Welcome to your monthly dose of health and wellness information. Each month, we will dive into practical tips, interview physician leaders and share the latest developments in different fields of medicine.

Mass General Brigham physicians have had the privilege of caring for thousands of Bermudian patients in Boston over the years, spanning a wide variety of conditions and complexities.

According to the Bermuda Government, 13 per cent of Bermudians suffer from diabetes — primarily type 2 — although the Bermuda Diabetes Association has put this figure as high as 20 per cent. The BDA has also estimated that as many as 1 in 3 may have prediabetes, putting them at risk of developing diabetes in the next five years. For this feature, Deborah Wexler, MD, MSC, chief of the diabetes unit at Mass General, shares advancements in diabetes care and the role of GLP-1 in treating the disease.

What are the biggest recent developments in diabetes care?

There have been several new developments that have transformed the care of diabetes in recent years. A variety of continuous glucose monitors allow patients to adjust insulin and prevent low blood sugar (hypoglycaemia) reactions for up to two weeks at a time. Automated insulin pumps use information from a continuous glucose monitor to adjust insulin delivery in real time based on blood sugar level, thus greatly reducing the risk of serious, low blood-glucose reactions.

On the medication side, we have two newer classes: SGLT-2 inhibitors and GLP-1-based therapies. SGLT-2 inhibitors reduce heart failure and kidney problems, while GLP-1-based therapies can both significantly lower blood glucose and weight while reducing the risk of heart and kidney problems.

How do GLP-1 medications work?

These work by stimulating gut hormone receptors over time to reduce appetite, slow digestion and increase insulin release after a meal. This promotes weight loss and prevents blood-glucose spikes by helping people with diabetes eat less, leading to better diabetes management overall.

Is GLP-1 exclusively for those with diabetes?

No. Some GLP-1 medications used for type 2 diabetes are also used to treat obesity, and many new medications in development are being evaluated for both diseases, as they can be treated by GLP-1-based therapies’ appetite-suppression effects.

• If you would like to request an appointment or learn more about care at Mass General Brigham, contact our international patient services team at patientcare@mgb.org or visit MassGeneralBrigham.org/Bermuda. If part of your care planning includes insurance, we recommend speaking with your insurance company before requesting an appointment