Healthcare professionals are urged to adopt tailored, sensitive approaches to managing diabetes in transgender individuals, recognising unique hormonal and psychosocial factors impacting care and outcomes.
Transgender people with diabetes often face extra obstacles in accessing care, and clinicians need to do more than simply apply standard treatment pathways, Jodie Gee, a clinical assistant professor at the University of Houston College of Pharmacy, said at the Association of Diabetes Care & Education Specialists annual meeting. Gee argued that care teams should build trust, use inclusive language and recognise that many patients carry stress and stigma that may not be visible during a routine appointment.
That message comes as public health guidance and recent research both point to a more complex picture of diabetes risk and treatment in transgender communities. The Centers for Disease Control and Prevention says LGBTQ people, including transgender individuals, may face a higher risk of type 2 diabetes, with factors such as smoking, excess weight and other health conditions contributing to that burden. At the same time, studies in journals including Climacteric, the Journal of Clinical Medicine and Diabetes Care have found that gender-affirming hormone therapy can affect cardiovascular risk markers and glucose metabolism, reinforcing the need for regular monitoring rather than assumptions about how any one patient will respond.
Gee said patients can continue gender-affirming hormone therapy alongside routine diabetes care, but clinicians should stay alert to changes in lipids, cardiovascular risk and glucose patterns, particularly in the first year of treatment. She advised annual lipid testing and closer glucose monitoring, noting that insulin needs may shift in different directions depending on whether a patient is taking masculinising or feminising therapy.
Beyond laboratory values, Gee urged diabetes teams to treat body image, device placement and language as part of clinical care. She recommended asking for consent before physical examinations, involving patients in decisions about continuous glucose monitor and insulin pump sites, and focusing weight conversations on metabolic health rather than appearance. The broader goal, she said, is to create an environment where transgender patients feel respected enough to engage fully in their diabetes care.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
