Author: Leslie Branon

pre diabetes
Can you reverse prediabetes? 
Posted on by Leslie Branon

Prediabetes occurs when your body gradually begins to poorly process glucose (or sugar). It is estimated that more than one in three Americans fall into this category, whether they are aware of it or not. Prediabetes can progress to type 2 diabetes when the body’s ability to regulate blood sugar continues to decline over time. A definitive type 2 diabetes diagnosis is confirmed following two abnormal fasting blood glucose levels or A1c tests.

At Texas Diabetes & Endocrinology, our team of board-certified endocrinology specialists are experts at treating diabetes in all its forms and stages. According to our endocrinologist Dr. Lucy Esteve, “one of the major risk factors for developing prediabetes is being overweight.”

Other common risk factors for prediabetes are an unhealthy diet, chronic sedentary lifestyle, high blood pressure, and genetics or a family history of diabetes. 

Typically, prediabetes is completely asymptomatic which is why it is so important to get screened if you have any of the risk factors above. Symptoms suggestive of diabetes include increased thirst or hunger, fatigue, frequent urination, numbness in the hands or feet, and slow-healing wounds. 

According to the American Diabetes Association, nearly 70% of people who are diagnosed with prediabetes go on to develop full-blown diabetes. 

This presents the question; can a diagnosis of prediabetes be reversed?

Can prediabetes be reversed? 

Many endocrinologists support that prediabetes can effectively be reversed through dedicated efforts and interventions such as improving diet and exercise. 

“Data has shown that with intensive lifestyle changes, with as little as seven percent weight loss, you are able to reverse diabetes and return your blood sugars to normal,” shares Dr. Esteve. 

What can you do to reverse prediabetes?

Losing weight, by eating healthy and exercising, is the most impactful measure you can take to try and reverse a prediabetes diagnosis. 

Dr. Esteve says that “when we are talking about dietary lifestyle interventions, we are talking about a low calorie, low fat whole food diet that avoids highly processed foods.”

Other things you can do to help in preventing prediabetes from advancing to diabetes include:

  • Staying hydrated (as water helps to maintain healthy glucose levels), and opting for clear, unsweetened beverages as often as possible
  • Reducing stress since stress can trigger the release of cortisol, a hormone that leads to insulin resistance 
  • Limiting alcohol consumption
  • Stop smoking 

How can TD&E help you in reversing your prediabetes?

Texas Diabetes offers our patients comprehensive weight loss management counseling which entails nutrition education, diet and exercise plans as well additional support through FDA-approved weight loss medications as needed. 

Contact Us to Help Manage your Diabetes, Osteoporosis 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.

Clinical Trial Offers HypoPARA Patient New Lease on Life
Posted on by Leslie Branon

Life with hypoparathyroidism has been a challenging journey for a Texas Diabetes patient,
who for the purposes of this blog will be referred to as “the patient”. Diagnosed at the age of
23 after their parathyroid glands were removed during thyroid cancer surgery, the 54-year old
Frisco resident has lived with the condition for over three decades.

Hypoparathyroidism is a rare condition where the parathyroid glands, located near the
thyroid in the neck, produce insufficient amounts of parathyroid hormone (PTH). PTH plays
a critical role in regulating calcium, phosphorus, and vitamin D levels in the blood and
bones.

“When I was diagnosed, there was no treatment for the disease, just medications to
manage the symptoms,” the patient recalls. Over the years, they relied on an exhausting
regimen of medications—up to 64 pills a day, taken every three hours—to keep their
calcium levels stable and avoid severe symptoms. Despite their best efforts, they faced
over 200 hospitalizations due to low calcium levels.

In 2019, the patient learned about a clinical trial for TransCon PTH, a new hormone
replacement therapy designed to restore physiologic levels of PTH. After speaking with
their endocrinologist, they applied to participate in the trial the day it went live on
ClinicalTrials.gov.

Within a week, they were contacted by Texas Diabetes & Endocrinology Research team to
begin the screening process. “The first four weeks were spent getting my blood levels
optimized for the trial,” they explain. The staff at Texas Diabetes played a critical role in
guiding them through this phase. “They communicated frequently and really walked me
through the process. It felt like I was the only patient they were working with.”

After successfully completing the optimization phase, the patient began the daily
injections, not knowing at the time if they were receiving the actual drug or a placebo.
Although the treatment regimen wasn’t easy at first, the team at Texas Diabetes was there
to support them.

Seeing Results

Soon, the patient experienced results beyond what they could have imagined – confirming
in their mind that they were receiving the actual drug. For the first time in decades, their
calcium levels stabilized, allowing themto gradually reduce and ultimately stop taking
daily pills.

“In less than six months of starting the trial, I was able to come off all my medications,”
they said. “I hadn’t been in range in over 30 years, and suddenly, I was.”

As their body adjusted to the new treatment, the symptoms that had plagued them for
years—numbness, tingling,muscle cramps, heart palpitations, fatigue and brain fog—
began to disappear.

“I didn’t realize how much brain fog I was living with until it lifted. I couldn’t remember the
names of everyday objects, and I would struggle to getmy thoughts out. But now, I feel like I
can think clearly again.”

Advocating for Change

With their newfound energy, the patient began volunteering for the HypoPARAthyroidism
Association, a nonprofit dedicated to raising awareness and support for those living with
the condition. Passionate about helping others, their volunteer work quickly turned into
accepting a position on the board and eventually a full-time role with the organization.

One of their proudest accomplishments is spearheading an Externally Led – Patient
Focused Drug Development meeting with the FDA for PTH.

“You can read about symptoms on a page, but that doesn’t tell you how it impacts
someone’s daily life,” they explain. “I wanted the FDA to understand how
hypoparathyroidism affects real people.”

The meeting brought together patients and experts to share their experiences with the FDA.

Looking Forward

The FDA approved TransCon PTH and it is expected to come to market in early 2025. The
patient is grateful to Texas Diabetes for applying to be an early access provider so they can
continue to take the medication while waiting for it to become available.

Reflecting on their decades long journey, the patient emphasizes the importance of clinical
trials in advancing treatment options for rare conditions. “There’s a misnomer that you only
do a clinical trial when it’s your last hope, but that’s not the case” they say. “The drug has
given me a chance at life again, and I can’t thank Texas Diabetes enough for giving me the
opportunity to feel like a new human being.”

The patient hopes their story will inspire others to consider participating in clinical trials
and raise awareness of the transformative power they hold. “If I had to do it all over again, I
would, in a heartbeat. It has been life changing.”

You can learn more about our research department and currently enrolling clinical trials here. Please feel free to contact us at (512) 334-3505, option 4, to speak to a recruiter about our enrolling studies.

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

Is it low blood sugar or anxiety ? 
Posted on by Leslie Branon

The body’s response to low blood sugar and its manifestation of anxiety are two separate things, but they are often confused and closely intertwined. 

Some common side effects that both low blood sugar (hypoglycemia) and anxiety share include sweating, shakiness, irritability, fast or irregular heartbeat, and lightheadedness. 

Low blood sugar typically stems from unhealthy eating habits (consuming high glycemic foods that cause a spike and then drop down in sugars), skipped meals, or from poorly managed diabetes. At Texas Diabetes & Endocrinology, our team of board-certified endocrinology specialists are experts at treating diabetes in all its forms. 

Anxiety is a common mental disorder that can result from a combination of factors like genetics, stress or trauma, and certain medications. Anxiety can also stem from an adverse reaction the body has to its own low blood sugar. 

One of our diabetes specialists, Dr. Lucy Esteve, shares insight on how you can differentiate low blood sugar from anxiety. 

 How can you tell if the symptom is a sign of low blood sugar versus anxiety?

The only way to tell if you truly have low blood sugar is to check your blood sugar level with either a blood glucose meter and perform a fingerstick glucose check, or by wearing a continuous glucose monitor (CGM) which measures interstitial glucose levels continuously over a period of 10 to 14 days.  

When using a glucose monitor, it is important to check this right at the time that you are experiencing symptoms. Hypoglycemia occurs when your blood sugar level drops below 70 milligrams per deciliter (mg/dL) and is considered severe when the level drops below 54 mg/dL.


How should you treat those symptoms? What if you aren’t sure of the cause?

If you detect  low blood sugar at home, you should treat it by consuming fast-acting carbohydrates such as 4 ounces of juice or regular soda, hard candies, or 15 grams of glucose tablets or gel. Follow this up with a long-acting carbohydrate such as a sandwich or biscuit and recheck your blood sugar level within 15 minutes.  Repeat this process until your blood sugar level is back within normal range.

The next step is to see a medical professional (either your primary care provider or an endocrinology specialist) to determine the cause of the low blood sugar.


What could be potential causes of low blood sugar? 

A helpful indicator to determine the cause of your low blood sugar is the timing of these symptoms in relation to food.  

Reactive hypoglycemia (or postprandial hypoglycemia) typically occurs within 3 to 4 hours of eating a meal high in carbohydrates such as pasta, pizza, potatoes, rice, bread or cake.

If you are experiencing low blood sugar symptoms overnight, this is suggestive of fasting hypoglycemia which occurs when the body is unable to maintain blood glucose levels during the fasting state. This can be caused by medications, alcohol, critical illness, liver dysfunction or tumors in the pancreas known as insulinoma. 

Dr. Esteve says that “because the symptoms of low blood sugar and anxiety often overlap, it is important to see a healthcare provider to differentiate these two conditions and to determine the best course of treatment.” 

Preventing Low Blood Sugar

To help prevent low blood sugar that could contribute to bouts of anxiety, whether you are diabetic or not, follow these tips:

  • Eat healthy portions of foods that are high in protein (like chicken, fish, nuts and beans) and non-starchy vegetables like spinach and broccoli
  • Exercise often to keep blood circulating effectively throughout the body and to trigger the release of endorphins or the brain’s feel-good chemical
  • Drink alcohol in moderation or limit it altogether to avoid blood sugar spikes 
  • Take all medications as directed and commit to regular check-up appointments with your primary care physician and specialists 

Contact Us to Help Manage your Diabetes, Osteoporosis 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.

How to Ease Holiday Travel with Diabetes 
Posted on by Leslie Branon

The holiday season is here, and with it comes the excitement of decorating, gift-giving, family, friends, food and possibly travel. While all of these things are what make the holidays the most special time of the year, they can also cause stress for some – especially those living with diabetes.

Holiday food indulgences and travel can be challenging with diabetes if you are not prepared, but they can absolutely be enjoyed if you take the time to plan ahead.

How can I travel during the holidays and still manage my diabetes effectively? 

Here are five tips for holiday travel from our team of board-certified endocrinologists at Texas Diabetes & Endocrinology: 

  • Check in with your physicians and endocrinologist and make sure that all your prescriptions are filled before you leave town.
  • Take care when packing your medications and bring extra supplies to have with you in case of a travel delay or an emergency (insulin, test strips, syringes, batteries for glucose monitors, etc.). If traveling by airplane, stash your medications in a carry-on bag so that they are easily accessible and not stuck in checked luggage if it’s lost.
  • Pack healthy snacks for your journey so that you do not have to rely on airport or rest  stop food that is typically full of added sweeteners, carbs, fats and sodium. Safe options that will help keep blood sugars low include hard-boiled eggs, sliced veggies or fruit, nuts, portable salads with grilled meats, or sandwiches on whole-wheat/low-carb bread or tortillas.
  • Once you have reached your destination, adjust the timing of your medications or injections to fit the new time zone you’ve arrived in, if applicable.  Set alarms for yourself on phones, smartwatches or Ipads so that you do not miss your scheduled dosages while enjoying your holiday activities. 
  • Test often to avoid any serious blood sugar highs or lows. Take into consideration your surroundings also and know that higher altitudes and cooler or warmer temperatures could have an effect on your readings.

Finally, remember to enjoy your trip and special time with family and friends! 

For information on how to safely navigate airport security with diabetes medications and medical supplies, visit the TSA/ U.S. Transportation Security Administration. 

Try new and festive foods in moderation and practice healthy portion control to avoid overindulging and unexpected spikes. More on smart eating tips for the holidays from TD&E can be found here.

Contact Us to Help Manage your Diabetes, Osteoporosis 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.

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