Room for improvement at risk factor management in transgender patients with diabetes
EASD 2017 - Lisbon, PortugalNews - Sep. 13, 2017
//Presented by Patricia Kapsner (University of New Mexico, Albuquerque, NM) at the European Association for the Study of Diabetes (EASD) Annual Meeting in Lisbon, Portugal (11-15 September).//
Transgender persons with diabetes treated with hormones for gender confirmation have several modifiable factors that contribute to diabetes severity and complications —including elevated levels of triglycerides and high levels of LDL-c, suggests a small study. This study draws attention to this vulnerable group who need more specialist support and evidence-based programs to improve diabetes care.
Transgender individuals have a gender identity that is different from their sex assigned at birth. Recent estimates from state and federal data suggest that around 0.6% of the adult population in the USA (1.4 million adults) identify as transgender.
Although gender affirming hormone treatment is known to have effects on lipid profiles, blood pressure, weight, and blood glucose, the hormones’ effect on diabetes risk or disease course is unclear. Furthermore, the management of diabetes in transgender patients has not been specifically studied.
In this small study, Dr Patricia Kapsner and colleagues from the University of New Mexico, Albuquerque, NM, USA analyzed data from all 300 transgender patients attending their multidisciplinary gender health clinic. They describe the characteristics of the nine individuals with type 1 diabetes or type 2 diabetes, and the specialist support that was needed to improve the quality of their care.
The researchers found that their patients with diabetes on hormones for gender confirmation had increased modifiable risks associated with diabetes. Triglycerides tended to be high in transgender women, most likely due to diabetes and use of oestrogens. LDL-c was higher and HDL-c was lower in obese patients with T2DM. They also found that diabetes patients had low levels of vitamin D, which needed treatment to prevent osteoporosis. Transgender women with T2DM also tended to be obese, requiring intensive weight loss management. The research team note that the dysphoria and high level of psychosocial issues (e.g., current or past substance abuse) added to the difficulties of managing diabetes and comorbidities.
The researchers point out that even with support from their multidisciplinary team (including endocrinologists, psychiatrists, diabetes educators, nutritionists, nurses, and social services), recommended targets for patients with diabetes are not always achieved.
//- Our reporting is based on the information provided by the EASD press service -//