes (T1D), but through his own intuition, research using ChatGPT, and the help of Dr. Keta Pandit, discovered that he had an inherited form of diabetes known as Maturity-Onset Diabetes of the Young (MODY).

24-year-old Cooper Myers was first treated for T1D while living in South Carolina after experiencing common diabetes symptoms (high blood sugar despite diet and exercise, fatigue, excessive thirst, and frequent urination). At the time of his diagnosis, he tested negative for GAD antibodies which are typically found in those with T1D. However, even with dedicated efforts at eating well and exercising, his blood sugar was still high, leading the doctor to believe he had T1D. 

Knowing his strong family history of diabetes on his father’s side, dating back to his great grandmother, coupled with the fact that he tested negative for antibodies, Cooper felt like something didn’t seem right about his diagnosis. 

Upon moving to Austin, TX, Cooper established care with Texas Diabetes and Endocrinology under board certified endocrinologist Dr. Keta Pandit and her team. Dr. Pandit managed Cooper’s insulin pump and noticed that he was having frequent low glucose values and had to continue reducing his insulin dosing. 

With a career in technology and extensive knowledge of AI, Cooper relayed his questions regarding his family history and lack of antibodies to ChatGPT, searching for insight on other forms of diabetes. He kept landing on references to Maturity Onset Diabetes of the Young (MODY), a genetic form of diabetes caused by a gene mutation.

Cooper shared his findings with Dr. Pandit, who seemed to agree with Cooper’s concerns at that time.  His insulin requirements were much lower than other TID patients, which raised concerns for Dr. Pandit as well. 

Diagnostic Testing Provides Clarity

Dr. Pandit supported re-evaluating Cooper’s diagnosis and ordered a variety of tests to look at specific antibodies, which included pancreatic antibodies to confirm there are no T1D antibodies and C-peptide which confirms that the pancreas is still producing insulin. After Cooper’s result showed he had no antibodies and low (normal) C-peptide levels, Dr. Pandit ordered a genetic blood test to examine the genes that were associated markers of MODY. 

After this lengthy process, and waiting more than a month for the results, it was confirmed that Cooper had MODY 2 (there are different types of MODY depending on which gene is affected). MODY 2 is caused by a mutation of the GCK gene.

Working with Dr. Pandit, Cooper was able to gradually change his medications and get off his insulin pump.  Now, his blood sugar and insulin production are properly managed, and he is living a normal and healthy life off his insulin. Dr. Pandit says that with his lifestyle, his prognosis is excellent. 

Cooper has now found a great support system online for fellow MODY patients who were misdiagnosed like himself. 

His advice to others who are concerned about a diagnosis is to trust your instincts and do your own research, but also discuss things with your doctor and trust their expertise and guidance.

Maturity Onset Diabetes of the Young

MODY is a genetic form of diabetes that is unlike Type 1 (T1D) or Type 2 (T2D) diabetes as it is not autoimmune (T1D) or triggered by factors like poor diet and obesity (T2D). A gene mutation in those with MODY limits the ability of the pancreas to make enough insulin to support healthy blood sugar levels. There are different subtypes of MODY depending on which gene is affected, each resulting in different symptoms and complications. 

MODY is a very rare diagnosis compared with commonly diagnosed conditions such as T1D and T2D. It is estimated to account for 5% of all diabetes cases in the United States. The genetic mutation that causes MODY has a 50% chance of being passed down to subsequent generations. If a child does inherit the mutation, they will generally develop MODY before they reach 25 years of age regardless of their lifestyle, ethnic group or other risk factors such as obesity or increased weight gain. 

Research shows that up to 80-90% of MODY cases are first diagnosed incorrectly as T1D or T2D. Key features of MODY are the age of diagnosis, under 25 years of age, having a parent with diabetes, and often diabetes in two or more generations. Testing for the presence of antibodies can help rule out the condition. Patients diagnosed with MODY classically do not need insulin. 

It is important to distinguish MODY from T1D and T2D because the treatment and management options are quite different. Insulin injections are primary mode of treatment for T1D, while generally Metformin is the first line of treatment for T2D. On the other hand, MODY is treated through other medications, such as sulfonylureas. 

Contact Us for Help in Managing your Diabetes

If you’d like to schedule an appointment with 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. 

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

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