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Donna Pacheco

GLP‑1 Stewardship in the Clinic: Prioritizing, Deprescribing, and Switching Without Chaos

Medical concept featuring GLP-1 medication, injection pens, stethoscope, and clinic policy checklists on a desk

What happens when a breakthrough therapy becomes too popular for its own good? Clinics across the country are struggling to manage demand for GLP‑1 receptor agonists amid soaring prescriptions, medication shortages, and shifting insurance coverage. Without a strategy, patients fall through the cracks—and providers are left making chaotic case-by-case decisions. …

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GLP‑1s on the WHO Radar: Turning Global Guidance Into Everyday Prescribing

GLP‑1 medication pen and stethoscope on a world map with WHO logo in background

What happens when a once-costly, class-specific treatment becomes a global health priority? That’s the question raised by the World Health Organization’s latest move: recognizing GLP‑1 receptor agonists as essential medicines and issuing new recommendations for their use in obesity and diabetes care. These updated GLP‑1 WHO guidelines are more than …

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Oral and Long‑Acting GLP‑1s: What They Mean for Adherence and Follow‑Up

GLP‑1 pill bottle, injection pen, and patient chart on a doctor’s desk during a consultation

What happens when medications become easier to take—but harder to track? Oral and monthly GLP‑1 therapies promise fewer injections and less hassle, yet they may also create blind spots in patient care. As these long‑acting options reshape diabetes treatment, they’re also changing how clinicians must think about follow‑up, side effect …

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GLP‑1s for PAD: Using Incretins to Protect Limbs as Well as Hearts

Medical depiction of GLP‑1 treatment for peripheral artery disease showing a highlighted leg artery, GLP‑1 injection, and blocked artery inset.

Peripheral artery disease (PAD) affects millions of people with type 2 diabetes worldwide, increasing the risk of cardiovascular events and limb loss. With recent research into incretin‑based therapies, particularly glucagon‑like peptide‑1 receptor agonists (GLP‑1s), clinicians are asking whether these drugs can improve outcomes in PAD patients treated with GLP‑1s, beyond …

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Aiming for MASH Resolution: How to Use GLP‑1s in Liver‑First Diabetes Care

A doctor holding a liver model with GLP-1 injection tools, healthy food, and a glucometer, symbolizing GLP‑1 MASH treatment in diabetes care.

What if the key to resolving both diabetes and liver disease lies in a single therapeutic approach? As rates of metabolic dysfunction-associated steatohepatitis (MASH) rise among people with type 2 diabetes, many clinicians are rethinking how they prioritize treatment. Rather than treating glucose and liver health in silos, combining therapies …

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GLP‑1s in Type 1 Diabetes With Obesity: When Do the 2026 Rules Say “Yes”?

A woman with type 1 diabetes and obesity consults with her doctor about GLP‑1 therapy, with insulin and diabetes tools visible.

Imagine managing type 1 diabetes and still gaining weight despite careful insulin use, exercise, and carb counting. That’s the frustrating reality for many people living with T1D and obesity. While insulin is life-saving, it can also promote weight gain, making the balance between glucose control and healthy weight even harder. …

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AI for Insulin Management: Letting Algorithms Help—Without Handing Over the Wheel

AI-driven diabetes tools including CGM sensor, smartphone displaying glucose data, and insulin pump with a digital brain hologram representing AI analysis.

Artificial intelligence (AI) is transforming many aspects of diabetes care, and smart insulin management powered by AI is quickly becoming one of its most promising innovations. Tools that read continuous glucose monitor (CGM) data and suggest insulin changes are rapidly entering clinical use. But while these tools are powerful, they …

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GLP‑1s in Menopause: Using Incretins to Protect Cardiometabolic Health in Midlife

Middle-aged woman smiling in a medical office, holding a medication bottle to represent GLP‑1 therapy during menopause.

Menopause marks a major transition in a woman’s life, defined not only by the end of menstrual cycles but also by profound hormonal and metabolic changes. One often under‑recognized shift is the acceleration of cardiometabolic risk. Women in midlife frequently experience increased central adiposity, changes in glucose regulation, rising blood …

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GLP‑1s and Bone Health: Do Incretins Protect or Put Patients at Risk?

Illustration showing a glowing skeleton, GLP‑1 medications, porous bone models, and a balance scale highlighting bone health risks.

Glucagon‑like peptide‑1 receptor agonists (GLP‑1 RAs) have transformed type 2 diabetes management by improving blood sugar control and promoting weight loss. Yet as clinical use grows, so does interest in how GLP‑1 medications affect skeletal health — particularly their impact on bone density, remodeling, and fracture risk. This article unpacks …

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