Diabetes care

Hana Kahleova, MD, PhD, MBA

What personalized nutrition apps get wrong about glucose

November 9, 2026Nov 9, 20262

A patient without diabetes came in recently with her phone open to a chart. For three weeks, she had worn an over-the-counter glucose sensor and logged every meal in an app that promised a diet tuned to her biology. The app had flagged her morning oatmeal and her lentil soup as “spike foods,” so she had stopped eating both. Her labs were normal. What she wanted from me was permission …

Tirzepatide after bariatric surgery: what nobody asked me

November 2, 2026Nov 2, 2026

I have been a nurse for thirty-two years and have given hundreds of injections. In late September 2025, my GP, my primary care doctor here in Australia, sent me an electronic prescription for tirzepatide. I collected it from the pharmacy and gave myself the first injection. I did not read the leaflet. I knew how to give an injection, so I gave it.

Two days later, my tongue was sticking to …

The GLP-1 shortage ended. The adherence problem did not.

Danielle Lightsey, RPh

October 29, 2026Oct 29, 2026

For several years, glucagon-like peptide-1 (GLP-1) medications seemed to dominate conversations in community pharmacy. Patients called asking whether specific products were available, prescriptions were transferred between pharmacies, and pharmacy staff spent considerable time checking inventories and monitoring shortages. It was…

GLP-1 receptor agonists, including semaglutide (Ozempic and Wegovy) and …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Chronic illness at work: A CEO decided to stop hiding

Laura Syron

October 20, 2026Oct 20, 2026

The job of a CEO requires a lot of public speaking: on Zoom calls, at podiums, in board meetings. Pretty much every day you're delivering some kind of address or talking points. My role as CEO is no different; the…

The job of a CEO requires a lot of public speaking: on Zoom calls, at podiums, in board meetings. Pretty much every day you’re delivering some kind of address or talking points. My role as CEO is no different; the only difference is that my speech or presentation might get interrupted by the “beep-beep-beep” of my continuous glucose monitor (CGM) alerting me that my blood sugar has spiked or dipped.

I …

Chronic kidney disease can hide behind a normal blood test

Dr. Girishkumar Modi

October 12, 2026Oct 12, 2026

A normal creatinine result can be reassuring. But for someone with diabetes, high blood pressure, or another risk factor for kidney disease, it may answer only part of the question. Creatinine helps us estimate how well the kidneys filter blood. It does not tell us whether albumin, a protein normally kept in the bloodstream, is leaking into the urine. Before we describe a kidney assessment as complete, we should know …

Hunger after stopping tirzepatide can feel like burning

October 5, 2026Oct 5, 2026

When my hunger returned, it felt as though my stomach was burning from the inside out. It was acute, painful, and very physical. I pushed everything else aside and concentrated on getting rid of it. There was no negotiating with…

When my hunger returned, it felt as though my stomach was burning from the inside out.

It was acute, painful, and very physical. I pushed everything else aside and concentrated on getting rid of it. There was no negotiating with hunger that intense. My attention narrowed to what I could eat to make it stop.

I am a registered nurse with more than thirty years of clinical experience. I have had bariatric …

What did the tirzepatide study actually test?

Jeffrey Laman, MD

September 28, 2026Sep 28, 2026

If you take Ozempic, Wegovy, Mounjaro, or Zepbound, or you are simply trying to make sense of GLP-1s (glucagon-like peptide-1) and GIPs (glucose-dependent insulinotropic polypeptide), you may have seen a recent Medscape article asking whether GIP really adds any benefit in type 2 diabetes. It is a fair scientific question. The problem is that the headline makes the answer sound much clearer than it is.

The study behind the article, …

Hana Kahleova, MD, PhD, MBA

GLP-1 weight regain: We are funding the wrong half

September 1, 2026Sep 1, 2026

I have some version of the same conversation every week now. A patient is starting semaglutide or tirzepatide, and partway through the visit they ask the question I suspect most of us are hearing constantly: What happens if I ever…

For a while I gave the honest-but-incomplete answer, that we’d cross that bridge when we got there. I don’t anymore, because I think the real answer has less to do …

Sliding scale insulin is a 1934 idea in a 2026 hospital

Michael Duben, MD

August 28, 2026Aug 28, 2026

Somewhere in a hospital right now, a physician is ordering a sliding scale of short-acting insulin to be given before a meal, at a dose set by the premeal blood glucose. Not a correction dose for hyperglycemia on top of a meal dose. The meal dose. Blood glucose before a meal describes what has already happened. It says nothing about whether the tray holds 20 g of carbohydrate or 90. …

GLP-1 weight loss stigma changes what patients disclose

August 22, 2026Aug 22, 2026

She had five close friends. She told one. Not because she doubted the prescription. Her GP had raised tirzepatide after her bloodwork showed worsening insulin resistance, and the decision followed a real clinical conversation. She told one friend because she…

She had five close friends. She told one.

Not because she doubted the prescription. Her GP had raised tirzepatide after her bloodwork showed worsening insulin resistance, and the decision followed a real clinical conversation. She told one friend because she did not know what the truth might do to the other four relationships.

Would her weight loss still count? Would lunch become surveillance? Would every smaller portion be treated as evidence? Would …

What to expect on weight-loss medication, beyond the scale

August 13, 2026Aug 13, 2026

I have been a registered nurse for more than thirty years. I am also a bariatric surgery patient and a glucagon-like peptide-1 (GLP-1) user. I thought that combination would put me in a good position when I started treatment. I…

I have been a registered nurse for more than thirty years. I am also a bariatric surgery patient and a glucagon-like peptide-1 (GLP-1) user.

I thought that combination would put me in a good position when I started treatment. I understood medications and adverse effects. I knew hydration, nutrition, and maintaining strength mattered, and that success could not be measured only by the scale. Even so, I found myself working …

Hana Kahleova, MD, PhD, MBA

The link between light and blood sugar control

August 10, 2026Aug 10, 2026

A patient sat across from me not long ago and said, "I feel like I'm doing everything right, and still failing." She had lost weight. She was taking her medications exactly as prescribed. She had reworked her diet along the…

A patient sat across from me not long ago and said, “I feel like I’m doing everything right, and still failing.” She had lost weight. She was taking her medications exactly as prescribed. She had reworked her diet along the lines we’d discussed. Yet her glucose readings remained stubbornly elevated.

I’ve heard some version of that sentence throughout my career as a physician and clinical researcher studying metabolism and diabetes. This …

Type 1 diabetes family history is still misunderstood

Shara Bialo, MD

July 28, 2026Jul 28, 2026

As a pediatric endocrinologist, I often meet families on one of the hardest days of their lives: a T1D diagnosis. I watch as the shock sets in. I hear their worries, their concern for the future, and the questions that arise when I mention that family history can increase the risk of developing the disease by up to 15-fold. “What does this mean for our family? Could this happen to …

Compounded GLP-1 drugs are not the same as approved ones

The Obesity Society

July 22, 2026Jul 22, 2026

For millions of people living with obesity, FDA-approved GLP-1 medications have created new opportunities to improve health, reduce the burden of related chronic diseases, and receive evidence-based treatment for a condition that has too often been dismissed as a matter of willpower. At the same time, extraordinary demand for these therapies has fueled the rapid growth of compounded alternatives that are often marketed as less expensive, personalized, or equivalent substitutes. …

GLP-1 coverage cuts hit disabled patients hardest

Tom Peteet, MD, MPH, MEd

July 8, 2026Jul 8, 2026

As a physician, telling my patients "no" never gets easier. In some cases, I have good reason, such as declining to increase opioids because of the risk of side effects. In other cases, I can only gently tell patients, "The…

As a physician, telling my patients “no” never gets easier. In some cases, I have good reason, such as declining to increase opioids because of the risk of side effects. In other cases, I can only gently tell patients, “The health care system doesn’t want to pay.” In the coming months, I will be saying “no” a lot more often. As of July 1, MassHealth, the state’s Medicaid program, …

Type 1 diabetes and the tennis match you cannot see

Andrea Hayes, MD

July 6, 2026Jul 6, 2026

When Alexander Zverev lost to Taylor Fritz in the Halle semifinal tennis tournament, he didn't blame his pancreas. He did the professional thing: He admitted Fritz outplayed him. But Zverev also let slip a detail that deserves more than a…

When Alexander Zverev lost to Taylor Fritz in the Halle semifinal tennis tournament, he didn’t blame his pancreas. He did the professional thing: He admitted Fritz outplayed him. But Zverev also let slip a detail that deserves more than a post-match shrug. Before the match, his glucose sensor decided to go rogue. Based on its creative interpretation of his blood sugar, Zverev injected a dose of insulin better suited for …

Continuous glucose monitor accuracy and patient trust

Arya Patel

June 23, 2026Jun 23, 2026

As a medical student, I see every day how uncontrolled blood sugar quietly destroys organs. Most of my classmates file this away for exam day, while I'm glued to my CGM app because these sequelae are not hypotheticals for me.…

As a medical student, I see every day how uncontrolled blood sugar quietly destroys organs. Most of my classmates file this away for exam day, while I’m glued to my CGM app because these sequelae are not hypotheticals for me.

A continuous glucose monitor (CGM) has been the backbone of my daily management since my type 1 diabetes (T1D) diagnosis five years ago. On July 1, 2026, my longtime sensor …

The Podcast by KevinMD

GLP-1s, weight loss, and the inflammation tests your patient needs [PODCAST]

The Podcast by KevinMD

May 25, 2026May 25, 2026

A cardiologist who helped set national cholesterol and weight targets for 40 years now says those numbers can mislead. Richard M. Fleming, a physician specializing in cardiovascular and inflammatory disease, argues that weight loss on a GLP-1 does not automatically…

Listen on Apple Podcasts · Spotify

Listen and followApple Podcasts Spotify YouTubeMore apps · Browse all episodes

How lifestyle interventions reverse type 2 diabetes

Mahima Gulati, MD

May 23, 2026May 23, 2026

I was a resident physician in New York City when I met a Jamaican woman in her early 40s, newly diagnosed with type 2 diabetes. The hospital was always crowded and the schedules unpredictable, making continuity difficult. But appointment after…

Her hemoglobin A1c was 7.2. She had mild obesity, and no major complications. …