menopause and diabetes
What should you know about menopause and diabetes?

There’s no doubt that cases of diabetes are on the rise. In fact, experts predict that by the year 2050, one in every three adults in the United States could suffer from this chronic disease that disrupts hormones, affects how the body reacts to food and sugars (glucose), and can lead to obesity, heart disease and stroke if not managed properly.  

At Texas Diabetes & Endocrinology (TD&E), our board-certified endocrinology experts treat diabetes, along with other endocrinology disorders like osteoporosis, every day. 

One group in particular that is experiencing an uptick in diabetes diagnoses is menopausal women.  During menopause, estrogen levels decrease (because of diminishing ovarian reserves) which can cause weight gain leading to potential insulin resistance and difficulty metabolizing glucose. 

New research now shows that Type 2 Diabetes (T2D) is one of the most common health risks associated with postmenopausal women (up to age 55 years). 

This particular study evaluated 2,295 postmenopausal women and surveyed them and their propensity towards diabetes via blood tests, physical exams and measurements, and in-person interviews. 

Here’s what was found:

  • Lower levels of the hormones estrogen and progesterone are key factors in contributing to more cases of T2D in women over the age of 40
  • The prevalence of T2D increased in women with a greater BMI (Body Mass Index) and also elevated cholesterol levels 
  • Mood swings and hot flashes associated with menopause can cause poor sleep which is also a contributing factor to obesity, and therefore diabetes 

One of the most important things women can do to prevent diabetes brought on by menopause is to get screened.

“In support of recommendations by the American Diabetes Association, we suggest getting tested for diabetes every three years after the age of 45 if you are overweight or have a family history of the disease,”  says TD&E board-certified endocrinologist and diabetes expert Dr.  Jean Chen.

“Additionally, adopting a healthy lifestyle including eating a well-balanced, low fat and low cholesterol diet, and exercising regularly incorporating weight-bearing workouts can go a long way in helping to prevent diabetes as women approach menopause and this transitional phase in life.”

Diabetes Treatment for Women in Menopause 

Hormone Therapy (HT), or hormone replacement therapy and estrogen supplements, is the standard treatment for women experiencing severe menopausal symptoms. HT can help balance and regulate hormones which are depleted and improve symptoms like hot flashes, help with insulin function, and decrease the potential for developing diabetes. 

HT has also been shown to reduce the risk of osteoporosis (weakened bones), another common condition as women reach menopause. 

At TD&E, we offer individualized treatment plans to help effectively manage your diabetes through tools like weight management and insulin pumps.  We also provide extensive treatment options for osteoporosis and fracture prevention.  

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.

Overcoming the Odds: T2D Patient’s Journey to Marathon Success

Adopting the philosophy of ‘mind over matter’ can have a powerful impact on many aspects of life. In many instances of illness or injury, people can often conjure up herculean efforts to boost their physical and mental well-being, alongside therapeutic intervention, to overcome a medical or health challenge. 

This is something that our 52-year-old patient Bhushan Karle was able to accomplish when he transitioned from living with type 2 diabetes (T2D) heavily reliant on medication and insulin to taking charge of his health and becoming a marathoner who now needs minimal medications.

Bhushan’s Story 

Bhushan was diagnosed with T2D in his early thirties. His parents also had diabetes, and he remembers them needing heavy doses of insulin while growing up in India. 

His initial reaction to the diagnosis was one of disappointment in himself for not taking better care of his health after seeing how his parents suffered from this condition.  Bhushan’s first treatment involved a combination of insulin and many pills until he met Texas Diabetes endocrinologist and diabetes specialist Dr. Keta Pandit.

She re-evaluated him and explored a variety of medications before eventually weaning him off of an insulin pump due to complications.

Taking Control of his Health 

Once he got off his pump, Bhushan made a conscious decision to radically shift his mindset and take better control of his health. This started with making small efforts at first, like getting back into sports that he always loved as a child. Regular exercise is highly beneficial for those with diabetes to help regulate blood sugars levels and maintain a healthy weight and blood pressure. 

Although his initial goal to exercise more was a step in the right direction, it wasn’t resulting in the changes he wanted to see. He was able to lower his A1C, but it still was not decreasing as much as he had hoped to make a significant difference. 

Adopting a Running Regimen 

Deciding that he wanted to be more aggressive with his physical activity, Bhushan started running with a group of friends in his community.

With this group, he was inspired to run a marathon, like the many others who were a part of it.  He enlisted the help of a coach, Dr. Mohan Achwal, who armed Bhushan with a spreadsheet to track his training and food intake. As a data analyst, this method really spoke to him and motivated Bhushan to chart and follow through with his progress. 

One big hurdle that Bhushan encountered while training for the marathon was not knowing what to eat. Runners need plenty of carbohydrates to fuel their training, but carbs can be dangerous for people living with diabetes and maintaining healthy AIC levels. 

Dr. Pandit, a runner herself, reminded Bhushan that his first intention to become a runner was to find a sustainable exercise plan that could support his lifestyle and help him control his diabetes. She encouraged him to avoid over training and fuel his body while keeping in mind that his pancreas will not respond to high carb meals the way his fellow runner friends’ do. 

“While insulin resistance improves with weight loss and exercise, beta cell function from pancreas doesn’t recover to a point where high carb meals can be consumed without close attention to glucose levels,” explains Dr. Pandit. “I encouraged him to candidly share with his friends that his plans will vary given his health condition and limitations.”

Bhushan took that advice to heart and found his own journey empowering rather than a limitation to his goals. His mindset shifted and his physical and mental endurance improved.

He eventually ran his first half-marathon in 2023 and completed his first full marathon in 2024. 

Bhushan shares that having Dr. Pandit and the staff at Texas Diabetes support helped encourage him along the way.  

“A doctor who empathizes with patients and an office that is collaborative is very important to have as part of your team,” he says. 

Supporting Your Goals 

Bhushan believes that anyone can make lifestyle changes with the right mindset. Tips that he offers for anyone with diabetes who wants to make an impactful change on their condition, which could mean the difference between taking insulin or not, are to:

  • Make eating bad/unhealthy food difficult or out of reach
  • Enlist a partner in your health and fitness goals to keep you accountable 
  • Find a coach to help guide you through your health/fitness journey
  • Replace regular bread with better options such as those that are low-glycemic, or made with whole or sprouted grains 
  • Start gradually, even if it is only walking, and add more intensity from there 

Dr. Pandit recommends finding a diet and exercise plan that is sustainable and enjoyable so that it does not feel like a chore. 

“To commit to a full lifestyle change, I encourage my patients to take an inward journey to find what truly brings them joy when it comes to an exercise plan – biking, hiking, running, yoga, pilates, gym memberships, group training and fitness plan, swimming, or joining a sport team,” she says. 

“The goal is to find something for fitness that is enjoyable, not to win a race or a medal,” shares Dr. Pandit. “Living with diabetes and achieving that level of lifestyle change is a medal.”   

Today, Bhushan has made such huge strides in staying active and eating well that his diabetes maintenance is minimal, and he has in effect, reversed many of the most serious side effects of his condition.  He currently works closely with Dr. Pandit and uses a continuous glucose monitor (CGM) to watch his blood sugar levels and maintain his life goals. 

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.

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.

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