Letting Go of Judgment – Embracing Curiosity
Letting Go of Judgement & Embracing Curiosity
by Beverly Thomassian
As healthcare professionals, I believe we can let go of the assumptions and judgments that so often cloud our perception of the very person we are trying to care for and lean into curiosity.
Feelings of judgment are more commonplace than you may think – almost like an unconscious thought pattern. These feelings can block the creation of a meaningful connection and leave the healthcare professional and the person in our care feeling …disconnected, misunderstood, or unseen. When judgment takes the lead, it builds a quiet wall that can prevent trust from forming and healing from taking root.
But when we become aware of these unconscious patterns and intentionally set them aside, we create space for empathy, curiosity, and genuine connection. It’s in that space that the healthcare professional and the person in our care can feel respected, valued, and heard.
You can become more aware of feelings of judgment and notice what they are saying to you. This awareness is the first step to showing up for the people in our care with deeper authenticity and compassion.
When you meet with people, this is what feelings of judgement sound like.
- “They still aren’t taking their medications every day”
- “I can’t believe they keep gaining weight”
- “How come they can’t exercise at least once a week”
- “Why are they still eating tortillas with each meal”
- “Can’t they check their blood glucose more often”
- “Don’t they understand they are going to get complications if they don’t lower their blood glucose”
If you hear yourself thinking these thoughts or something similar, at first, simply commit to noticing it. Don’t beat yourself up for having these thoughts and feelings. As healthcare professionals, we have a whole trunk full of biases and lived experiences. It’s okay; we are actively working on releasing the shackles of judgment from ourselves and the people in our care. Now, take a deep breath and see if you can reframe this thought through the lens of curiosity.
By exchanging judgment with curiosity, you actively engage in more mindful practice and start meeting people where they are – with compassion. Curiosity does not judge; it leans in with openness, seeking to understand rather than to label. It invites connection, discovery, and the possibility of seeing things, especially people—in a new and compassionate light.
After all, we all signed up for this profession to make a positive impact in people’s lives. Meeting people with the lens of curiosity brings out the best in us, matching the reason we entered health care in the first place – to help with healing.
The goal is give yourself permission to set those feelings of judgment aside so you can show up as your best self and make the difference you want.
This approach has numerous benefits for the caregiver and the person receiving care.
When you provide nonjudgmental care infused with curiosity and compassion, you honor the strengths of the people you’re serving. You’re also infusing your consciousness with kindness in place of judgment. This approach, based on curiosity and compassion, leads to more effective care and healing that flows both ways.
Join our Group – Healing Through Connection
We know these unconscious feelings can get in the way, yet no one talks about them. Let’s start an open and honest dialogue about these feelings. The best caregiver in the world experiences moments of judgment that can get in the way of how they show up for people. The solution is to talk about these feelings with colleagues and friends in a safe space.
We’ve developed a community to do just that. It’s a community for healthcare professionals involved in caring for people with chronic diseases. We all want the same things – which is to provide more effective care based on compassion. When you meet other people in this community, you’re going to realize that you’re not alone and that other people experience the same feelings you do. And instead of you dealing with it by yourself, there is going to be an entire community of healthcare professionals supporting each other.
Benefit of this “Healing Through Connection” FaceBook Group
– Professionals can share authentic feelings around caregiving and find connection
– Give permission to these common feelings that you and other people experience
– Know that you’re not alone in this – you don’t need to feel bad or judge yourself
– these are normal human feelings that caregivers have and it’s time that we acknowledge them
Ignite your passion & prepare for Diabetes Certification!
Join our Expert Team at our dynamic Virtual DiabetesEd Training Conference April 16-18th, 2025
Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more! If you’re preparing for the CDCES or BC-ADM exam, this conference—paired with free bonus courses—serves as the ideal study companion!
With interactive co-teaching, we keep sessions engaging, relevant, and fun. Let’s learn and grow together!
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun! The faculty includes:
- Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES
- Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
- Christine Craig, MS, RD, CDCES
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 11 Bonus Online Courses: As a course attendee, you automatically receive a bonus online course bundle of 11 online courses valued at over
Question of the Week | Remote Eye Screening Precautions
Retinal photography with remote reading by experts has great potential to provide screening services in areas where qualified eye care professionals are not readily available.
However, in person exams are still necessary in which of the following scenarios?
- If the retinal photos are of optimal quality.
- If abnormalities are detected.
- Immediately after diagnosis of type 1 diabetes.
- For those on long term aspirin therapy.
Want to learn more about this question?
Join us live on April 8th @ 11:30 am PST for our
Level 2 | Microvascular Complications, Prevention & Treatment | Eye, Kidney, Nerve Disease
This course provides the need-to-know information regarding the microvascular complications of diabetes. It includes a brief overview of pathophysiology & clinical manifestations along with prevention strategies & screening guidelines. This straightforward program will provide participants with the information they can use in a clinical setting & also provides critical content for certification exams.
Rationale of the Week | Weight-Inclusive Diabetes Care
For last week’s practice question, we quizzed participants on weight inclusive diabetes care. 85% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
Question:
How does weight-inclusive care improve clinical outcomes in diabetes management?
Answer Choices:
- It eliminates weight stigma, leading to enhanced engagement and collaboration.
- It reduces A1c only in those who experience weight loss.
- It leads to greater weight loss, which is the key factor in diabetes management.
- It removes the need for lifestyle modifications and focuses only on medication.
Getting to the Best Answer
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.
Answer 1 is correct. 85% chose this answer, “It eliminates weight stigma, leading to better patient engagement and adherence to treatment.” Studies suggest that weight stigma in healthcare leads to worse health outcomes, as patients in larger bodies are more likely to delay care or avoid medical visits altogether due to fear of judgment. A weight-inclusive approach fosters trust and encourages long-term behavior change, which ultimately improves glycemic control and patient well-being.
Answer 2 is incorrect. 2% of you chose this answer, “It reduces A1c only in patients who experience weight loss.” Research has consistently shown that health-promoting behaviors—like increasing fiber intake and engaging in regular movement—can improve blood sugar levels independent of weight loss.
Answer 3 is incorrect. About 10% of respondents chose this, “It leads to greater weight loss, which is the key factor in diabetes management.” While weight loss is often associated with improved health markers, the key drivers of better outcomes in diabetes care are sustainable habits, not weight change itself. Many individuals improve their metabolic health and blood sugar levels through consistent health behaviors, regardless of changes in body size. The focus should be on sustainable, evidence-based interventions rather than weight as an outcome.
Finally, Answer 4 is incorrect. 1% chose this answer, “It removes the need for lifestyle modifications and focuses only on medication.” Medications like metformin and GLP-1 receptor agonists are valuable tools in diabetes management, but they work best when combined with behavior-based interventions. A weight-inclusive model does not dismiss the role of medication; rather, it ensures that patients receive comprehensive, stigma-free care that includes sustainable lifestyle adjustments.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
by Jessica Jones, MS, RD, CDCES, CEO and Co-founder of Diabetes Digital, a virtual nutrition counseling platform for people with diabetes and prediabetes
Want to learn more about this question?
Enroll in our upcoming webinar led by Jessica Jones, MS, RD, CDCES
Weight-Inclusive Diabetes Care: Turning Compassion into Practical Tools
Join us live on June 5, 2025, at 11:30 am PST
This session provides healthcare providers with actionable strategies to integrate weight-inclusive care into diabetes management practices, focusing on improving outcomes through respect for body diversity and individual autonomy. Weight stigma is a well-documented barrier to effective care, contributing to poorer glycemic control, disordered eating, and care avoidance. By shifting from a weight-focused approach to one aligned with Health at Every Size (HAES®), providers can foster trust, enhance participant engagement, and support sustainable health behaviors.
Jessica Jones, MS, RD, CDCES, will share evidence-based insights on mitigating weight stigma and applying HAES-aligned strategies in practice. Participants will learn how to build rapport, set realistic nutrition goals, and implement interventions that prioritize blood sugar management, joyful movement, and intuitive eating. This session equips providers with tools to deliver compassionate, person-centered care, improving both clinical outcomes and the provider-participant relationship..
Course topics:
- Foundations of weight-inclusive diabetes care: overview and evidence
- Shifting perspectives: building trust and redefining success
- Practical tools for sustainable blood sugar management
Instructor: Jessica Jones, MS, RD, CDCES, CEO and Co-founder of Diabetes Digital
Jessica Jones, MS, RDN, CDCES, is a nationally recognized Registered Dietitian Nutritionist and Certified Diabetes Care & Education Specialist committed to making nutrition education accessible to everyone. As the CEO and co-founder of Diabetes Digital, Jessica has been pivotal in developing an innovative telehealth platform that provides tailored nutrition counseling for individuals with diabetes and prediabetes. Additionally, she co-hosts the Diabetes Digital Podcast, engaging listeners with thoughtful conversations on managing diabetes.
With over a decade of clinical experience, Jessica has contributed significantly to the field through her co-authorship of the “28-Day Plant-Powered Health Reboot” cookbook and “A Diabetes Guide to Enjoying the Foods of the World.” She also wrote the Diabetes Chapter for the Food and Nutrition Care Manual Textbook and regularly shares her insights as a columnist for SELF magazine.
As a co-founder of Food Heaven, an online platform and podcast with more than 5 million downloads, she offers essential resources on cooking, intuitive eating, and embracing body respect. Jessica’s contributions have been celebrated in prominent publications, including Oprah Magazine, Women’s Health, The Food Network Magazine, SELF Magazine, the Huffington Post, and Bon Appetit. She lives in Sacramento, CA with her husband and “spirited” Maltese Shih Tzu puppy, Poppy.
Honoring Excellence: Celebrating This Year’s Diabetes Education Scholarship Recipients
DiabetesEd Services "Making A Difference" Scholarship
We are delighted to celebrate our “Making a Difference” scholarship recipients for our upcoming Virtual DiabetesEd Training Conference that airs April 16th – 18th, 2025.
Celebrating Our Diabetes Education Scholarship Recipients
We’re thrilled to announce the incredible success of our diabetes education scholarship program! This year, we received over 35 applications from passionate health professionals across the country, each making a remarkable impact in their communities.
Given the exceptional caliber of the applicants, we decided to expand the program and award a total of 17 scholarships. These awards are part of our new Bridge Program, an initiative aimed at creating more opportunities for healthcare professionals working in underserved areas to pursue careers in Diabetes Care and Education. This program is not just about gaining knowledge—it’s about forging connections, nurturing growth, and building a community of dedicated diabetes care experts.
We’re proud to spotlight the individuals who are deeply committed to advancing their expertise in diabetes education. Through their efforts, we’re confident that we can make a meaningful difference in the lives of those living with diabetes.
Here’s a look at this year’s recipients:
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Seven Exemplar Recipients will receive full registration for the Virtual DiabetesEd Training Conference.
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Ten Silver Recipients will enjoy 50% off registration for the Virtual DiabetesEd Training Conference.
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Bronze Awards will be given to all remaining applicants, with $150 off any online course or course package.
We’re excited to continue supporting these talented professionals in their journey and look forward to the positive impact they will make in diabetes care. Together, we can build a brighter future for those affected by diabetes.
Exemplar Recipients
Awarded the Entire Conference Registration
Paula Shine
MPH, NBC-WHC
Atlanta, GA
Aisha Stone Corr
BSN, RN,CCM, DCES
Dallas Metroplex, TX
Julia Saltzgiver
RD/RDN
Salem, OR
Lauren Figg
MSW
Palo Alto, CA
Heather Tate
RN, MSN
Showlow, AZ
Jessica Rodriguez
APRN, FNP-C
Clovis, NM
Meredith LaFrance
MS, RDN, CD
Everson, WA
Silver Recipients
Awarded 50% off Conference Registration
We Hope You can Join our Conference!
Past Scholarship Recipients
Eligibility Requirements
The goal of these scholarships is three-fold:
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- To expand opportunities for a diverse group of U.S. healthcare professionals to improve diabetes care in their community; and
- To support applicants’ efforts to become Certified Diabetes Care and Education Specialists (CDCES) and
- To provide financial assistance with the DiabetesEd Course registration fee.
“Making a Difference” Scholarship: Diabetes Education Services is committed to improving equity and access to diabetes training and education for a diverse group of healthcare professionals. We don’t want financial barriers to stop anyone from attending this conference. In appreciation of those who are role models and advocates for practicing the best diabetes care in their communities.
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- Available to all diabetes educators who are eligible to apply for the CDCES exam who come from an under-served community and are providing care and education to communities that lack access to Diabetes Specialists and healthcare resources
- Applicants must be in the process of gaining practice hours and planning to take their CDCES Exam within the next 3 years
- Preference is given to those facing financial hardships that are interfering with their ability to pursue this dream of achieving their CDCES.
- All applicants must be a U.S. residents.
Subscribe to Stay Updated
We offer scholarships twice a year, in the Spring and the Fall. To be notifed when our next application cycle begins, subscribe to our newsletter below.
Special Thanks to the “Making a Difference” Scholarships Donors
These scholarships are available due to the generous contribution of diabetes colleagues, friends, co-instructors, and mentors.
“Making a Difference” Scholarship Donor – Lonnie Vaughn, RNC, BSN, CDCES
Our esteemed donor for the Making a Difference Scholarship, Lonnie, possesses a profound understanding of the challenges that diabetes care and education specialists face in the healthcare setting. As a leader in the field of diabetes management, Lonnie has been championing best care practices at Doctors Medical Center in Modesto for over 30 years. Her role as a certified diabetes educator, trainer, mentor, and advocate is recognized and celebrated by patients and professionals, underscoring the unique value she brings to the cause.
Lonnie’s Vision: Lonnie wants to lift the next generation of diabetes care and education specialists to advocate for under-resourced individuals and fight for evidence-based, compassionate care for ALL people living with diabetes.
A note from Coach Beverly: I met Lonnie over 25 years ago at a conference where I was presenting on diabetes care. Her curiosity and passion for the topic were reflected in her attention, thoughtful questions, and dedication to her community. I invited her to join our live conference team to teach, coordinate, and share her passion and energy for the best diabetes care. She not only rose to the challenge, she surpassed all expectations and became an integral part of our Diabetes Education Services family. Lonnie’s impact on the community is immeasurable. She has mentored and trained over a dozen CDCESs (and hundreds of interns) at Doctors Medical Center, investing in the future of this honorable and essential profession. I am deeply grateful for Lonnie’s years of generous contributions and dedication to ushering in the next generation of diabetes care and education specialists. Thank you, Ms. Lonnie Vaughn, for being such a bright and present light in the world of diabetes care and education.
Question of the Week | Who Benefits Most from Mindful Eating as a Primary Strategy? by Evgenia Evans, MS, RDN, CDCES
Mindful eating can support diabetes management in various ways.
For which of the following individuals would mindful eating be most effective as a primary strategy rather than a complementary approach?
- A 46-year-old male with type 1 diabetes on a fixed carbohydrate meal plan.
- A 30-year-old pregnant female recently diagnosed with gestational diabetes.
- A clinically underweight 77-year-old female with pre-diabetes and osteoporosis on a high-protein, high-calcium diet.
- A 28-year-old female with type 2 diabetes, a BMI of 35, and a history of disordered eating
Want to learn more about this question?
Enroll in our upcoming webinar led by Evgenia Evans, MS, RDN, CDCES
Mindful Eating for Successful Diabetes Management
Join us live on June 11, 2025, at 11:30 am PST
This engaging and practical webinar, developed by Evgenia Evans, MS, RDN, CDCES, a positive psychology practitioner, is tailored explicitly for healthcare professionals including dietitians, diabetes care specialists, and providers.
Using evidence-based strategies, participants will gain a deeper understanding of the benefits of incorporating mindfulness into the eating experience, including enhanced glycemic management, improved emotional well-being, and healthier eating behaviors. The webinar includes an overview of mindfulness and mindful eating strategies, such as engaging all five senses, recognizing hunger cues, addressing cravings, and using practical tools to create supportive eating environments.
Participants will also learn how to adapt these approaches to diverse populations and the unique needs of individuals. Join us to deepen your expertise, participate in insightful discussions, and empower individuals to cultivate sustainable, positive relationships with food while achieving long-term health goals.
Course topics:
- Introduction to the concept and benefits of mindful eating for individuals with diabetes
- Overview of key strategies for mindful eating
- Practical tools for incorporating mindful eating into professional practice (of Diabetes Educators)
- Cultural and individual adaptations of the mindful eating approach
Instructor: Evgenia Evans, MS, RDN, CDCES
Evgeniya Evans, MAPP, RDN, LDN, CDCES, specializes in chronic disease prevention, diabetes management, and women’s health. Her unique approach integrates mindfulness-based nutrition and positive psychology, creating transformative impacts on her patients’ health and well-being.
Evgeniya’s academic journey reflects her dedication to lifelong learning and her holistic understanding of nutrition and health. She began with four years of Sociology studies at Omsk State University in Russia, followed by earning a Bachelor of Science in Nutrition and Dietetics from the University of Illinois Chicago. She furthered her expertise with a master’s degree in Applied Positive Psychology from the University of Pennsylvania. This diverse educational foundation allows her to address the socio-psychological factors that influence dietary behaviors and deliver a well-rounded approach to patient care.
At Cook County Health’s Diabetes Clinic within the Endocrinology Department, Evgeniya provides medically tailored nutrition therapy and culturally sensitive counseling. She works with individuals from various socio-economic backgrounds, guiding them through their unique health challenges with compassion and precision. Her dedication to creating personalized, sustainable dietary strategies highlights her commitment to promoting long-term health and vitality for her patients.
In addition to her clinical practice, Evgeniya is a passionate educator. She teaches several classes at her clinic, including Pillars of Diabetes Management with Lifestyle, Nutrition for Health and Vitality, and The Art of Mindful Eating. Her emphasis on education underscores her belief in the transformative power of fostering a healthy, enjoyable lifestyle supported by mindful eating and a positive mindset.
Evgeniya envisions a world where individuals are free from the struggles of dieting and food-related shame. She dreams of a future where no one feels deprecated by their appearance or food choices, and everyone enjoys the vitality and health to pursue their dreams. She is devoted to fostering vibrant, authentic lives where cooking, eating, and sharing meals with loved ones are sources of joy, love, and positive connection.
Rationale of the Week | Triglyceride Management
For last week’s practice question, we quizzed participants on Triglyceride Management. 63% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
JT is 58-years-old and has type 2 diabetes, hypertension, and BMI is 32 kg/m². Medications include metformin, lisinopril, and atorvastatin. Diet intake includes frequent highly processed foods, sugary beverages, no alcohol consumption, and minimal physical activity. Recent lab work indicates A1c: 7.2%, LDL:82 mg/dL, HDL: 38 mg/dL, triglycerides: 345 mg/dL, AST/ALT were both normal.
Given these findings, what is the recommended first-line intervention for managing his elevated triglycerides according to the 2025 ADA Standards of Care?
Answer Choices:
- Omega-3 fatty acids
- Lifestyle modification (nutrition, physical activity, and weight management)
- Start a Statin
- Start a Fenofibrate
Getting to the Best Answer
Answer 1 is incorrect. 7.93% chose this answer, “Omega-3 fatty acid.” Icosapent ethyl, a refined omega-3 fatty acid, is typically considered when triglycerides ≥ 500 mg/dL to help lower levels and reduce pancreatitis risk, but they are not typically first-line for triglycerides at 345 mg/dL. For individuals with known cardiovascular risk consideration of additional of Icosapent ethyl could be added after maximizing statin therapy.
Answer 2 is correct. 63% of you chose this answer, “Lifestyle modification (nutrition, physical activity, and weight management.” The first-line recommendation for triglycerides 150-499 mg/dL is lifestyle modification. This may include dietary modifications (types of fats, reducing added sugars, refined carbohydrates, and alcohol), increasing physical activity, and weight loss, if applicable. If triglycerides remain elevated or reach ≥ 500 mg/dL, pharmacologic treatment such as icosapent ethyl or fibrates may be considered to reduce the risk of pancreatitis.
Answer 3 is incorrect. About 10% of respondents chose this, “Start a Statin.” JT is already taking a statin, atorvastatin. Although we can consider maximizing statin therapy as LDL is above 70 mg/dl, this is not the best answer. Statins may have a modest triglyceride-lowering effect, they are not the primary treatment for hypertriglyceridemia at this level.
Finally, Answer 4 is incorrect. 18.41% chose this answer, “Start a Fenofibrate.” Fenofibrate are typically recommended when triglycerides elevate greater than 500 mg/dL to reduce pancreatitis risk and addition could be
considered if lifestyle therapy does not indicate benefit.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Ignite your passion & prepare for Diabetes Certification!
Join our Expert Team at our dynamic Virtual DiabetesEd Training Conference April 16-18th, 2025
Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more! If you’re preparing for the CDCES or BC-ADM exam, this conference—paired with free bonus courses—serves as the ideal study companion!
With interactive co-teaching, we keep sessions engaging, relevant, and fun. Let’s learn and grow together!
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun! The faculty includes:
- Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES
- Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
- Christine Craig, MS, RD, CDCES
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 11 Bonus Online Courses: As a course attendee, you automatically receive a bonus online course bundle of 11 online courses valued at over
Fasting: Religion, Health, and Diabetes Care
Fasting has been practiced for centuries, rooted in spiritual, religious, and medical traditions. Religious fasting can be found throughout cultures and faith-based traditions, such as Islam, Judaism, Christianity, Buddhism, and Hinduism, as well as in Native American tribal ceremonies. During Ramadan, an Islam holy month, fasting occurs from dawn to dusk from February 28 through March 29th.
Christians may observe daily fasting, alternate-day fasting, or an abstinence during the 40 days of Lent. While many religions have exceptions for individuals with chronic conditions, including diabetes, many may choose to participate in fasting.
Religious fasting has distinct differences from dietary fasting.
The intention, motivation, duration, frequency, of these approaches differ significantly. Fasting for health and longevity practices can be found in early ancient Ayurvedic medicine and modern intermittent fasting trends. Therapeutically, 5th-century Greek physician Hippocrates recommended fasting for symptoms of certain illnesses. In recent years, researchers have explored the metabolic effects of fasting, particularly its role in insulin sensitivity and glucose control, sparking interest in its potential benefits and risks for individuals with diabetes.
The American Diabetes Association (ADA) has recognized the importance of understanding how fasting may play a role in the lives of individuals with diabetes. The 2025 Standards of Care have been updated to provide more structured guidance (see infographic below).
The new recommendations highlight individualized care plans, focusing on pre-fasting risk assessments, medication adjustments, and glucose monitoring strategies to ensure safety during fasting.1 To assess risk, clinicians are encouraged to consider the duration of fast, type of diabetes, daily activity, and individual diabetes risk factors while using standardized tools, such as the International Diabetes Federation-Diabetes and Ramadan International Alliance (IDF-DAR) risk tool.2
While the type and duration of fasting may differ, this risk calculator may also provide assessment of risk for varying religious fasting and may guide fasting-focused education to minimize risks of hypoglycemia, hyperglycemia, and dehydration.
Although religious and non-religious fasting may have differences in intention and motivation for the individual living with diabetes, risk assessment, education, and treatment adjustment are recommended for all.
Medication modifications are typically required for individuals on high-risk therapies such as insulin or sulfonylureas.
The Standards of Care guidelines emphasize pre-fasting education on the frequency of glucose monitoring, encouraging continuous glucose monitoring (CGM) to optimize safety during fasting periods. Current knowledge reports that SGLT2 inhibitors do not need to be adjusted during fasting but should be withheld from initiation close to the start of fasting.1
For individuals with type 1 diabetes, insulin pump therapy helps reduce the risk of hypoglycemia during fasting by allowing for setting temporary basal rates or, in the case of Automated Insulin Delivery systems, modifying insulin delivery based on sensor glucose feedback.
A referral to a Registered Dietitian with expertise in religious fasting can provide personalized and culturally sensitive meal and fluid planning to prevent dehydration and minimize post-prandial hyperglycemia when breaking a fast, or hypoglycemia due to change in typical meal patterns. A comprehensive medication plan tailored to the individual’s risk factors, dietary intake, and medication regimen is crucial to ensuring safety during fasting.
Non-religious fasting typically has motivations in weight loss, improving metabolic risk factors, or longevity.
Intermittent fasting can comprise alternate-day fasting, or a 5:2 dietary plan, each involving low calorie (500-600 kcals) intake either every other day or two of seven days of the week. Time-restrictive eating is a daily practice in which the focus is on fasting and eating hours. The most common is the 16:8 method, in which an individual focuses on fasting for 16 hours, and eating is restricted to a planned 8 hours.
While evidence suggests that time-restricted eating and intermittent fasting results in 3-8% weight loss over 12 weeks and improved metabolic markers, the outcomes are comparable to consistent calorie reduction plans.1 Just as with all nutrition therapy approaches, interventions need to be individualized, ensuring dietary patterns are sustainable and align with cultural, religious, and personal preferences while maintaining glucose stability and overall well-being.
For diabetes educators, these updated guidelines reinforce the necessity of proactive counseling and culturally sensitive care.
By staying informed on best practices for fasting, diabetes care and education specialists can guide individuals in making informed decisions that support their faith and their health.
Education includes discussing medication modifications, meal planning strategies, safe exercise recommendations, and the importance of fluid balance during fasting periods. Providing clear, evidence-based recommendations ensures that individuals with diabetes feel supported in their tradition or dietary choice while also minimize health risks.
References:
- American Diabetes Association Professional Practice Committee; 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024. Diabetes Care 1 January 2024; 47 (Supplement_1): S77–S110. https://doi.org/10.2337/dc24-S005
- International Diabetes Federation-Diabetes and Ramadan Alliance (IDF-DAR) Fasting Risk Assessment. Downloaded from https://www.mdcalc.com/calc/10522/international-diabetes-federation-diabetes-ramadan-alliance-idf-dar-fasting-risk-assessment on February 19th, 2024.
Want to hear more from this expert?
Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more! If you’re preparing for the CDCES or BC-ADM exam, this conference—paired with free bonus courses—serves as the ideal study companion!
With interactive co-teaching, we keep sessions engaging, relevant, and fun. Let’s learn and grow together!
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun! The faculty includes:
- Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES
- Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
- Christine Craig, MS, RD, CDCES
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 11 Bonus Online Courses: As a course attendee, you automatically receive a bonus online course bundle of 11 online courses valued at over
Question of the Week – Weight-Inclusive Diabetes Care
How does weight-inclusive care improve clinical outcomes in diabetes management?
- It eliminates weight stigma, leading to better engagement and collaboration.
- It reduces A1C only in individuals who experience weight loss.
- It leads to greater weight loss, which is the key factor in diabetes management.
- It removes the need for lifestyle modifications and focuses only on medication.
by Jessica Jones, MS, RD, CDCES, CEO and Co-founder of Diabetes Digital, a virtual nutrition counseling platform for people with diabetes and prediabetes
Want to learn more about this question?
Enroll in our upcoming webinar led by Jessica Jones, MS, RD, CDCES
Weight-Inclusive Diabetes Care: Turning Compassion into Practical Tools
Join us live on June 5, 2025, at 11:30 am PST
This session provides healthcare providers with actionable strategies to integrate weight-inclusive care into diabetes management practices, focusing on improving outcomes through respect for body diversity and individual autonomy. Weight stigma is a well-documented barrier to effective care, contributing to poorer glycemic control, disordered eating, and care avoidance. By shifting from a weight-focused approach to one aligned with Health at Every Size (HAES®), providers can foster trust, enhance participant engagement, and support sustainable health behaviors.
Jessica Jones, MS, RD, CDCES, will share evidence-based insights on mitigating weight stigma and applying HAES-aligned strategies in practice. Participants will learn how to build rapport, set realistic nutrition goals, and implement interventions that prioritize blood sugar management, joyful movement, and intuitive eating. This session equips providers with tools to deliver compassionate, person-centered care, improving both clinical outcomes and the provider-participant relationship..
Course topics:
- Foundations of weight-inclusive diabetes care: overview and evidence
- Shifting perspectives: building trust and redefining success
- Practical tools for sustainable blood sugar management
Instructor: Jessica Jones, MS, RD, CDCES, CEO and Co-founder of Diabetes Digital
Jessica Jones, MS, RDN, CDCES, is a nationally recognized Registered Dietitian Nutritionist and Certified Diabetes Care & Education Specialist committed to making nutrition education accessible to everyone. As the CEO and co-founder of Diabetes Digital, Jessica has been pivotal in developing an innovative telehealth platform that provides tailored nutrition counseling for individuals with diabetes and prediabetes. Additionally, she co-hosts the Diabetes Digital Podcast, engaging listeners with thoughtful conversations on managing diabetes.
With over a decade of clinical experience, Jessica has contributed significantly to the field through her co-authorship of the “28-Day Plant-Powered Health Reboot” cookbook and “A Diabetes Guide to Enjoying the Foods of the World.” She also wrote the Diabetes Chapter for the Food and Nutrition Care Manual Textbook and regularly shares her insights as a columnist for SELF magazine.
As a co-founder of Food Heaven, an online platform and podcast with more than 5 million downloads, she offers essential resources on cooking, intuitive eating, and embracing body respect. Jessica’s contributions have been celebrated in prominent publications, including Oprah Magazine, Women’s Health, The Food Network Magazine, SELF Magazine, the Huffington Post, and Bon Appetit. She lives in Sacramento, CA with her husband and “spirited” Maltese Shih Tzu puppy, Poppy.
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