Anjanette Tan, MD

Anjanette Tan, MD Endocrinology, Diabetes, and Metabolism

Calcium comes from your plate first. Food sources are absorbed more efficiently, arrive with supporting nutrients, and a...
06/02/2026

Calcium comes from your plate first. Food sources are absorbed more efficiently, arrive with supporting nutrients, and are distributed naturally across the day.

The supplement fills the gap. It does not replace the foundation.And if you have been diagnosed with osteoporosis: calcium and vitamin D are essential coadministration with antifracture therapy.

They are not the therapy itself.

Save and Share it with someone who is managing a bone health diagnosis.🦴⛑️

06/01/2026

Calcium and vitamin D are essential for bone health. They are not treatment for osteoporosis.

If you have been diagnosed with osteoporosis, calcium and vitamin D are the foundation — not the intervention. FDA-approved antifracture medications reduce fracture risk by 40 to 70 percent. Calcium supplements do not.

Additionally: most adults are already getting 600 to 700 mg of calcium from food daily. Supplementing beyond what your diet cannot provide is guideline-concordant.

Pushing total intake above 1500 mg/day increases kidney stone risk without adding bone benefit.

Food first. Supplement to fill the gap. And if you have osteoporosis — ask your doctor whether you need medication.

If you have been diagnosed with osteoporosis, are you on a prescription medication for it? Drop ✅ yes or ❌ no. This data matters.

05/30/2026

People ask if GLP-1s work in type 1 diabetes. Yes. But not just for weight loss. In ADJUST-T1D: 36% of patients achieved TIR >70%, TBR

If you or your patient is starting a GLP-1 receptor agonist with type 1 diabetes, here is what the clinical trial eviden...
05/29/2026

If you or your patient is starting a GLP-1 receptor agonist with type 1 diabetes, here is what the clinical trial evidence says should happen.

Insulin drops fast — at the starting dose, within the first 4 weeks. Bolus more than basal. The reduction is mostly a direct drug effect early on, not weight loss.Reduce bolus settings by 20–30% at initiation — proactively. Monitor closely for 8 weeks.

Then continue adjusting as weight loss accumulates.The AID system helps. But it works within the parameters you and your endocrinologist set. Those parameters have to change.

Save and Share this with someone you know who’s starting GLP-1.📍🛟

05/28/2026

Real talk: the drop in bolus insulin when you start a GLP-1 in type 1 diabetes is bigger than the drop in carb intake — and that gap tells us something important about mechanism.

In ADJUST-T1D: carbs down ~20g/day by week 4. Bolus insulin down 23%.
In TIRTLE1: bolus insulin down 49% by week 2.Gastric emptying slows. Meal bolus frequency drops from 4.6 to 3.4 per day.

The AID system's automated corrections were not significantly changed — it wasn't compensating for missed boluses. The bolus need genuinely fell.
The basal-to-TDD ratio shifted from 0.56 to 0.62. The whole insulin profile changed.

Bolus settings — ICR and correction factor — need proactive adjustment at initiation.
The pump works within the parameters you set. If those don't change, hypoglycemia risk is real even on closed loop.

Tomorrow: the practical clinical checklist.
Save and share this series with someone who can relate. 📍

The evidence for GLP-1 receptor agonists in type 1 diabetes is no longer sparse.It is growing — and it is specific.ADJUS...
05/27/2026

The evidence for GLP-1 receptor agonists in type 1 diabetes is no longer sparse.

It is growing — and it is specific.ADJUST-T1D. TIRTLE1. Two years of real-world data. Meta-analyses pooling hundreds of patients. These medications work in T1D, and when paired with automated insulin delivery and a structured titration protocol, they work safely.

The earlier trials that showed more risk ran without CGM, without AID, without an insulin adjustment plan. The safety profile is different when the clinical infrastructure is right.Slide through.

References on the last slide — always.
Save this. 📌
Share it with your endocrinologist if you have T1D.🩺

05/26/2026

What scares me about GLP-1s in type 1 diabetes isn't the medication. It's starting without a plan.

In the ADJUST-T1D trial, total daily insulin dropped 18% by week 4 — at the lowest starting dose of 0.25 mg. Bolus insulin dropped 23%. And 83% of that reduction was a direct drug effect, not weight loss.

The drop comes before the scale moves.
You don't wait to adjust. You adjust at initiation — proactively reducing bolus settings by 20–30%.The trials give us this roadmap.

This week I'm walking through what they found.
Save this series if you or someone you love has type 1 diabetes.💙

05/23/2026

My mentors always encouraged me to teach. ⁣
And this is where teaching now occurs.⁣
I present what is on my mind.⁣
I post what I wish I had more time to tell my patients.⁣
Thank you for all the follows and comments. 💬⁣
Thank you for the messages. ✉️⁣🫶🏼
⁣

05/22/2026

Osteoporosis has no symptoms. This is not reassurance — it is the clinical reality that makes it so dangerous.Bones do not hurt until they fracture.

There is no ache, no warning signal, no gradual discomfort to alert you. By the time pain arrives, the fracture has already occurred.

What to watch for instead: 🚨
height loss of more than 1.5 inches from your peak adult height, unexplained early satiety or reduced appetite, or a persistent mid-back ache that improves lying down.

These are not symptoms of osteoporosis. They are symptoms of fractures that may have already happened silently. Get your height measured at every visit.
Ask what the number means.

When was the last time a doctor measured your standing height? Drop ✅ if recently or ❌ if you honestly cannot remember.

FRAX is the most widely validated fracture risk calculator in the world. It is also incomplete in specific ways that mat...
05/21/2026

FRAX is the most widely validated fracture risk calculator in the world. It is also incomplete in specific ways that matter for people with type 2 diabetes, those on long-term steroids, people with thyroid disease, and those with hyperparathyroidism.

FRAX does not include falls, does not distinguish recent from remote fractures, and does not include diabetes as a variable — despite 40 to 70% higher fracture risk in T2D patients relative to their bone density.Knowing what your calculator includes — and what it misses — is part of understanding your actual risk.

Save and Share this to friends and family, early evaluation can change your whole approach.📋📌

Address

6844 Harris Parkway
Fort Worth, TX
76132

Telephone

+18172630007

Website

Alerts

Be the first to know and let us send you an email when Anjanette Tan, MD posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Shortcuts

Share

Category