Transgender patients with diabetes carry a heavy burden — and many clinicians don't fully realize it. At the Association of Diabetes Care & Education Specialists (ADCES) annual meeting, clinical pharmacist Jodie Gee, PharmD, highlighted the unique challenges this population faces, from systemic barriers like insurance denials and provider shortages to personal concerns about how gender-affirming hormone therapy (HT) might affect their diabetes.

The good news: patients can safely use gender-affirming HT alongside routine diabetes care. But clinicians need to stay alert to physiological changes, especially in the first six months of therapy, and tailor their approach accordingly.

Key Takeaways:

• Conduct annual lipid screening and assess cardiovascular disease risk for transgender patients on HT
• Insulin doses may need to be reduced for transgender males and increased for transgender females
• Obtain consent before physical exams and collaborate with patients on CGM and insulin pump placement
• Screen for combined diabetes distress and minority stress
• Use preferred names and pronouns, minimize personal biases, and coordinate with gender-affirming care specialists

Why it matters: With limited data and guidance on diabetes management in transgender populations, clinicians are often navigating uncharted territory. Building inclusive, culturally competent care environments isn't just good practice — it's essential for reducing health disparities in this underserved group.