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Donna Pacheco

The Diabetes Warning Sign Hiding in Routine Liver Tests

Routine liver enzyme blood test alongside a glucose meter illustrating the connection between liver enzymes and diabetes risk.

Many people think of liver function tests as a way to detect liver disease. However, researchers are discovering that routine liver enzymes may also reveal important clues about future metabolic health. Understanding liver enzymes diabetes risk is becoming increasingly important because these commonly ordered blood tests may help identify people …

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The Postpartum Cliff: Why So Many Women With Gestational Diabetes Never Get Follow-Up Care

New mother holding her baby while reviewing postpartum diabetes follow-up reminders and glucose screening recommendations after gestational diabetes.

Postpartum screening after gestational diabetes is one of the most important yet overlooked steps in preventing future type 2 diabetes. Although blood glucose levels often return to normal after delivery, the long-term metabolic risk does not disappear. In fact, up to half of individuals diagnosed with gestational diabetes mellitus (GDM) …

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Could Your Smartwatch Detect Diabetes Before a Blood Test?

Person wearing a smartwatch displaying metabolic health data alongside a blood glucose meter, illustrating wearable diabetes screening technology.

For decades, diagnosing diabetes has depended on blood tests performed during routine medical visits. However, what if your smartwatch could recognize early warning signs before glucose levels become high enough for a formal diagnosis? Researchers are now exploring wearable technologies for diabetes screening that continuously analyze physiologic data collected throughout …

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Maxed Out on Medications, Not Ready for Surgery: Is Metabolic Endoscopy the Missing Middle Ground?

Physician performing a metabolic endoscopy procedure showing endoscopic treatment of the stomach and digestive tract for type 2 diabetes management.

For many people living with type 2 diabetes, treatment eventually reaches a frustrating crossroads. Despite multiple medications, including GLP-1 receptor agonists, SGLT2 inhibitors, and insulin, glycemic targets may remain difficult to achieve. Meanwhile, bariatric surgery can produce major metabolic benefits, but its invasiveness limits acceptance for many patients. This treatment …

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The Diabetes Complication Nobody Sees Coming: Cognitive Decline in Midlife Adults

Middle-aged adult with diabetes showing signs of cognitive decline, with brain health visualization and diabetes management tools representing the connection between diabetes and cognitive function.

For decades, diabetes care has focused on preventing complications such as retinopathy, nephropathy, neuropathy, and cardiovascular disease. Yet another complication may be developing much earlier and often without obvious symptoms: diabetes-related cognitive decline. While memory loss and dementia have traditionally been viewed as concerns of older age, growing evidence suggests …

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The First Disease-Modifying Treatment After a Type 1 Diabetes Diagnosis: Why Teplizumab Is Changing the Conversation

Pediatric endocrinologist discussing teplizumab treatment options with a family following a new type 1 diabetes diagnosis.

For decades, treatment after a type 1 diabetes diagnosis focused almost entirely on insulin replacement and blood glucose management. While advances in technology have improved care, clinicians have had few ways to address the autoimmune process driving beta-cell loss. That is beginning to change. With the FDA’s expansion of teplizumab-mzwv …

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New Diabetes Risk Factor Clinicians Are Paying Attention To: Loneliness

Middle-aged woman with diabetes supplies sitting alone at a table, illustrating the connection between loneliness and diabetes management.

When most people think about diabetes risk factors, they picture blood sugar levels, diet, exercise habits, or genetics. However, researchers and clinicians are increasingly focusing on another factor that may have a profound impact on health outcomes: loneliness. The connection between loneliness and diabetes is gaining attention as evidence continues …

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Is Diabetes Making People Age Faster? What the New Science Reveals

Split-face medical illustration showing a woman with youthful features on one side and advanced aging on the other, alongside DNA strands, a glucose meter, and cellular imagery representing accelerated biological aging in diabetes.

For decades, scientists have known that people with type 2 diabetes face a higher risk of heart disease, kidney disease, cognitive decline, and other age-related conditions. However, emerging research suggests these complications may be linked to something even more fundamental: accelerated biological aging in diabetes. In other words, diabetes may …

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Should Patients Still Be Using Flash CGM? Navigating the Shift to Real-Time Monitoring

Patient with a continuous glucose monitor reviewing glucose data on a smartphone while transitioning from flash CGM to real-time CGM technology.

As diabetes technology continues to evolve, clinicians are increasingly faced with an important question: should patients still be using flash continuous glucose monitoring (CGM), or is it time to switch to real-time CGM? While flash CGM systems have significantly improved glucose monitoring and patient engagement over traditional fingerstick testing, real-time …

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A Positive Type 1 Diabetes Screen Isn’t Always Equal: Why IA-2 Changes the Risk Calculation

Clinical illustration showing IA-2 autoantibody testing, type 1 diabetes risk assessment, blood sample analysis, and patient monitoring strategies used in islet autoantibody screening risk stratification.

As population-based screening for type 1 diabetes (T1D) becomes more common, clinicians increasingly encounter positive islet autoantibody results in children and adults who have no symptoms. However, not all positive screening results carry the same clinical significance. A single positive autoantibody may indicate elevated risk, yet the specific antibody detected …

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