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Donna Pacheco

Are Wearables Redefining Prediabetes — or Over-Medicalizing It?

Person using wearable glucose monitoring technology and smartphone app to track metabolic health and prediabetes risk

Prediabetes has traditionally been diagnosed during annual physical exams through fasting glucose tests or A1C measurements. However, new diabetes prevention tools and wearable technologies are rapidly changing that model. Today, wearable devices, continuous glucose monitors (CGMs), and predictive metabolic tracking tools are giving people real-time insight into their glucose patterns …

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Why Early Combination Therapy Is Gaining Momentum in Young-Onset Type 2 Diabetes

Young adult managing early-onset type 2 diabetes with CGM technology, healthy lifestyle habits, and combination therapy medications.

Young adults diagnosed with type 2 diabetes early in life often face a more aggressive disease course than older adults. While metformin has long served as the standard first-line therapy, many clinicians are now reconsidering whether a “metformin-first and wait” strategy is enough for this higher-risk population. As research continues …

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Can AI Eye Exams Expand Diabetic Retinopathy Screening Access?

ai-diabetic-retinopathy-screening-eye-exam

Diabetic retinopathy remains one of the leading causes of preventable blindness worldwide. Yet despite clear screening guidelines, many patients with diabetes still miss their annual retinal exams. Busy schedules, limited specialist access, transportation barriers, and lack of awareness often delay diagnosis until vision changes become permanent. As healthcare systems search …

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Cancer Therapy Is Changing Diabetes Management: What Clinicians Need to Know Now

Doctor discussing diabetes oncology care with a cancer patient while reviewing glucose monitoring and immunotherapy-related hyperglycemia risks.

Cancer treatment is evolving rapidly, and with that progress comes a new challenge for clinicians managing glucose disorders. As immune checkpoint inhibitors (ICIs) and PI3K inhibitors become more widely used in oncology, therapy-related hyperglycemia is appearing more often in clinical practice. Many patients receiving cancer treatment now face unexpected glucose …

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Continuous Ketone Monitoring Is Coming Fast: Can It Actually Reduce Outpatient DKA Risk?

Patient wearing a continuous ketone monitoring sensor while reviewing real-time glucose and ketone data on a smartphone app designed to help detect rising DKA risk.

New advances in diabetes technology are moving beyond glucose alone. While continuous glucose monitoring transformed diabetes management over the last decade, wearable ketone monitoring systems are now emerging as the next major innovation. Researchers, device manufacturers, and international diabetes organizations are increasingly focused on whether real-time ketone data can help …

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The FDA’s New Insulin Switching Rules: What Interchangeable Biosimilars Mean for Diabetes Care

Insulin pens beside an FDA symbol and prescription form representing interchangeable insulin biosimilars and pharmacy-level insulin switching in diabetes care.

A patient arrives at the pharmacy expecting their usual insulin refill, only to discover the box, brand name, and pen device suddenly look different. The pharmacist explains that the medication is an interchangeable biosimilar approved for automatic substitution. Although the insulin is considered clinically equivalent, the unexpected switch can still …

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Treatment Complexity in Type 2 Diabetes: When More Options Make Decisions Harder

Physician reviewing multiple Type 2 diabetes medications and treatment options during a patient care consultation

Managing Type 2 diabetes used to follow a relatively predictable path. Clinicians often started with metformin and added medications gradually as glucose control worsened. Today, however, diabetes care looks very different. The number of available therapies has expanded rapidly, and while that growth has improved patient outcomes, it has also …

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The Diabetes Diagnosis Gap: Are We Missing Patients Who Don’t Fit Classic Risk Profiles?

Doctor reviewing a patient for possible diabetes misdiagnosis using diagnostic tools in a clinical setting

Diabetes screening has improved over the last two decades, yet many patients still fall through the cracks. While clinicians often rely on traditional risk models that focus on obesity, age, family history, and sedentary lifestyle, not every patient with diabetes fits that familiar picture. As a result, many diabetes cases …

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When A1C Improves but the Patient Doesn’t: Rethinking What “Good Control” Really Means

Older woman with diabetes reviewing improved A1C results while appearing fatigued and emotionally overwhelmed at home

Improving hemoglobin A1C has long been considered the gold standard in diabetes care. However, many clinicians now question whether lower numbers always translate into healthier, happier patients. The growing debate over how A1C levels relate to real-world diabetes outcomes highlights an important issue in modern medicine: a patient can achieve …

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When GLP-1 Therapy Plateaus: What Clinicians Should Do Next

Clinician reviewing patient progress during a GLP-1 plateau with metabolic trend chart on computer screen

Everything seems to be working perfectly until it suddenly isn’t. A patient is losing weight steadily, HbA1c levels are improving, and confidence is high during every follow-up visit. Then progress slows. The scale barely changes. Blood sugar readings stop improving. Patients start asking whether the medication has stopped working, while …

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