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5 Minutes With Endocrinologist Dr. Alice Cheng

5 Minute Read
Dr. Alice Cheng

Want to get to know some of the leaders who are shaping the future of diabetes care? In our “5 Minutes With” series, experts share what drew them to this work, what innovations most excite them, and the greatest challenges and opportunities in diabetes care. 

This week, we interviewed Dr. Alice Cheng, an endocrinologist at Trillium Health Partners and Unity Health Toronto and associate professor at the University of Toronto, about diabetes care in the Asian community, healthy equity, and more. 

In her work as an endocrinologist, Cheng has made significant contributions to diabetes care, especially in Canada where she helped create the clinical practice guidelines for Diabetes Canada. She also co-hosts the “Diabetes Care On Air” podcast and chairs the planning committee for the American Diabetes Association annual conference. 

In addition to her work in diabetes, Cheng created The Med Ed Pledge, a pledge to increase diversity in continuing education for healthcare providers. 

April Hopcroft: How did you come to work in diabetes and why do you do this work?

Alice Cheng: I started medical school thinking I wanted to be a pediatrician because I had the coolest pediatrician as a kid and I wanted to be just like her. Then I had the great fortune to do an elective as a first-year medical student with Dr. Robert Silver, an endocrinologist at the University of Toronto. He was so inspirational – an empathetic clinician, a fantastic teacher, and was passionate about diabetes. Needless to say, that elective had a great impact on my career choice and I have zero regrets! 

Working in diabetes is very rewarding. It is a privilege to play a small part in the lives of people living with diabetes by supporting them through different phases of life and learning from their lived experiences. 

Colleagues in the diabetes community are generally really nice people from different ares of expertise who share a common goal. In addition, there is so much hope to offer with the existing treatments and all the future treatments to come. 

Hopcroft: What do you see as the biggest challenges in the field of diabetes care? 

Cheng: There are many challenges one can choose from, but if I had to pick one, I would say health equity. We do have fantastic tools and resources to positively impact the health trajectory of someone living with diabetes. However, access to these tools and resources is very different within a country and between countries. Being able to develop strategies that are scalable and low-cost is the biggest challenge. 

Hopcroft: Are there any recent developments in the understanding of diabetes that you think people should know about? What future innovations are you most excited about?

Cheng: We are getting closer and closer to having continuous ketone sensors, which can potentially open up safe access to organ-protecting therapy, like SGLT-2 inhibitors, for people living with type 1 diabetes. This will be a game-changer.

Hopcroft: What’s one thing people in Asian communities should know about diabetes?

Cheng: Diabetes is common in our communities and genetics play a very big role. It is not someone's "fault" when they develop diabetes – regardless of type of diabetes. 

Diabetes stigma is an issue in every community but I hear about it a lot in the Asian and Pacific Islander community in my practice. In addition, young-onset type 2 diabetes is common in our communities. Therefore, regular screening for diabetes from one's healthcare provider is important. 

Hopcroft: One of the challenges Asian people with diabetes face is that concerns about physical health status, body image, and appearance are often intermingled. What advice do you have for someone trying to manage this?

Cheng: Physical health and body adipose (fat) are indeed strongly linked. The concern is around the location of the adipose tissue. It is the visceral adipose tissue (inside the belly) that is unhealthy, whereas the subcutaneous adipose (under the skin) is not necessarily unhealthy. 

This has led the medical community to talk more about waist-to-height ratio and less about body mass index (BMI) to get at health concerns around abdominal adipose tissue. Unfortunately, that differentiation is not well recognized by society. 

The societal pressures around appearance were always driven by arbitrary definitions of "beauty" and have now inappropriately utilized "health" as another way to make people feel bad when they don't meet society's misplaced standards of beauty. So, I think educating people that societal standards and health standards are different may be helpful. 

Learn more about diabetes in Asian communities here: