Table of Contents
September 17, 2026
2 min read
Key takeaways:
Transgender people with diabetes face unique barriers to care.
Gender-affirming HT may lead to physiological effects for people with diabetes.
A welcoming environment should be fostered for transgender people.
It is critical for diabetes care and education specialists to create an inclusive space and be mindful of an individual’s concerns when caring for transgender people with diabetes, according to a presenter.
Gender-affirming hormone therapy can lead to effects on glycemic outcomes and may alter cardiovascular risk for transgender people with diabetes, said Jodie Gee, PharmD, BCACP, clinical associate professor at University of Houston College of Pharmacy and ambulatory care clinical pharmacist at Vecino Family Health Center. During a talk at the Association of Diabetes Care & Education Specialists annual meeting, Gee discussed strategies for how diabetes care and education specialists can support transgender patients.
Diabetes care and education specialists should be aware of barriers transgender people with diabetes face and create an inclusive environment. Image: Adobe Stock
“One of the things that I learned throughout my experience is transgender patients face a lot of barriers to diabetes care and healthcare in general,” Gee said during a presentation. “They carry a lot [of burden] that we don’t even realize. … Diabetes care and education specialists can help reduce disparities through communication and creating a safe healthcare environment.”
Jodie Gee
Gee said caring for transgender people with diabetes can be challenging due to a lack of data and guidance on diabetes management in that population. Data are also mixed regarding whether transgender people have increased risk for developing diabetes compared with the general population.
Transgender people with diabetes should be medically treated according to guidelines. However, some patients are concerned that gender-affirming HT may lead to diabetes development or worsening of diabetes, Gee said.
“Patients can safely use gender-affirming HT with routine diabetes care,” Gee said. “Those two realms can coexist successfully.”
Gender-affirming HT can lead to some physiological effects on patients, with those effects differing for females transitioning to male and males transitioning to female. Gee advised healthcare professionals to conduct annual lipid screening for transgender people with diabetes, assess atherosclerotic cardiovascular disease risk and increase glucose monitoring during HT. Additionally, insulin doses may need to be reduced for transgender males and increased for transgender females.
“Generally speaking, when we see these [physiological] changes, it’s critical within that first year,” Gee said. “You’ll see the changes within the first 6 months of therapy.”
There are several special considerations diabetes care and education specialists should be aware of for transgender people with diabetes, Gee said. Body image is one big concern, with Gee advising healthcare professionals to obtain consent before physical exams and collaborate with patients on continuous glucose monitoring and insulin pump placement. Gee said she uses a chart to help the patient determine where they would like a device placed on their body.
“I let the patient select,” Gee said. “At the end of the day, they have to live with this day in, day out.”
Healthcare professionals should approach weight concerns with transgender people carefully and focus on metabolic health, Gee said. Flexibility should be used with nutrition strategies and creating meal plans. Healthcare professionals should screen for the combined burden of diabetes distress and minority status among transgender people. Gee added that diabetes care and education specialists should coordinate with gender-affirming care specialists because of the effects of HT on cardiometabolic health.
One of the most important takeaways for healthcare professionals is to create a welcoming environment that feels safe for transgender people with diabetes, Gee said.
“When we look at strategies to create a safe and inclusive space, you want to make sure that we use inclusive language,” Gee said. “You want to use what the patient’s stated name or preferred name is; their preferred pronouns. We want to minimize our personal biases. We want to create a welcoming environment.”
For more information:
Jodie Gee, PharmD, BCACP, CDCES, can be reached at jgee3@uh.edu; on LinkedIn @JodieGee; or on Instagram @thesweetspot_pharmd.
Sources/Disclosures
Source:
Gee J, et al. Presentation S14. Presented at: ADCES26; Aug. 7-10, 2026; Columbus, Ohio.
Disclosures:
Gee reports conducting research for Dexcom.
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