Dearest community,

I miss hanging out with you. But now is a time to be present with ourselves. This weekend, I considered finding my crochet hooks and making an afghan. I finished 2 books, made banana bread, mashed potatoes and put old books in a donate box. Our family has played dozens of games of Rook, even though our two teenage boys consistently outwit me and my husband.

I have found myself slowing down and observing more. I discovered two new birds nest during my daily walk. I paused to watch a curious quail poke its head into my succulents. I have delighted in the night time calls of the geese as they head home.

Last week, a narration appeared in my Facebook feed that I have kept going back to. The message has afforded me comfort and guidance during this time of reflection. I hope it resonates with you and I thank the Council of 13 Indigenous Grandmothers for sharing their wisdom.

A message from the Council of 13 Indigenous Grandmothers:

“As you move through these changing times… be easy on yourself and be easy on one another.

You are at the beginning of something new. You are learning a new way of being. You will find that you are working less in the yang modes that you are used to.

You will stop working so hard at getting from point A to point B the way you have in the past, but instead, will spend more time experiencing yourself in the whole, and your place in it.

Instead of traveling to a goal out there, you will voyage deeper into yourself. Your mother’s grandmother knew how to do this.

Your ancestors from long ago knew how to do this. They knew the power of the feminine principle… and because you carry their DNA in your body, this wisdom and this way of being is within you.

Call on it. Call it up. Invite your ancestors in.

As the yang based habits and the decaying institutions on our planet begin to crumble, look up. A breeze is stirring.

Feel the sun on your wings.”

Read more at the Council of 13 Indigenous Grandmothers:

Join us on April 2nd from 11:30 am – 12:45 pm

Get ready to succeed a the CDCES exam. This course will transform your test anxiety into calm self-confidence and test taking readiness.

We will review sample test questions and the reasoning behind choosing the right answers.

Topics covered include the changes in requirements for 2020, exam eligibility and test format, strategies to succeed, and a review of study tips and test-taking tactics.

After registering, you will receive a confirmation email containing information about joining the webinar.

Intended Audience: This FREE webinar is designed for individuals or groups of diabetes educators, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants and other health care providers interested in achieving excellence in diabetes care and becoming Certified Diabetes Care and Education Specialists®.

Certification Exams & COVID-19

Many people in our community are wondering how the shelter-in-place due to COVID-19 impacts any previously scheduled certification exams, so we wanted to provide an update from PSI, the testing centers for the Certification Board for Diabetes Care and Education (CBDCE).

The PSI centers for testing closed on March 19 and will be closed till at least April 13th, but will reassess this timeline, as necessary.

PSI states, “Effective immediately, candidates can reschedule up to and including the day of testing at no penalty and no documentation required.”

Due to this closure, all rescheduling rules and no show policies will be relaxed until April 30th; you can reschedule your test till then at no cost.

To avoid long wait times, PSI encourages you to reschedule online through their website. Though you can also reschedule by calling: 833-333-4755 Call Centers are open: 4:30 a.m.-7:00 p.m. PDT M-F, 6:00 a.m.-2:30 p.m. PDT Sat-Sun

For more information on the PSI closures, click here. For site closures regarding the BC-ADM exam, click here.

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MJ, a 49-year-old with type 1 diabetes, states during your telehealth session that they are not feeling very well and are worried about getting COVID-19.

Which of the following is an accurate statement?

1. People with diabetes are at higher risk of getting COVID-19
2. People with diabetes have the same risk of getting COVID-19 as the general population
3. People with type 1 diabetes have a slightly higher risk of getting COVID-19 than those with type 2 diabetes
4. Regardless of the type of diabetes, COVID-19 rates are slightly lower

Click here to test your knowledge!

COVID & Diabetes Update
Navigating a Crisis

Recorded & Ready for Viewing

Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM, has completely updated this critical presentation, to bring health care professionals up-to-date on the current state of COVID and its impact on diabetes care. She summarizes key information including critical teaching points and management strategies for people with diabetes who develop a COVID-19 infection.

Topics Include:

1. Discuss the current state of diabetes in the United States.
2. Describe the relationship between COVID and health care disparities 
3. Explore the impact of COVID infection on those with pre-existing diabetes.
4. Discuss treatment strategies for COVID and diabetes, including new vaccines.
5. List critical teaching points for people with diabetes and COVID.

Join us to learn critical information about Diabetes and COVID Management

Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF and Touro University and a nationally recognized diabetes expert.

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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

Mary Jane Oliver was an American poet who won the National Book Award and the Pulitzer Prize.

Her wisdom and candor offers readers the opportunity to see the world as it is and then slightly adjust their gaze to see the potential for hope and healing.

In this time of uncertainty, we can look to poetry, art and music to provide comfort, wisdom and a little beauty. We hope you enjoy this poem that Coach Beverly has chosen to share.

I WORRIED

I worried a lot. Will the garden grow, will the rivers

flow in the right direction, will the earth turn

as it was taught, and if not, how shall I correct it?

Was I right, was I wrong, will I be forgiven,

can I do better?

Will I ever be able to sing, even the sparrows

can do it and I am, well,

hopeless.

Is my eyesight fading or am I just imagining it,

am I going to get rheumatism,

lockjaw, dementia?

Finally I saw that worrying had come to nothing.

And gave it up. And took my old body

and went out into the morning,

and sang.

By Mary Jane Oliver, (September 10, 1935 – January 17, 2019) From Swan, 2010

Also read our blog 10 Mental Health Strategies while we Shelter-in-Place

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As we enter this unprecedented phase of the pandemic, how do we as individuals and parents cope? Dr. Giuseppe (Bepi) Raviola serves as the director of the global mental health team at Partners In Health. To help us through this difficult and scary time, he has outlined mental health strategies to help us adapt and cope while we engage in social distancing and upheaval of our daily lives.

We highlight several practices that might help us gain steady emotional footing in this strange new scenario that we are suddenly together in. Coach Beverly has also incorporated a few of her own suggestions.

10 Practices

1. Social distancing doesn’t mean emotional distancing. Find ways to keep connected with your important people. Use technologies such as skyping, facetime and others to keep in touch. Write those thank you cards you have been meaning to send or write a letter to a special person in your life.
2. Create a schedule for your day and try to develop a routine if you are staying home. Make sure to include outdoor activities, time for mindfulness and connecting with others.
3. Carve out time for physical activity. Try to stretch daily and breathe deeply. There are lots of dance instruction and yoga classes online for free. Maybe you want to try a new type of exercise that you can find online. Take a walk outside while talking to friends on the phone. National Parks are not charging admission fees to encourage people to enjoy nature.
4. Try to limit internet time reading about COVID-19. Instead, consider this is a time for learning and intellectual engagement. Start learning that new language, read a book on a topic you are not familiar with, take online courses for continuing education. Dust off your guitar or piano or other instruments and take online lessons.
5. Positive family time can help counter feelings of fear. Play games together, sing karaoke, work on outside projects, cook meals, or just hang out in a shared space.
6. Remember to do the things that you really enjoy doing, that you can do in this situation.
7. Reach out to neighbors that need help getting food and basic necessities. Look for ways to volunteer in your community.
8. Take time for focused meditation and relaxation. We have a wonderful and free Mindfulness Practice for Health Care Professionals that you may want to explore.
9. Limit exposure to TV and internet news. Choose small windows and then find ways to cleanse yourself of it.
10. Bathe daily, if possible, to reinforce feelings of cleanliness. Take a bath in mineral salts, light candles, listen to soothing music.

Read more here.

Remember that we will get through this. We are resilient, smart and resourceful.

With love, Coach Beverly.

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Taking care of ourselves, our families and our patients are our first priorities at this time.

It is very quiet in most neighborhoods this morning; no commuter cars on the streets, no school bus noises, no sounds of children playing. This desolate environment reminds us that there is a lot of unknown for all of us.

It is so important right now to make sure we are all prepared for social distancing and flattening the curve of the spread of this pathogen.

We want to offer a few resources for those living with diabetes to prepare for what’s ahead and how to manage stress during this time. Endocrinologists are urging people that use insulin to plan ahead and have extra supplies on hand.

• DDRC Emergency Preparedness Kit
• ADA Treatment & Care Fact Sheet
• CDC Guidelines for Protecting Yourself and Others from the Coronavirus
• CDC Steps to Take if You’re Sick
• CDC Tips for Managing Stress

Written by Catherine Cullinane RN, CDCES, our resident Tech Thursday Content Writer

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Our March 3rd Question of the week was a question about type 1 and alcohol. Although 66% of respondents chose the correct answer, one third did not. We thought that this was an important topic to discuss further, so we can pass on correct info to people living with diabetes.

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question

March 3 Question of the week: SZ has type 1 diabetes and uses an insulin pump. SZ wants to celebrate her 21^st birthday with friends and asks about drinking alcohol. Which of the following is a correct statement?

Answer Choices:

1. Since alcohol causes hyperglycemia, make sure to avoid mixed drinks
2. Check glucose 1-2 hours post drink to see if extra insulin is needed
3. 5 ounces of wine is about one serving of alcohol
4. White wine affects blood glucose more than red wines

As shown above, the most common choice was option 3, the second most common answer was option 2, then option 1, and finally option 4.

The majority of participants chose answer 3, the correct answer. However, if you chose a different answer, read more to learn about the relationship between alcohol and glucose.

Option 1 is incorrect – Since the liver is busy breaking down alcohol, it is not able to release glycogen stores after alcohol consumption, which can lead to hypoglycemia (not hyperglycemia). The sugary carb content of mixed drinks can cause a temporary rise in glucose levels and the alcohol can cause delayed hypoglycemia.

Option 2 is also incorrect. While it is a good idea to check glucose 1-2 hours post drink to see evaluate blood glucose levels, giving extra insulin post alcohol consumption can contribute to hypoglycemia.

Option 3 is correct. One serving of alcohol is 5 ounces of wine, 12 ounces of beer or 1 ounce of spirits.

Finally, Option 4 is incorrect because one serving of white wine affects blood glucose the same as one serving of red wine. Although alcohol lowers blood glucose, it’s good to remember that it is not calorie-free. A glass of wine can provide about 120 k/cals and beer can provide more than 150 k/cals. Plus, alcohol can raise triglycerides and worsen neuropathy. Moderation is key.

We hope you appreciate this week’s rationale and keep studying hard! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

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Our Diabetes Detective Team scans the diabetes news to discover the most relevant info that Diabetes Educators need in their daily practice. We post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

Question of the Week – March 17, 2020

Join us!
DiabetesEd Specialist Course in Sacramento
Earn 38 CEs | May 13 – 15, 2020

Come join us at our, DiabetesEd Specialist Course in historic Sacramento, CA. Whether you are new to diabetes or a seasoned expert, you’ll leave our live seminar with the latest research plus teaching tools you can immediately apply to your clinical practice.

If you are interested in taking the CDCES exam or are seeking a state of the art review of current diabetes care, this course is for you. Our team of expert faculty has been fine-tuning this course for over fifteen years, and we know what you need. In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today! 

Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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