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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!
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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Canagliflozin (Invokana), an SGLT-2 Inhibitor, just received a new Food and Drug Administration (FDA) indication.
Adults with type 2 diabetes and diabetes kidney disease who take canagliflozin (Invokana) experience a reduction of:
This new indication is based on the results of the CREDENCE Trial, which was designed to see if canagliflozin had a renal vascular protective effect.
The trial enrolled over 4, 400 people with type 2 diabetes and GFRs between 30 and 90. The results clearly indicated several benefits.
Researchers observed a 32% risk reduction of end stage renal disease among patients who took canagliflozin (HR = 0.68), as well as a 28% risk reduction for starting dialysis, having a kidney transplant or experiencing renal death.
In a sub-group of the CREDENCE Trial, cardiovascular death for type 2 diabetes dropped by over 30% and in the CANVAS Study, there was a 33% drop in risk of hospitalization for heart failure.
Please see Oral Meds Pocketcard for side effects and precautions of canagliflozin and SGLT-2 Medications. In the most recent ADA Standards, two SGLT-2 Inhibitors, empagliflozin and canagliflozin are indicated for individuals with heart failure, chronic kidney disease and an elevated CV risk profile.
The use of these SGLT-2 Inhibitors offer hope and a new strategy to protect renal function and decrease heart disease risk in those living with diabetes.
For more information see this Helio Article on the new FDA indication for Canagliflozin.
Please see our GLP-1 Receptor Agonists and Injectibles Pocketcard for new oral GLP-1 tablet.
Download FREE Medication PocketCards on our website.
Purchase PocketCards – Updated physical PocketCards will ship out no later than October 18, 2019.
Download our FREE CDCES Coach App
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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For Question of the week, test takers usually choose the correct answer 70-80% of the time. However, for this Tuesday’s question of the week, only about 23% of respondents chose the correct answer.
So, we thought this would be a perfect opportunity for another answer rationale. We’ll explore this question and the best answer in more detail and throw in some test-taking tips along the way.
Question of the week on October 8:
The American Diabetes Association recommends which of the following interventions to decrease risk of cardiovascular disease?
Answer Options:
As shown above, the most common choice was option 1, the second most common answer was option 3, then option 2, and finally option 4.
For this question, a key consideration is what “The American Diabetes Association recommends.” This focus helps test takers hone in on ADA Standards.
Option 1 is juicy but incorrect. The ADA standard for individuals without cardiovascular disease risk or history is to maintain a B/P of less than 140/90. The blood pressure target in Option 1 of 130/80, is the B/P target for individuals with cardiovascular disease or a 10 year CVD risk of 15% or greater. The general goal for people with diabetes is to keep B/P less than 140/80. However, for those with a higher risk of CV events, the target is 130/80. Blood pressure targets are based on the individual assessment of risk.
Option 3 is incorrect because ACE-Inhibitor and Angiotensin Receptor Blockers should not be paired together. Option 3 says “add a Angiotensin Receptor Blocker” not switch to. Giving an ACE and and ARB together is not recommended due to potential renal issues.
Option 4 is incorrect because aspirin therapy is recommended for individuals over the age of 50 with CV risk factors.
Option 2 is the best answer. The standard for people with diabetes who are over the age of 40 is to start a statin to reduce the risk of cardiovascular disease. No CVD history is required to initiate statin therapy in this standard for people over the age of 40 with either type 1 or type 2.
For more info, here is a link to ADA’s Standard Ten. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2019
Our DiabetesEd Online University also offers courses on Standards of Care and Cardiovascular Disease. Check it out here!
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!
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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Multiple studies have examined metformin for its potential tumor and cancer fighting ability. The National Center for Biotechnology Information (NCBI) published such a study in 2016. Researchers found substantial pre-clinical evidence suggesting anti-cancer properties of metformin based on in-vitro and in-vivo analysis. Their analysis suggested metformin could be used as a radiation sensitizer or immunotherapy drug, besides its direct anti-proliferative properties .
In mice with lung cancer, metformin was used and researchers saw a 72% reduction in tumor burden. Tumors are known to exhibit the Warburg effect, but metformin blunts this and consequently downregulates the growth of cancer stem cells.
Several observational studies showed a correlation between metformin use and lessened cancer incidence. The results demonstrated that metformin users have statistically significant reductions in liver, pancreatic, colorectal and breast cancers.
You can read more details on the study and enjoy their infographics and tables of data here.
Coach Beverly reports no conflict of interest for medication postings.
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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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!
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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The Journal of General Internal Medicine recently surveyed nearly 300 physicians, and the findings were alarming.
Their research suggests approximately 25% of all physicians misdiagnose people who have diabetes with prediabetes instead.
Additionally, the average provider didn’t know 33% of the risk factors for prediabetes, were unfamiliar with prevention or management of the condition, and generally under-screened for it.
Only 42% of the physicians knew the correct fasting A1c to diagnose prediabetes.
Researchers from John Hopkins University recommend providing physicians with better knowledge on diabetes prevention and for insurance to cover plans that help better diagnose and treat prediabetes.
The hope is these two strategies will help with more accurate screening and earlier intervention to avoid development and progression of type 2 which can lead to kidney failure, heart disease, or stroke. Read the full study and statistics here.
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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Join us live with your questions on October 10, 2019 @ 11:30 a.m. PST!
Coach Beverly offers this FREE webinar to help get you prepare for the CDCES Exam. All her tips and tricks are meant to ease your mind and reflect the updates to the CDCES content outline. Register below with a name and email and you can join us live next Thursday!
Topics covered include:
We will review sample test questions and the reasoning behind choosing the right answers.
After registering, you will receive a confirmation email containing information about joining the webinar.
Intended Audience: This FREE webinar is designed for individual 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®.
Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator who has passed her CDCES Exam 6 times. She is a nationally recognized diabetes expert for over 25 years.
See our Preparing for CDCES Resource Page >>
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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For Question of the week, test takers usually choose the correct answer 70-80% of the time. However, for this Tuesday’s question of the week, only 25% of respondents chose the correct answer.
We thought this presented a perfect opportunity to explore this question and the best answer in more detail and throw in some test-taking tips along the way.
Question of week on October 1:
As shown above, the most common choice was option 4, the second most common answer was option 3, then option 1, and finally option 2.
Test taking strategies:
A good strategy for the exam for questions that give multiple distracting facts at once, is to read through each answer carefully and use process of elimination. First, get rid of one to two false answers that are either wrong or don’t address the main intent of the question. This leaves two answers and a 50% chance of choosing the BEST answer.
The key sentence here is “You ask to see JRs logbook, but JR shows you an app they use to track blood glucose levels.” Then there is a prompt to give a response.
Option 4 is a “juicy” answer because the first sentence shows JR admitting they’re tired. But the answer does not address the main intent of the question. Another distraction in the question includes that that they’re specifically feeling tired between lunch and dinner.
Option 4 also ignores the fact the educator asked to see their logbook and they respond by showing an app. Option 4 gets the test taker off-topic from the core question.
Also off-topic is Option 3. The test question vignette includes another distraction when it highlights that JR is specifically feeling tired between lunch and dinner. It would be easy to assume they are tired because of low blood sugar, which a midafternoon snack could fix, but there is no data to support that JR is having hypoglycemia. When reading the entire question, the core issue is that the educator asked to see a logbook but are shown an app instead.
Option 2 nods to the key intent of the question, but the educator fails to acknowledge that JR is trying to use an app to track blood glucose levels and other self-care behaviors. Instead, the educator ignores the app usage and instructs JR to keep a written log. This does not convey a person-centered approach, but instead asks JR to track blood glucose in a way that is familiar to the educator.
Option 1 is the person-centered option that acknowledges the individual and their preference for tracking their diabetes data using technology. “Looks like you really like using apps.” At that point in an appointment, the educator can use a curiosity based approach, “Can I please see the data you are collecting on your app? Have you noticed any trends or incidence of hypoglycemia in the afternoon?”
Together, JR and the educator might even explore other apps that might be useful and support JR in living with diabetes).
Language & Diabetes is a great, free resource to gain more insight into why Option 1 is the best answer to this question. Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
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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