SGLT inhibitors have changed the treatment landscape for cardiovascular and kidney disease, particularly in people with type 2 diabetes, heart failure, and chronic kidney disease. That success raises an obvious question: why are SGLT inhibitors in type 1 diabetes still largely outside routine clinical practice? The answer is not a …
Read More »Beyond A1C: Can CGM Help Prevent Severe Hypoglycemia and DKA?
Continuous glucose monitoring has changed how clinicians and people with diabetes think about glucose control. Yet the next question is more important than whether CGM improves A1C or Time in Range. Can it prevent events that send patients to the emergency department or hospital? Growing evidence suggests that CGM may …
Read More »The Hidden Hyperglycemia Trigger: When Dehydration Makes Blood Sugar Worse
For people with diabetes, an unexpected glucose spike may have a less obvious cause than food or missed medication. Dehydration and high blood sugar can create a self-reinforcing cycle. When the body loses too much fluid, glucose becomes more concentrated in the bloodstream. At the same time, rising glucose can …
Read More »Normal Blood Sugar, But Still in DKA? The Hidden Danger of Euglycemic Ketoacidosis
Euglycemic diabetic ketoacidosis can challenge one of the most familiar clinical shortcuts in diabetes care: DKA should come with markedly elevated glucose. In patients taking sodium-glucose cotransporter 2 (SGLT2) inhibitors, however, dangerous ketoacidosis may develop while glucose remains normal or only modestly elevated. As a result, euglycemic DKA in patients …
Read More »Fasting or Random Glucose Testing? Navigating the New Rules for Cancer Therapy–Induced Hyperglycemia
As cancer treatment becomes increasingly sophisticated, clinicians are encountering a growing metabolic challenge. Cancer therapy–induced hyperglycemia has emerged as an important concern with the expanding use of immunotherapies and targeted therapies. In some patients, hyperglycemia develops gradually. In others, particularly those receiving immune checkpoint inhibitors, severe diabetes and diabetic ketoacidosis …
Read More »What Really Happens When Patients Stop Insulin Without Telling Their Doctor?
For many people living with diabetes, insulin is more than a medication—it is a lifeline. Yet despite its critical role, some patients stop taking insulin without informing their healthcare provider. The reasons vary widely and may include medication costs, treatment fatigue, fear of side effects, weight gain concerns, or misunderstandings …
Read More »Fasting With Diabetes: How Clinicians Can Reduce Hypoglycemia and DKA Risk
Patients with diabetes are increasingly exploring fasting for religious, cultural, and metabolic health reasons. From Ramadan observance to intermittent fasting trends, many individuals choose to abstain from food and fluids for extended periods despite potential risks. For clinicians, this creates an important challenge. Simply advising patients not to fast often …
Read More »Diabulimia in Type 1 Diabetes: The Warning Signs Clinicians Often Miss
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 …
Read More »Continuous Ketone Monitoring Is Coming Fast: Can It Actually Reduce Outpatient 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 …
Read More »Continuous Ketone Monitoring in Hospital Care: Could It Improve DKA Management?
Diabetic ketoacidosis remains one of the most serious complications of diabetes, yet managing it often relies on intermittent data points. What if clinicians could see ketone levels change in real time instead of waiting hours between lab tests? Continuous ketone monitoring for DKA is now emerging as a promising concept …
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