nonalcoholic fatty liver disease
T2D and Non-Alcoholic Fatty Liver Disease (NAFLD)

Diabetes is a serious condition that not only causes hormonal and blood sugar imbalances, but can also damage nerves, blood vessels and other organs. Common side effects of diabetes include poor circulation, non-healing foot and leg ulcers, vision loss, kidney damage and liver disease.  

At Texas Diabetes & Endocrinology (TD&E), our board-certified endocrinology experts treat diabetes and help with the many other issues that coincide with it, like Non-Alcoholic Fatty Liver Disease (NAFLD). 

Here’s what you should know about the liver and diabetes related NAFLD…

The liver performs many functions including helping to regulate blood sugar levels, making vital proteins, and filtering toxins and chemicals from your blood. The liver can be damaged by alcohol, hepatitis, autoimmune diseases but much more commonly from fat accumulation which is called NAFLD.  

NAFLD can lead to serious complications such as liver cirrhosis, or scarring that could cause potential liver failure. 

Research shows that up to 70% of those living with type 2 diabetes (T2D) also have NAFLD. 

How is NAFLD diagnosed?

NAFLD is usually asymptomatic.  There are blood tests that can suggest the diagnosis but the best non-invasive test isa dedicated screening called FibroScan.  

TD&E is one of the only endocrinology clinics in Austin to offer this innovative diagnostic test to closely examine the liver. FibroScan uses ultrasound imaging to assess liver tissue and can quantify fat accumulation and the degree of liver damage., 

If you have T2D and abnormal liver labs or other risk factors such as obesity or high cholesterol your endocrinologist may suggest a FibroScan to assess your liver health. 

How do you treat NAFLD? 

While there currently is no cure for NAFLD, the same healthy lifestyle changes recommended to help manage diabetes can also help to slow, or even reverse, liver damage and decrease fatty buildup, including:

  • Maintaining a healthy weight, or losing weight if overweight or obese
  • Eating a well-balanced diet to lower high cholesterol levels 
  • Staying physically active and aiming for at least 150 minutes of exercise per week
  • Controlling your diabetes and blood glucose levels as directed by your endocrinologist
  • Avoiding alcohol or consuming in moderation

If you are living with T2D and have other risk factors for NAFLD, speak with your physician about getting screened. 

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.

What’s the link between osteoporosis and the gut biome? 

May is Osteoporosis Awareness Month. This condition, marked by severely weakened bones, is one that our board-certified endocrinologists treat daily here at Texas Diabetes & Endocrinology (TD&E).

While it is commonly known that calcium helps to strengthen bones and protect against osteoporosis, new research shows that good gut health (or the gut biome) can also play a large role in osteoporosis prevention and boosting bone density (the amount of minerals stored in bones to make them strong). 

The gut biome is the complex mix of microorganisms that live in the body’s intestines and helps with immunity and food processing. 

What is the connection between osteoporosis and the gut biome? 

new study recently published strongly supports previous findings that a healthy gut biome can in fact improve bone density and help protect against osteoporosis.  This important connection between the gut biome and the body’s bones is known as the gut-bone axis. 

Data shows that eating fruits and vegetables high in Vitamin C can increase production of the bone-making cells that protect them from weakening, or possibly fracturing and breaking, which is typically associated with osteoporosis. This conversion of Vitamin C into powerful bone-boosting cells takes place in the gut. 

Research also continues to show that foods rich in calcium (like dairy products) and high in protein (lean meats and legumes) help to fortify bones and keep them strong. 

Additionally, tracking certain types of bacteria that exist in the gut biome, and then supplementing with lacking bacteria known to boost bone-making cells, may become an increasingly more common option for osteoporosis prevention.  This can be facilitated by a physician recommending a mix of synbiotics (probiotics combined with prebiotics) to promote healthy bacteria in your gut biome.

According to TD&E endocrinologist Dr. Mauli Shah, along with keeping your gut check in health, other ways you can help prevent osteoporosis are with “regular exercise (weight bearing or resistance exercises are best), and taking Vitamin D and calcium supplements.” 

When should you see a doctor for osteoporosis?

Dr. Shah offers the following recommendations for when you should visit a doctor, or endocrinology expert, regarding your risk for osteoporosis:

  • All women 65 years of age and older 
  • Post-menopausal women with certain risk factors, such as those who’ve had a previous fracture or been treated with steroids
  • People who have a family history of osteoporosis or hip fractures 
  • People with rheumatoid arthritis
  • Women who have entered premature menopause or men with low testosterone

Osteoporosis Treatment at Texas Diabetes

Our endocrinology and osteoporosis experts will help develop the right treatment plan for you to address your unique bone health needs. We typically recommend lifestyle modifications to start, like getting more exercise and eating well. Then we’ll determine what combination of dietary supplements, medications, and/or injections and IV infusions are best suited to protect and strengthen your bones. 

Contact Us to Help Manage your Osteoporosis, 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.

CGM
FDA Approves New OTC Continuous Glucose Monitor (CGM) 

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.

How ChatGPT helped one patient correct his diabetes misdiagnosis

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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