For last week’s practice question, we quizzed participants on 2024 ADA Standards. 44% 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:
The new ADA 2024 Standards of Care include dozens of updates to diabetes clinical practice.
Which of the following statements has actually been added to the ADA 2024 Standards of Care?
Answer Choices:
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 incorrect. 23.05% chose this answer. “Evaluate B12 levels for Individuals on long-term metformin therapy at least yearly.” This juicy answer is very tempting. It is true the metformin can be associated with lower B12 levels. However, the ADA does not recommend checking B12 levels annually for people taking this biguanide. Instead, they suggest regularly monitoring B12 levels in people on metformin therapy who have signs of B12 deficiency such as neuropathy or anemia.
Answer 2 is correct. 44.04% of you chose this answer. “Screen people with diabetes, caregivers, and family for diabetes distress at least annually.” Yes, this is the BEST answer! Many individuals with diabetes experience unrecognized and undertreated diabetes distress, which can lead to decreased engagement in self-management activities and worsen outcomes. We address diabetes distress and discuss strategies to address this common emotional response to diabetes in our ReVive 5 Training Program.
Answer 3 is incorrect. About 16.27% of respondents chose this. “Provide COVID 19 immunizations annually to people with diabetes starting at age 18.” The ADA recommends starting COVID 19 immunizations in people with diabetes starting at 6 months and follow-up with boosters as recommended,
Finally, Answer 4 is incorrect. 16.63% chose this answer. “Test for type 1 autoimmunity annually starting at age 5 for those with family history of autoimmune conditions.” Autoimmune testing is recommended for those with immediate family members with type 1 diabetes and other risk factors. There is no age cut-off nor is there a recommendation for annual testing.
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!
Objectives:
Intended Audience: This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
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, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
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!
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.
If your New Year’s resolution includes getting ready for diabetes certification exams, keep reading!
The Certification Board for Diabetes Care and Education Specialists (CBDCE) has posted a few critical updates on its website regarding CDCES testing blackout dates and an extension of COVID-19 pandemic professional practice requirements. This information will help as you plan your exam dates and work toward acquiring professional practice hours.
Blackout Periods for Application Submission, Scheduling, and CDCES Testing
According to the CBDCE website, to improve the candidate experience, they will be moving to a new application platform in early 2024. Due to this change, there will be specified periods where no applications are accepted, and testing will be closed.
Blackout period for exam application
To accomplish the transition to a new platform, there will be a two-week blackout period from February 9, 2024, to February 27, 2024, when individuals cannot apply for the CDCES exam.
Blackout period for exam application AND testing
In addition, there will be a blackout period where scheduling or testing is unavailable from February 19, 2024, to February 27, 2024.
Please consider this important information as part of your plan to apply, schedule, and take your CDCES exam. We will keep you updated and let you know if any changes occur.
Professional Practice Experience Updates
Starting in 2021, the CBDCE increased the period of time allowed to accumulate professional practice hours from 4 years to 5 years. This additional time allotment addressed the impact of the COVID-19 pandemic on the ability of health professionals to accrue practice experience in diabetes care and education (DCE). The CBDCE also decreased by half the number of diabetes care and education hours required within 12 months prior to taking the application.
The good news is that the CBDCE Board of Directors approved making these initial temporary changes to the professional practice requirement for initial certification to a permanent state (see table below).
According to the CBDCE Website, Professional Practice Experience Requirement Changes are identified
below:
Learn more about changes in the Pandemic Impact Certification Statement or visit CBDCE website.
Plus, you can join our FREE webinar coming up soon (see below)
Starting your journey to becoming a CDCES? You won’t want to miss our FREE Preparing for CDCES Exam Webinar! This course will transform your test anxiety into calm self-confidence and test-taking readiness. Coach Beverly has taken (and passed) the CDCES exam 7 times and loves sharing her insights on exam success. She will include the latest exam updates with her clear spoken and engaging approach.
A perfect way to kick off your New Year and it’s FREE!
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
The 2024 ADA Standards of Care includes expanded content on the prevention and treatment of hypoglycemia.
Based on the updated guidelines for the treatment of hypoglycemia, which of the following is true?
Click Here to Test your Knowledge
Objectives:
Intended Audience: This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
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, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Every year, Coach Beverly excitedly waits for the release of the new ADA Standards of Care. She loves scanning the content pages to discover updates and advances leading to improved diabetes care. She then takes on the task of translating this new information into her presentations, Cheat Sheets, and web content to reflect the latest guidelines.
This first 2024 newsletter features the updated risk screening guidelines and immunization recommendations. We share our library of Cheat Sheets that integrate the new Standards and are ready to download and share with your colleagues and people living with diabetes alike.
For those taking the CDCES exam, we highlight updated information about practice requirements and blackout periods. Plus, we answer the most commonly asked question about the CDCES in our blog.
We invite you to read our interview with Christine Craig, MS, RD, CDCES, nutrition expert, and winner of the 2023 Impact Award. As the newest member of our team, We are excited to integrate her fresh perspective and breadth of knowledge into our blogs, questions of the week, and online presentations.
We encourage you to test your knowledge with our Question and Rationale of the Week.
January kicks off our Level 1 Fundamental Series, followed by our annual ADA Standards of Care update and Level 3 Boot Camp Course Series in February. We hope to see you there!
Here is to a 2024 filled with self-compassion and moments of awe.
Coach Beverly and Bryanna
Featured Articles
FREE Webinars & Resources
Upcoming Events – See the complete calendar listing
This course facilitated by Coach Beverly will help you transform your nervousness into focused energy that will help you succeed. She will provide test taking tips based on her experience taking the certification exam six times. She will explain how to dissect the question, eliminate wrong answers, and avoid getting lured in by juicy answers.
Plus, the Test Taking Toolkit provides you over 220+ sample practice online practice questions, simulating the exam experience. A perfect way to assess your knowledge and create a focused study plan, while increasing your test taking confidence.
This Test Taking Practice Exam Toolkit is designed to prepare you for exam success. This Webinar includes:
Intended Audience: These courses are knowledge-based activities 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 preparing for Certification Exam Success!
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
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, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
For last week’s practice question, we quizzed participants on the new ADA Standards for type 2 diabetes medication. 49% 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
Based on the newly released 2024 American Diabetes Association (ADA) Standards of Care, which of the following statements is NOT accurate regarding treatment for hyperglycemia?
Answer Choices:
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 incorrect. 13.71% chose this answer. “Semaglutide and tirzepatide have the highest weight loss efficacy.” This statement is accurate. These two incretin mimetics not only substantially lower A1C levels, they also are associated with the highest percentage of weight loss of all the diabetes medications. See Diabetes Med PocketCards for more information.
Answer 2 is correct. 48.72% of you chose this answer. “Metformin may be only safely used in people with an estimated GFR of 45 or greater.” YES, great job! This answer is FALSE (making it the best answer). If a person with diabetes is taking metformin and their GFR drops below 30, then we stop the medication. However, we can start or continue metformin therapy if the GFR is 45 or greater. In addition, metformin doesn’t harm the kidneys, it actually protects them by lowering blood glucose levels. See Diabetes Med PocketCards for more information.
Answer 3 is incorrect. About 18.48% of respondents chose this. “Avoid dual GIP and GLP-1 RA therapy in people with gastroparesis.” This answer is also accurate. Tirzepatide (Mounjaro) can substantially slow gastric emptying which could exacerbate gastroparesis. For that reason, it is not a recommended therapy for people with gastroparesis.
Finally, Answer 4 is incorrect. 19.08% chose this answer. “Consider combination therapy in people presenting with A1C levels 1.5–2.0% above goal.” This answer is also accurate. The ADA Standards of Care recommend more intensive pharmacologic intervention for those with substantially elevated A1C to improve and prolong pancreatic function.
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!
Topics:
This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the annual updates to the American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provides critical teaching points & content for healthcare professionals involved in diabetes care & education.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
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, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Which of the following is an accurate new 2024 ADA Standard of Care?
The new ADA 2024 Standards of Care include dozens of updates to diabetes clinical practice. Which of the following statements has actually been added to the ADA 2024 Standards of Care?
Click Here to Test your Knowledge
Class Topics & Webinar Dates:
Intended Audience: This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with diabetes and preparing for the CDCES Certification Exam.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
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, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
MR is frustrated that their morning glucose is almost always elevated. Since you have heard about the impact of “chronotype” on glucose, you ask them about eating patterns and explore whether they are early birds or night owls.
The 2024 American Diabetes Association (ADA) Standards of Care introduced the field of chrononutrition, the science of how our body’s 24-hour cycle (circadian rhythm), nutrition, and health interact. Growing evidence shows that factors, including when and type of food is eaten, hormones, genetics, exercise, sleep cycles, and a person’s daily light exposure, influence health and risk for metabolic disease.
When we consider a person’s chronotype, we realize that it’s not just “what” individuals eat that impacts metabolic health. Could “when” they eat and their chronotype be just as crucial for glucose regulation? Can we leverage this information to suggest modifications in the type of nutrients consumed throughout the day to support improved glycemia?
We have learned the association between circadian rhythm disruptions and metabolic disorders from people who perform shift work. Working in shift work and having type 2 diabetes is associated with increased A1c, neuropathy, and decreased psychological well-being.1 Glucose metabolism and tolerance follow a circadian rhythm throughout the day. Hormones, such as insulin and cortisol, cycle daily and regulate insulin sensitivity and glucose metabolism changes. Research suggests when food intake is out of sync with the daily cycle, this can reduce glucose tolerance and increase the risk of metabolic diseases such as type 2 diabetes, obesity, and cardiovascular disease.
“Meal timing and food nutrient components (chrononutrition) play an important role in regulating the circadian clock, enhancing metabolic health, and reducing the risk of type 2 diabetes.” 2
Post-prandial glucose response is affected by what and how much we eat and can vary based on the time of day the meal is consumed. Meal timing can affect type 2 diabetes, so it is important to consider timing in addition to composition alone. In a 2020 review article by Henry et al., they reported several different studies completed in individuals with type 2 diabetes and healthy subjects. These studies suggested both morning and late-night eating can contribute to the greatest glucose excursions. Eating after 8 pm was independently associated with an increase in A1C levels. Consuming more than a third of daily calories late in the evening led to higher post-meal glucose excursions and reduced morning glucose tolerance compared to other times of day. And a study of individuals with type 2 diabetes showed higher post-meal glucose trends after morning meals verses identical meals consumed throughout the day. These small studies suggest that modifying when a meal is consumed could reduce glycemia and the risk of diabetes. However, more extensive studies are needed to support causation and associate it with a person’s genetics and true chronotype.
Macronutrient meal composition and the time of day consumed may also play a role in chrononutrition. Whether it is a variation of calories consumed or manipulating different macronutrients from meal to meal, the relationship between food type and timing could affect glucose metabolism. Changes in insulin sensitivity throughout the day can affect post-meal glucose in response to varying carbohydrate quantity, quality, and rate of digestion. Davis et. Al, 2019 found that increased protein and lower carbohydrates at dinner meals reduce night post-prandial glucose compared to standard meals.
The key nutrition recommendations from the 2024 ADA Standards of Care are focused on individualizing eating patterns, meal plans, and dietary approaches. Research continues to evolve in this field, and there is much more to understand and validate. Most of the articles regarding chrononutrition referenced in the ADA Standards of Care are specific for type 2 diabetes, but we know circadian cycles and metabolism also play a role in type 1 diabetes. More research is needed to improve our understanding of why nutrients consumed at different times of day have differing effects, how this relates to the individual’s circadian biomarkers and genetics, and how it interplays with psychological factors that drive sleep cycles.
There is much to learn, but are there practical approaches we could consider implementing now? Yes! We can start by:
Blog contributed by nutrition expert Christine Craig, MS, RDN, CDCES
References:
Class Topics & Webinar Dates:
Intended Audience: This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with diabetes and preparing for the BC-ADM or the CDCES certification Exam.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
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, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
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!
For last week’s practice question, we quizzed participants on what is the best approach for people with low literacy skills. 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
Question: Which of the following strategies is most effective when working with someone with low literacy skills?
Answer Choices:
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. 63.27% chose this answer. “Be concrete and focus on problem solving.” Yes, this is the best answer. Since a person with low literacy can’t take notes or read information later, they will need to commit new information to memory. By providing concrete examples and engaging in collaborative problem solving, a person with low literacy can more effectively retain the information.
Answer 2 is incorrect. 13.70% of you chose this answer. “Speak slowly and clearly.” Just because a person hast low literacy doesn’t mean they have an intellectual disability. Maybe they didn’t have a chance to complete their education or experienced some other impediment to learning how to read and write. We can use a usual conversational pace and annunciation with this individual.
Answer 3 is incorrect. About 10.20% of respondents chose this. “Direct the teaching to the support person and encourage reinforcement.” A general rule of effective communication is to direct the teaching and education to the person with diabetes, while including the support person.
Finally, Answer 4 is incorrect. 12.83% chose this answer. “Underline key points on educational materials.” Since people with low literacy have limited ability to read and write, using print materials with words would not be an effective method to provide education. Use of pictures and infographics, videos, podcasts or other educational strategies that don’t require literacy, would be excellent alternatives.
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!
Topics:
This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the annual updates to the American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provides critical teaching points & content for healthcare professionals involved in diabetes care & education.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
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, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
All hours earned count toward your CDCES Accreditation Information
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!
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.