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Care Team Spotlight: Endocrinologist Madona Azar, MD, MPH

Dr. Azar joined the UMass Memorial Diabetes Center of Excellence care team in 2022 and is an associate professor of medicine in the Division of Endocrinology, Diabetes, and Metabolism at UMass Chan Medical School. She is interested in increasing awareness for metabolic dysfunction-associated steatotic liver disease (MASLD) and implemented a screening process for people with diabetes and prediabetes to determine the risk of liver fibrosis. She is also on the Diabetes in Pregnancy Program care team.

Dr. Azar was born and raised in Beirut, Lebanon. She met the man who is now her husband when they were 18 years old during their first year of medical school at St Joseph’s University in Beirut. They moved to the United States after graduating in 2003. Her interest in diabetes began during the first year of residency while training at Cooper University Hospital in New Jersey. Dr. Azar participated in a research project focused on inpatient diabetes care in the ICU. Current clinical interests include diabetes & cardiometabolic health and endocrine conditions in pregnancy.

Her road to Massachusetts was far from a direct path. After beginning an endocrinology fellowship at Penn State, she and her husband moved to Oklahoma because he got a job at Oklahoma University (OU). That’s where she completed her fellowship training and met her mentor, a seasoned clinician scientist who worked extensively with the Diabetes Control and Complications Trial (DCCT), a landmark type 1 diabetes study.

After completing her fellowship, Dr. Azar became a faculty member at Oklahoma, where she would work for ten years. During that time she held several leadership positions, including the Paul H. and Doris Eaton Travis Chair in Endocrinology, medical director of the Physicians Endocrinology and Diabetes Clinic, director of the Adult Clinical Services and Diabetes Education and Outreach at Harold Hamm Diabetes Center (HHDC), and the Endocrinology fellowship director. While at OU Health, Dr. Azar led projects that focused on diabetes education and outreach programs in the community. One such project consolidated clinical and research collaborations between the HHDC and the Choctaw and Chickasaw Nations of Oklahoma, leading to increased awareness about the importance of screening for, and diagnosis of, diabetes early in pregnancy in high-risk indigenous women.

Dr. Azar, her husband, and their two daughters moved to Lebanon in 2019 to be with family. They wanted the children to experience and connect with their culture. The plan was to stay for a few years before moving to New England where her only sibling lives. She was hired as the Internal Medicine Program Director at Lebanese American University. During that time, Lebanon experienced a political revolution.

On August 4, 2020, an explosion caused by a large amount of ammonium nitrate stored at the Port of Beirut, killed more than 200 people, and injured thousands, including some of Dr. Azar’s family members. Her office was badly damaged. “The blast occurred around six in the evening,” she said. “The next morning, I found shards of glass embedded on my desk and chair. If I had worked late that night, I probably would have been killed or at least badly injured.”

In 2022 they decided to return to the United States, and knew they wanted to live and work in Massachusetts. “I fell in love with the UMass campus in Worcester during my first visit,” she said. “It has a similar feel to Oklahoma University, and we really liked the area. The people were wonderful. I had a good feeling right away.”

They enjoy spending time outdoors and appreciate the property they’re able to have living in Central MA “as opposed to living in a big city.”

Challenges to Treating People with Diabetes

Dr. Azar says some people are angry that they have diabetes or perhaps they’ve have had a bad experience with care in the past. If they arrive with a negative, depressed, or defeatist attitude, her goal is to listen, identify their motivation, and determine what will inspire them to improve their health. Then she can suggest small steps towards improving their situation.

Small Steps...Big Changes

“I met with a man and his wife, listened to their concerns to understand their goals, and suggested a plan with a few attainable changes that will help them. He agreed to start walking 30 minutes a day, cut down on bread consumption. We will follow-up in 30 days.” Dr. Azar subscribes to the philosophy that small steps can result in big changes. “I give it to them in in bite-sized chunks. Nobody can lose 50 pounds overnight. We add one small but sustainable change every visit. For example, drink water instead of sugary soft drinks. People must be engaged for it to be successful!”