Hi Reader, 👋

I looked at my calendar this week and realized July had gone by without me sending anything. So this one is arriving a few days into August.

Here's what's been on my mind.

I've been watching the new season of The Pitt. One storyline follows a person with diabetes who ends up in the emergency room in diabetic ketoacidosis, and the reason he ends up there isn't carelessness. He couldn't afford his insulin, so he stretched what he had.

I won't spoil the rest for you.

But it stayed with me, because I kept thinking about the people I actually see. Cost is one reason someone takes less medication than they were prescribed. It's the most visible one, and it's real. It isn't the only one.

What I Hear in My Office 📊

Some of the reasons that come up most often:

🌿 "I feel fine." Medication as something you take when you're unwell, and stop when you're better. That fits a lot of health traditions. It's also the reason some people take their medication only when they see a high number, which isn't how most diabetes medications work.

💊 "I'm worried about my liver and kidneys." Not a vague worry about side effects. A specific one, and it comes from somewhere real. It deserves a proper answer rather than being waved off.

🤔 "Nobody told me what it's for." A client recently asked me why his doctor prescribed a statin when his cholesterol was already in range. Good question, and there's a real reason. I was glad he asked instead of quietly deciding his doctor had made a mistake.

There are a few more, including one I think sits underneath most of the others. That one needs more room than I have here.

The full blog post is coming soon, with more on each of these and what actually helps.

Take These Questions With You 💡

Most of what I've described comes down to a conversation that never happened.

So I put together a handout: ten questions worth asking whenever a medication is new, or whenever something changes. Things like what happens if you miss a dose, what to do about side effects, and what to tell your care team about any herbal or traditional remedies you're taking.

Print a copy for your appointment, or fill it in digitally. Note the answers as you go, so you have them later.

You're getting this before it goes anywhere else!

One thing I'd add. If you've stopped a medication, or you're taking less of it than prescribed, tell your provider. Not as a confession. As information they need. If your labs come back unchanged and they think you've been taking it as prescribed, the next logical step is usually to increase the dose, which is the opposite of what you want.

Coming Up Next 📅

I'll be at the ADCES annual conference this month, which is where the diabetes care and education world shares the latest. I always come home with more than I expected.

I'll share what's worth knowing in the next newsletter.

🤝 Ready to Work Together?

If you're managing diabetes or weight and want to make sure your nutrition is truly working for you — not just your numbers — I'd love to help. I accept insurance and see clients virtually and in person in Massachusetts.

👉 Fill out my intake form here and we'll go from there.

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👋 About Karen

I'm Karen Lau, a Registered Dietitian and Certified Diabetes Care and Education Specialist with over 15 years of clinical experience at a major medical institution, helping Asian Americans manage diabetes while honoring their cultural traditions. I work with clients virtually and in person in Massachusetts, and I do accept insurance. Ready to get started? Fill out my intake form here and we'll take it from there.

Note: This content is for general knowledge and educational purposes only, not medical advice. While this guide follows current medical guidelines, always consult your healthcare team for personalized recommendations and advice specific to your situation. This newsletter was authored by me, with my professional expertise, clinical experience, and original ideas forming the foundation of the content. Claude, an AI assistant from Anthropic, helped organize and expand my thoughts into this comprehensive newsletter while maintaining my voice and professional perspective.​

To your health—body, mind, and heritage,

Karen​
​Diabetes Dietitian & Diabetes Care Specialist (RDN, CDCES)
​
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