How Dr. Lorraine Lipscombe is creating better care for women with diabetes

As the director of endocrinology at Women’s College Hospital and a physician-scientist at Women’s College Research Institute, Dr. Lorraine Lipscombe dedicates her time to studying diabetes in women — from identifying risk factors to improving access to care.

By Sarah Treleaven

Dr. Lorraine Lipscombe has long been part of a tradition of female trailblazers. “My medical school class was the first class in the history of McGill University that had equal numbers of women as men,” she says. “When I graduated, we were still in the early stages of women being leaders in this profession.”

Since graduating in 1998, Dr. Lipscombe has become a leader in her own right. Today, she is the director of endocrinology at Women’s College Hospital (WCH) — Canada’s leading institution dedicated to advancing healthcare for women — as well as a physician-scientist at Women’s College Research Institute and a passionate advocate for women’s equitable access to healthcare. Her primary research focuses on the prevention and care of diabetes in women, for which she was awarded a 2015 Goldie Award for Research from the department of medicine at the University of Toronto.

Having joined WCH in 2006, she points to the hospital’s own trailblazing path in healthcare for women as a major factor in her decision to join the institution. “Women’s College had and still has a reputation to not just promote women’s health but also to support female academic physicians. That was really important to me.”

How did she reach the top of her field? Her journey began while growing up in Montreal. Dr. Lipscombe was always interested in the workings of the mind, and so decided to study psychology as an undergraduate at Concordia University. But an unexpected turning point came in a course about the physiology of behaviour, which tied body and brain together into a fascinatingly complementary system.

Dr. Lipscombe started working on a professor’s project looking into how hormones affect maternal behaviour in rats, and she found herself smitten. She continued to “love hormones” while at medical school, and moved onto research related to diabetes and insulin production, which led to a specialization in endocrinology. “I realized pursuing medicine would help me to help others change their behaviours for a better health outcome,” says Dr. Lipscombe.

An early breakthrough helped Dr. Lipscombe chart her ultimate career course. While she was working on her master’s thesis at the University of Toronto, completed in 2005, she was able to show not only that women with diabetes have a higher risk of breast cancer, but also that women who have survived breast cancer have an increased risk of developing diabetes. “We were the first to show that there’s a bidirectional relationship between breast cancer and diabetes, and that there are implications for both populations of women,” says Dr. Lipscombe. “That was really exciting for me.”

She was invited to present her research at the American Diabetes Association, which helped her to secure funding for her further landmark research that has determined that diabetic women receive fewer mammograms and have a higher mortality and more advanced stage of breast cancer at diagnosis. As Dr. Lipscombe explains, this female-focused research is much needed. “There are still a lot of research gaps when it comes to women, and we’re still applying much of what we know about men and chronic illness,” says Dr. Lipscombe. “We need research that fits.”

Dr. Lipscombe has also married her research and clinical care with a particular eye to women’s healthcare experiences and accessibility. “Diabetes disproportionately affects women with lower incomes and ethnic minorities, including more recent immigrant groups,” she says. “For women with low incomes, it can be challenging for them to engage in some of the healthier recommendations we have, such as exercise and healthy diets, especially if they’re already juggling responsibilities. With newer immigrants, we often see mistrust in the Western medical system and we have to break down barriers and earn the type of trust they typically reserve for family members.”

The trick for Dr. Lipscombe is to help these women navigate available resources while keeping an eye on cultural and social circumstances. With that in mind, she is currently testing a home-based intervention program to improve outcomes for women with recent gestational diabetes in order to reduce their elevated risk of developing type 2 diabetes. “New mothers are busy and it can be very hard for them to step out of their schedules and competing responsibilities to seek out care,” says Dr. Lipscombe, who has three children. “We found that a lot of women couldn’t just come into the hospital on a schedule.”

“I started my career in the wake of some wonderful trailblazers who paved the way for women like me.”

So they decided to try a different approach — modeled, in part, on Women’s College Hospital’s telephone-based cardiac rehabilitation coaching program. The program involves one 10 to 20-minute phone call per week in order to set goals related to diet and exercise. “We found that women loved the program and many were able to accomplish their goals after six months,” says Dr. Lipscombe.

Along the way, as she has refined her practice, Dr. Lipscombe has relied on the examples set by and encouragement of her female mentors. “I started my career in the wake of some wonderful trailblazers who paved the way for women like me,” she says.

Dr. Barbara Woodside, professor of psychology at Concordia University, was the researcher who introduced Dr. Lipscombe to rat hormones in her undergrad and was highly influential as one of very few female neurobiology scientists. Dr. Janet Hux, Dr. Lipscombe’s master’s thesis supervisor and a diabetes researcher, encouraged the budding endocrinologist to ignore any inklings of imposter syndrome and serve as a panelist at the Public Health Agency of Canada. And Dr. Gillian Hawker, previously physician-in-chief at Women’s College Hospital, taught Dr. Lipscombe to set lofty goals. “She taught me to look at my burning questions and then develop the skills to solve those problems,” she says. “She taught me that I could dream big and not be afraid.”

Dr. Lipscombe now finds inspiration in both her workplace and her patients. Women’s College Hospital has been highly supportive of initiatives to test innovative models of care, including pilot programs that leverage existing resources in order to apply them to new populations. “We get a lot of support from the department of medicine, from the cardiac rehabilitation program, which is the only program of its kind in Canada specifically designed for women, and from the hospital’s foundation,” says Dr. Lipscombe.

She is also fortunate, she says, to have patients who are willing to share their experiences, becoming partners in providing better care. “They help me identify the needs and gaps in their treatment so I can turn that into research that helps improve outcomes,” says Dr. Lipscombe. “I’m very blessed to have the skills and resources to do that.”

For more than 100 years Women’s College Hospital (WCH) has been developing revolutionary advances in healthcare, and working to close the health gaps that exist in healthcare for women because their unique needs are not taken into consideration. Today, WCH is a world leader in the health of women and Canada’s leading, academic ambulatory hospital. It focuses on delivering innovative solutions that address Canada’s most pressing issues related to population health, patient experience and system costs.

For more information about how WCH is transforming patient care, visit www.womenscollegehospital.ca. To find out how you can give and get involved, visit www.wchf.ca.