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Donna Pacheco

Diabulimia in Type 1 Diabetes: The Warning Signs Clinicians Often Miss

Young woman with type 1 diabetes appearing emotionally distressed beside diabetes supplies and healthy food, representing warning signs associated with diabulimia treatment challenges.

Patients with type 1 diabetes already face the daily burden of balancing insulin, food intake, exercise, and glucose monitoring. However, for some individuals, insulin becomes more than a treatment tool. It becomes a method for weight control. This dangerous behavior, commonly referred to as diabulimia, involves the intentional restriction or …

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Why Oral Health Is Becoming Part of Diabetes Management

Dental professional examining healthy gums beside a glucose monitor to illustrate the connection between oral health and diabetes management.

A bleeding gumline might seem like a minor dental issue, but researchers are increasingly finding that it can signal much more than a need to floss. Chronic inflammation inside the mouth may influence blood sugar control, cardiovascular health, and even long-term diabetes outcomes. As evidence continues to grow, healthcare providers …

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Misdiagnosed as Type 2? Why We Need to Screen More Adults for LADA

Doctor explaining LADA diabetes screening to an adult patient previously diagnosed with type 2 diabetes during a clinical consultation.

Up to 10% of adults diagnosed with type 2 diabetes may actually have Latent Autoimmune Diabetes in Adults (LADA), yet many cases remain undetected for years. Because symptoms often develop slowly, LADA is frequently mistaken for traditional type 2 diabetes. However, the wrong diagnosis can delay insulin therapy, worsen glucose …

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Extreme Heat and Diabetes: Why Clinicians Are Paying Closer Attention

Diabetes supplies and water bottle exposed to extreme summer heat during a climate change-related heat wave

Extreme heat is no longer a rare seasonal inconvenience. Across the globe, heat waves are becoming longer, more frequent, and more dangerous. For people living with diabetes, rising global temperatures and more frequent heat waves can create serious health risks that many patients may not fully understand. As discussions about …

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Diabetes and Fracture Risk: Why Bone Health Is Becoming a Bigger Clinical Concern

Bone model beside a glucose meter illustrating the connection between diabetes and fracture risk

People living with diabetes already face challenges related to blood sugar, cardiovascular disease, kidney health, and nerve damage. However, another issue is now gaining attention among healthcare professionals: bone health. Research continues to show that patients with diabetes have a higher risk of fractures, falls, and long-term mobility problems, even …

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Managing Diabetes Around Organ Transplant Surgery: What Clinicians Need to Know

Medical team performing organ transplant surgery with glucose monitoring tools, immunosuppressive medications, and diabetes management equipment in a hospital setting.

The management of diabetes during organ transplantation has become a growing clinical challenge. As transplant programs expand and survival rates improve, more patients are living with complex metabolic complications before and after surgery. One of the most important concerns is post-transplant hyperglycemia, which can affect patient outcomes at nearly every …

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Ultra-Rapid Insulin and Automated Delivery: Are Mealtime Boluses Becoming Less Critical?

Person using an automated insulin delivery system with ultra-rapid insulin during a meal while monitoring glucose levels on a smartphone app.

For years, diabetes care has relied on one key rule: insulin should be given before meals whenever possible. Yet many people living with diabetes still struggle with timing. Busy schedules, unpredictable eating habits, and delayed dosing often lead to postprandial glucose spikes. Now, with the rise of ultra-rapid insulin AID …

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Why More Diabetes Patients Are Being Referred for Sleep and Circadian Evaluations

Older diabetes patient using CPAP therapy during sleep with glucose monitor and circadian health graphics illustrating sleep and diabetes care.

Poor sleep does more than leave people tired the next day. For many individuals living with diabetes, disrupted sleep may quietly worsen glucose control, increase cardiovascular risk, and complicate long-term metabolic health. As research continues to uncover the close relationship between sleep and metabolic function, more healthcare providers are referring …

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Can Muscle Quality Predict Diabetes Outcomes Better Than BMI?

Man performing resistance training with muscle anatomy overlay, glucose monitor, and healthy meal representing muscle quality and diabetes health.

For decades, body mass index (BMI) has been the standard tool for assessing metabolic health and diabetes risk. However, many clinicians now question whether weight alone tells the full story. Some people with a “normal” BMI still develop insulin resistance and type 2 diabetes, while others with higher body weight …

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The New Diabetes Workforce Problem: Who Will Manage the Growing Number of Complex Patients?

Overworked diabetes specialist in a busy endocrinology clinic facing patient backlog and workforce shortages

As diabetes rates continue to rise across the United States, another healthcare challenge is becoming harder to ignore: the diabetes workforce shortage. While new medications, continuous glucose monitors, and AI-supported tools are changing care, many patients still struggle to find specialists who can help them manage complex treatment plans. This …

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