women with apple watch on wrist looking at screen
Wearable Devices and Your Health: Insights from Dr. Lucy Esteve

Wearable technology is becoming an increasingly popular way to monitor health — and for good reason. These devices offer valuable information that can help you better understand your body and make changes to support your overall health. 

We asked endocrinologist Dr. Lucy Esteve to share everything you need to know about using wearable devices to help achieve your metabolic health goals. 

Why are wearables important in the fight against diabetes?

Over one-third of the U.S. population has prediabetes, and 9 out of 10 people remain undiagnosed. That’s why there’s a pressing need for more widespread screening in the community to help prevent progression to diabetes and the complications that come with it. Wearable devices give us an opportunity to engage patients in their own health and help them make informed changes.

What types of wearable devices are available, and what do they track?

Wearables are non-invasive biometric sensors worn on the body and used worldwide for personalized health monitoring. Think of devices like the Apple Watch, Fitbit, Garmin, and Oura Ring. They generate objective data such as step count, calories burned, sleep patterns, and physiological stress. That immediate feedback can be leveraged to improve glycemic control, encourage self-care, and boost self-efficacy.

Can wearables measure blood sugar?

It’s important to know that, as of yet, smartwatches in the U.S. are not FDA-approved for detecting glycemic dysfunction and don’t provide reliable, real-time glucose levels. However, continuous glucose monitors (CGMs) are minimally invasive wearables that are FDA-approved for managing diabetes and they’ve truly revolutionized how we detect and address blood sugar issues.

What’s new in CGM technology?

We now have over-the-counter CGMs like Abbott’s Lingo and Dexcom’s Stelo. These are designed for people who want to track their metabolic health even without a diabetes diagnosis and do not require a prescription. They allow users to monitor trends in blood glucose rather than single data points like a lab draw, and data can even be shared with healthcare professionals via apps like Dexcom Clarity.

Are there limitations to these devices?

OTC CGMs can be costly, and they only measure glucose levels (they don’t provide additional biometric data). They also don’t have high or low glucose alerts, and accuracy can vary within an acceptable range. Finally, not all of them are integrated into electronic health record systems, which can make clinical workflow more challenging.”

Can you share an example of when CGM technology made a difference for a patient?

A patient in her 40s came to see me for evaluation of intermittent episodes of anxiety, shakiness, palpitations, dizziness, fatigue, and weight gain despite a healthy lifestyle. Her extensive cardiac work-up (EKG, stress testing and echocardiogram) and psychiatric evaluation (for anxiety disorder) were normal, and even her fingerstick glucose checks looked fine. We decided to try a CGM for two weeks, and she carefully logged her meals, symptoms, and exercise. When we reviewed the data together, we found she was having rapid blood sugar spikes after higher-carb meals, followed by quick drops — typical of reactive hypoglycemia. By simply adjusting her diet and adding more frequent high-protein snacks every 2–3 hours, her symptoms improved dramatically.

The Bottom Line

Wearable devices are powerful tools that can help patients and healthcare providers work together toward better health outcomes. As Dr. Esteve explains, they are not a replacement for medical evaluation, but when used correctly, they can be a game-changer in understanding and managing your health.

Consult with an Endocrinologist in Austin, TX

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

pre diabetes
Can you reverse prediabetes? 

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.

reduce prediabetes risk
How to Reduce Your Prediabetes Risk

Prediabetes is a condition where blood sugar levels are higher than normal, but not high enough to be clinically diagnosed as type 2 diabetes. Prediabetes can have serious side effects including an increased risk of heart disease and stroke. 

There is consistent evidence that shows the relationship between blood glucose and cardiovascular risk extends into the prediabetes range. While there is not as much evidence that shows treating mild hyperglycemia (prediabetes) reduces risk for these complications, treating prediabetes can help prevent or delay diabetes onset and preserve insulin production function.

What is the Data?

It is estimated that 37.3 million people (11.3% of the US population) have type 2 diabetes. However, 96 million people over the age of 18 are estimated to have prediabetes (which is 38% of the adult US population) and 26.4 million people with prediabetes are over the age of 65. Overall, approximately 25% will progress to diabetes over the next 3-5 years.  

Recent Research

A recent study indicated that about 5 percent of people diagnosed with prediabetes will develop type 2 diabetes within a year. Early intervention of lifestyle changes – such as diet and exercise – can help reduce your risk. Dr. Lindsay Harrison recently discussed this research with Healthline, saying, “The benefits of intervention persisted over 10 years after the start of the study. There is evidence that reverting to normal glucose even briefly had a long-term reduction of progression to diabetes. Overall, lifestyle intervention is both effective and cost-effective. Although lifestyle changes have not been shown to reduce morbidity or mortality thus far, lifestyle changes are generally beneficial and do not have adverse effects.”

There have been several other studies in the prediabetes population which show that changes in lifestyle slow the progression to diabetes.  For example, the Diabetes Prevention Program (DPP) found that intensive lifestyle and metformin interventions reduced the cumulative incidence of diabetes by 58 and 31 percent respectively compared to placebo. The study found lifestyle changes to be particularly effective for individuals over age 60, while metformin was more effective in individuals younger than age 60.

Reduce Your Risk

As you can see, lifestyle changes are a big factor in reducing your risk developing type 2 diabetes after being diagnosed with prediabetes. Some steps you can make include:

  • Develop healthy eating habits
  • Incorporate additional exercise into your routine 
  • Quit smoking

If you’re looking to start making some of these lifestyle changes, we can help! Our NextStepMD program is designed to help our patients lose weight, maintain weight loss, and gain better control of their health. Our medically supervised program is for our patients with diabetes, but is also open to patients who have prediabetes or don’t have diabetes at all. Our weight loss strategies include the use of nutrition education, diet and exercise plans as well as FDA-approved weight loss medications if necessary.

If you’d like to learn more about our full range of diabetes services, please call Texas Diabetes and Endocrinology 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.