Author: Leslie Branon

GLP-1RA gastrointestinal side effects
What are the GI side effects of GLP-1RA Medications, like Ozempic?
Posted on by Leslie Branon

In treating T2D diabetes patients, our Texas Diabetes & Endocrinology board-certified experts may recommend medication to help lower blood sugars in addition to lifestyle changes. Some injectable forms of medical therapy, known as GLP-1RA medications, have been trending in the news lately due to their role in weight-loss management. 

These drugs go by popular brand names such as Ozempic, Mounjaro, and Trulicity. 

While the medicines are very effective for many patients and can be used safely with regular monitoring, recent data reports that there can be serious gastrointestinal (GI) side effects in rare cases. 

GLP-1RA Gastrointestinal Side Effects

GLP-1RAs help to slow the speed at which food passes through the stomach, causing people to feel fuller longer and better regulate blood sugar levels.

This form of drug treatment however can also lead to GI side effects (like severe nausea and vomiting) in some people. 

A new study in the Journal of the American Medical Association recently revealed that those taking GLP-1RAs for weight loss were at an increased risk of GI issues such as:

  • Biliary disease
  • Gastroparesis
  • Pancreatitis
  • Bowel obstructions

These conditions reportedly contributed to many patients electing to discontinue use on their own.

A study published in the American Journal of Managed Care found that approximately 50% of those being evaluated and who were on GLP-1RA meds stopped them within a year. 

What are the consequences of stopping GLP-1RA meds without direction from your doctor?

While initially stopping these medications may not have immediate health repercussions,  it could likely have an effect down the road. 

Failure to properly manage diabetes could lead to complications from continuously elevated blood sugars – like nerve damage, vision loss and worsening kidney function. Stopping these medications could also lead to regaining any lost weight, which typically also worsens insulin resistance and blood sugar control.

With any new therapy, it is important to follow all instructions carefully and as directed by your doctor.   Our endocrinology experts will always discuss treatment options with you and any potential risks or side effects. 

If you ever experience side effects from your diabetic medications, please contact us right away so that we can evaluate the situation and discuss effective alternatives. 

Contact Us Today to Learn More about  Diabetes and Weight Loss Management

If you’d like to schedule an appointment with Texas Diabetes & Endocrinology and discover how our diabetes services  and weight-loss management program can help you lead a full and active life, 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.

Texas Diabetes first to offer new treatment to delay stages of T1D
Texas Diabetes First to Offer New Treatment to Delay Stages of T1D
Posted on by Leslie Branon

At Texas Diabetes & Endocrinology, we take pride in offering the most innovative treatments and top clinical trials for conditions affecting the endocrine system, like diabetes.

Recently one of our patients, Liberty, became the first person in Central Texas to try a new drug, TZIELD, to delay the onset of stage 3 type 1 diabetes (T1D). TZIELD is an infusion-based treatment that was approved by the FDA in 2022. 

Liberty works as a scientist at The University of Texas at Austin and was recently diagnosed with T1D at the age of 39 years old. 

T1D is an autoimmune disorder that occurs when the pancreas fails to make insulin because the body’s immune system attacks the cells (known as beta cells) needed to do so. It develops in gradual stages and differs from type 2 diabetes (T2D) which is when the body becomes resistant to insulin. 

It can be challenging to differentiate between the two forms of diabetes as symptoms (frequent urination, fatigue, sudden weight loss and increased thirst) may be similar. 

It is important to visit with an experienced, board-certified endocrinologist to obtain a thorough and accurate diagnosis. A T1D diagnosis can be determined based on clinical presentation, time of onset, and diagnostic blood tests that identify autoimmune markers such as autoantibodies.

What are the stages of T1D ? 

Stage 1: the body’s immune system starts attacking beta cells while blood sugar levels are still typically normal 

Stage 2: beta cells continue to be attacked as blood sugars may begin to rise, however no insulin is needed yet 

Stage 3: blood sugar levels ultimately spike to more than healthy levels and insulin is now needed to manage the condition  

Liberty’s Story and the Link between T1D and Autoimmune Disorders 

Liberty had already been under the care of endocrinologist Dr. Keta Pandit to treat her Hashimoto’s thyroiditis, a chronic autoimmune condition that leads to low thyroid hormone production. 

During a routine blood test, it was discovered that her A1C level was elevated which classified her as ‘prediabetic.’ 

With regular exercise and adopting a low-carb diet, Liberty initially was able to lower her numbers without medication. 

However, she later began to experience fatigue after eating and shakiness at night, prompting her to seek a new evaluation from Dr. Pandit.  

Given that there is a connection between autoimmune diseases and T1D, Liberty and Dr. Pandit discussed the possibility of having it, which was later confirmed through testing.  

How is T1D treated? 

Because T1D cannot be effectively managed with a healthy diet and exercise, administering insulin is the typical course of treatment.

Since Liberty was diagnosed at the earliest stage of T1D, she did not yet require insulin. 

As a scientist herself, she was keen to participate in any clinical trials or innovative therapies that could help slow the progression of the condition. Dr. Pandit suggested infusion therapy with TZIELD. 

TZIELD works by targeting the immune cells that attack the beta cells needed to produce insulin. 

Liberty had her first set of infusions in December 2023 over a 14-day period. She tolerated the infusion well, with minimal side effects. 

Dr. Pandit is monitoring Liberty’s A1C levels to see if they stay low enough and will continue with TZIELD infusions as long as they continue to preserve her pancreatic beta cells to delay insulin dependence. 

To others who may be experiencing symptoms of diabetes, Liberty shares that it’s important to make sure and get a proper and distinct diagnosis for either T1D or T2D so that you can fully understand your options for treatment, or in her case, the ability to even slow progression of the disease. 

“Listen to your body,” she says. “I could have contributed my fatigue to work or stress, but it’s important to take your health seriously if you feel something is wrong.”

Contact Us Today to Learn about Managing Diabetes 

If you’d like to schedule an appointment with Texas Diabetes and Endocrinology and discover how our diabetes services  can help you lead a full and active life, 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.

Endocrinology Top Doctors
Congratulations to our 2024 Top Doctors
Posted on by Leslie Branon

We welcomed the new year celebrating board certified endocrinologists Valerie Espinosa, MD and Lindsay Harrison, MD for being recognized on the 2024 Top Doctors list in Austin Monthly magazine. 

Dr. Espinosa joined Texas Diabetes and Endocrinology in 2005. She is board certified in endocrinology and metabolism and active in clinical research concerning diabetes, obesity and thyroid disease. 

Dr. Harrison joined Texas Diabetes and Endocrinology in 2013. She is board certified in internal medicine, endocrinology, diabetes and metabolism. 

Austin Monthly Top Doctors is an annual peer-nominated recognition of the best physicians in Travis, Williamson and Hays counties. Using an online survey, physicians are asked to nominate colleagues who they would trust with the medical care of themselves or their family. We are could not be prouder to have our physicians included on this list.  

Congratulations Dr. Espinosa and Dr. Harrison!

For more information on our comprehensive endocrinology services, schedule a consultation with one of our board certified endocrinologists by requesting an appointment online or call (512) 458-8400. 

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

heart disease prevention
Heart Disease and the T2D Connection
Posted on by Leslie Branon

People with diabetes are twice as likely to have heart disease or suffer a stroke than non-diabetics. 

In fact, the American Heart Association recently issued its  Heart Disease and Stroke Statistics for 2023 which found that one in three adults in the U.S. have three or more risk factors that contribute to cardiovascular disease, metabolic disorders, and/or kidney disease. This supports the likelihood that if you have diabetes, you may also be prone to heart disease. 

How does diabetes contribute to heart disease?

High blood sugar levels can damage the blood vessels and nerves surrounding the heart, leading to deterioration and serious damage over time. 

Texas Diabetes team of endocrinology specialists can not only help manage your diabetes, but we can monitor your heart health and assess your risk for cardiovascular disease too. 

Our endocrinology experts recommend several tips to both manage your diabetes and support a healthy heart.  

Five Tips to Manage Diabetes While Supporting Heart Health 

1.         Maintain a healthy weight. Discuss your goal weight with your physician for optimal health and remember that steady and gradual weight loss is the safest route. 

2.         Exercise regularly. Regular exercise, at least 150 minutes per week for adults, helps boost circulation and lower blood glucose levels. Find a sport or active hobby that you enjoy so that you’re more likely to stick with it!

3.         Follow a heart healthy diet. Eat right-sized portions and try using the Diabetes Plate Method to guide your meals. Load up on brightly colored, non-starchy vegetables, lean proteins, and whole grains. 

4.         Look after your mental health. Effectively managing stress can help keep hormones and blood pressure in check, both of which lead to better diabetes management and heart health. Find things that help you to unwind, like walks, reading, meditation, or warm baths, and build them into your daily schedule as you would any other important activity. 

5.         Take medications as prescribed. Make sure you are taking all of your diabetes medications and insulin as directed by your physician to support healthy blood pressure and cholesterol levels. And stay on top of all your numbers that you should be regularly monitoring, such as your A1C, blood glucose levels, and blood pressure. 

In addition to managing your diabetes, we can help assess your risk for cardiovascular disease so that we can best determine your treatment.  

Heart Disease Prevention at TD&E

At Texas Diabetes and Endocrinology, we conveniently offer cardiovascular risk assessment testing in our clinics which includes: 

  • Advanced Lipid Test: this diagnostic evaluates more than traditional testing (cholesterol, LDL & HDL) in order to measure abnormal lipid levels that are often missed 
  • Coronary Artery Calcium (CAC) Test: this is a non-invasive procedure similar to an X-ray that detects calcium/plaque in the arteries that feed your heart which can help diagnose coronary artery disease before showing signs or symptoms 

Our physicians and advanced practice providers are trained in lipidology and have extensive experience in treating cholesterol disorders. 

Contact Us Today to Learn about Managing Diabetes and Preventing Heart Disease 

If you’d like to schedule an appointment with Texas Diabetes and Endocrinology and discover how our diabetes treatment and heart prevention services can help you, 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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