Sierra Endocrine Associates

Endocrinology, diabetology & Metabolism
Joseph B Hawkins, Jr. MD, FACE

Serving the San Joaquin Valley

7230 N Millbrook Ave

Fresno, CA 93720


 DIABETES Disease Management

Successful management of diabetes requires the combined effort of a properly informed and educated patient, along with a support team of nutritionists, nurse educators, nurse practitioners, endocrinologists, and mental health advisors. It is this team approach which has proven to be successful in clinical research that we strive to bring to our clinical practice.

Doctor and Patient Intensive Therapy Program

Sierra Endocrine Associates has received recognition from the American Diabetes Association for our Intensive Therapy Program for type 1 diabetes.

We focus on intensive management of diabetes by striving for optimal glucose control along with a comprehensive program to monitor for, prevent, and treat the chronic complications of diabetes. Prevention of diabetes specific complications such as diabetic eye disease (retinopathy), diabetic kidney disease (nephropathy), and nerve damage (neuropathy) can be accomplished by controlling glucose to near normal levels.

 Sierra Endocrine Associates uses all available methods for insulin delivery in many different combinations in order to meet the needs of each individual patient. Insulin pens and external insulin pumps are common components for our Intensive Therapy Program.

Insulin Pens

Using an insulin pen is more convenient than using a syringe to take insulin, especially when away from home. There are currently several types of insulin pens available from three manufacturers.

Advancements in Diabetes Management

We also continuously monitor new developments in our field to ensure we are offering our patients the most effective and easy to use tools for diabetes management. The Medtronic MiniMed glucose sensor and alternative routes for administering insulin, such as inhaled insulin, are recent additions to the tools we may use to assist you in achieving your diabetes treatment goals. Buccal (through the mouth) insulin products are currently being developed. Sierra Endocrine Associates will be prepared to offer new technologies and treatments as soon as they become available.

Educating Our Patients

We have an Intensive Management Education and Training Program. Our program is designed especially for patients who are intensively managed, currently use insulin pumps, or are considering insulin pump therapy.

Insulin Pumps

Insulin pumps offer greater lifestyle flexibility. There are three primary companies that manufacture insulin pumps: Medtronic MiniMed, Inc., Smiths Medical MD, Inc., and the Animas Corporation.

 Pre-pregnancy and Pregnancy Counseling

Pre-pregnancy and pregnancy counseling on diabetes management is an active part of our practice. All together we assist over 300 women a year in managing diabetes before and during their pregnancy.



What are the benefits of continuous glucose monitoring (CGM)?


A continuous glucose monitor (CGM) offers individuals with type 1 or type 2 diabetes round-the-clock glucose readings with fewer fingersticks, and depending on the CGM product you choose, none at all.*†  Having this level of ongoing, timely feedback can help users make more informed treatment decisions that may help reduce A1C levels.1

Whether you treat your diabetes with multiple injections or an insulin pump, you can expect wide-ranging health and convenience benefits from using a CGM device, including:

• More insight than monitoring alone : Unlike a single reading from a blood glucose meter, a CGM provides real-time, dynamic information about the speed and direction (trending higher or lower) of your glucose levels.

• Improved glycemic control : Having continuous feedback on diet, exercise and insulin requirements from a CGM can help you make more informed treatment decisions which can lead to tighter glycemic control than using a blood glucose meter alone.2

• Fast, proactive response : CGM systems take glucose readings every few minutes and allow you to set customizable thresholds with alerts when your readings are out of target range. This means you’ll often know before you begin to feel symptoms and you can proactively respond.

• Fewer fingersticks :CGM devices use tiny sensors to measure glucose levels just beneath the skin. These sensors connect to a transmitter which wirelessly transmits readings to a receiver or a compatible smart device. At any time, you can see your reading with just a glance. No need to interrupt what you’re doing. 



At Sierra Endocrine Associates we  hold firmly to the principle that our greatest asset is the ability to listen to the needs of our patients. Each member of our team is committed to delivering care in a compassionate, patient-centered environment. You will meet with a member of our team who will take a thorough history of your heath, review available testing and information and explain the process  for going forward.


At Sierra Endocrine Associates we  utilize all available technology including downloading glucose meter, sensor and pump data for analysis at the time our your visit. We also utilize cloud connections to review your blood glucose and pump information between visits if needed.



After a thorough evaluation treatment options, risks, benefits and side effects of medications are discussed and then  recommendations are made.


At this time no cure for diabets is available so  once diagnosed treatment can be expected to be for many years.  Like many chronic conditions adjustments in treatment may be needed. We will meet with you at regular intervals  to review your condition and response to treatment. Using periodic lab testing we can determine if the treatment is having the desired effects as well as monitor for any side effect s or adverse reactions.