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Current HbA1c level: Many plans require HbA1c above a certain threshold (commonly 7.0% or higher) to demonstrate inadequate blood sugar control

Botox was first approved by the FDA in 1989 for blepharospasms and strabismus in adults

It is the last step of the routine and my essential

Metabolic dysfunction can show up in lab work before it produces a formal diagnosis

It helps prevent lean muscle loss, supports metabolism, and keeps you full even on reduced calorie intake

For some carefully selected patients, that opens the door to eventually reducing the drug burden rather than escalating it: a lower biologic frequency, a smaller methotrexate dose, or getting off chronic steroids