Welcome to our first 2023 Question of the Week. We decided to freshen up some of our images and are excited to share our new purple light bulb graphic for Question of the Week. Thanks for joining us and Happy New Year.

1. A 29-year-old newly started on antiretroviral therapy.
2. A 24-year-old who leads a sedentary lifestyle and father has history of heart disease.
3. A 14-year-old whose cousin with type 1 diabetes.
4. A 26-year-old who just delivered a baby three weeks early.

Click Here to Test your Knowledge

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Want to learn more about this question? Enroll in our upcoming

Level 1 | Diabetes Fundamentals 2023 Updates | 9+ CEs

This bundle is specifically designed for healthcare professionals who want to learn more about diabetes fundamentals for their clinical practice or for those who are studying for the Certified Diabetes Care and Education Specialist (CDCES) exam.

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 CDCES Certification Exam.

2023 Webinar Updates

1. January 10, 2023 – Class 1 – Getting to the Nitty Gritty 1.5 CEs
2. January 12, 2023 – Class 2 – Nutrition and Exercise 1.5 CEs
3. January 17, 2023 – Class 3 – Meds Overview for Type 2 – 1.5 CEs
4. January 19, 2023 – Class 4 – Insulin Therapy & Pattern Management 1.5 CEs
5. January 24, 2023 – Class 5 – Goals of Care – 1.5 CEs
6. January 26, 2023 – Class 6 – Hypoglycemia, Sick Days, Monitoring, Foot Care 1.5 CEs

All hours earned count toward your CDCES Accreditation Information

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Want an overview of the new 2023 ADA Standards of Care in Diabetes?

Join us live on February 2, 2023, at 11:30 am PST for our

Level 2 | ADA Standards of Care 2023 Update | 2.0 CEs

All hours earned count toward your CDCES Accreditation Information

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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 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.

1. Evaluate B12 levels for Individuals on long-term metformin therapy at least yearly.
2. Screen people with diabetes, caregivers, and family for diabetes distress at least annually.
3. Provide COVID 19 immunizations annually to people with diabetes starting at age 18.
4. Test for type 1 autoimmunity annually starting at age 5 for those with family history of autoimmune conditions.

Click Here to Test your Knowledge

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Want to learn more about this question?

Level 2 | ADA Standards of Care CE Course

Airs live on February 1, 2024, at 11:30 am PT

Topics:

• A review of changes & updates to the annual ADA Standards of Medical Care in Diabetes.
• Identification of key elements of the position statement.
• Discussion of how diabetes educators can apply this information in their clinical setting

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.

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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.

For last week’s practice question, we quizzed the new ADA 2023 standards on hypertension. 48% 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 2023 ADA Standards of Care are out, and they include several important clinical updates that are critical for our practice and certification exams.

What best represents the updated definition of hypertension in the 2023 Standards?

Answer Choices:

1. Hypertension is now defined as a systolic blood pressure greater than or equal to 130 or a diastolic blood pressure greater than or equal to 80.
2. Hypertension is now defined as a systolic blood pressure greater than or equal to 130 and a diastolic blood pressure greater than or equal to 80.
3. Hypertension is now defined as a systolic blood pressure greater than or equal to 140 or a diastolic blood pressure greater than or equal to 90.
4. Hypertension is now defined as a systolic blood pressure greater than or equal to 140 or a diastolic blood pressure greater than or equal to 80.

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Getting to the Best Answer

Answer 1 is correct. 48.07% chose this BEST answer – GREAT JOB. According to Standard 10, Cardiovascular Disease and Risk Management, hypertension is now defined as a systolic blood pressure greater than or equal to 130 or a diastolic blood pressure greater than or equal to 80. This is in agreement with the definition of hypertension by the American College of Cardiology and American Heart Association. People with diabetes and hypertension qualify for antihypertensive drug therapy when the blood pressure is persistently elevated and is greater than or equal to 130/80. The on-treatment target blood pressure goal is less than 130/80, if it can be safely attained.

Answer 2 is incorrect. 21.74% of you chose this answer, “Hypertension is now defined as a systolic blood pressure greater than or equal to 130 and a diastolic blood pressure greater than or equal to 80.” This is so close to being the being the best answer, but it is not accurate. If either the diastolic or systolic pressure meet the cut-off, the person is considered to have a blood pressure reading that is above target.

Answer 3 is incorrect. 16.89% of respondents chose this answer, “Hypertension is now defined as a systolic blood pressure greater than or equal to 140 or a diastolic blood pressure greater than or equal to 90.” This was the definition of hypertension in the 2022 and older standards. The 2023 definition of hypertension is blood pressure equal to or greater than 130/80.

Finally, Answer 4 is incorrect. 13.29% chose this answer, “Hypertension is now defined as a systolic blood pressure greater than or equal to 140 or a diastolic blood pressure greater than or equal to 80.” This is a blending of hypertension definition from the 2022 and 2023 standards. The 2023 definition of hypertension is blood pressure equal to or greater than 130/80.

Thank you so much for reading this “Rationale of the Week”.
You can view the 2023 Standards on our CDCES Coach App or you can pre-order your own ADA 2023 Standards here.
Hope you can join our ADA Standards of Care Webinar Update in February.
See below for info.

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Want to learn more about this question? Join us for our

Level 2 | ADA Standards of Care CE Course | 2.0 CEs

Updates air live between Feb. 2, 2023, at 11:30 am PST

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2023 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for healthcare professionals involved in diabetes care and education.

Objectives:

1. List significant changes and updates to the 2023 ADA Standards of Medical Care.
2. State 3 updates on new blood pressure and lipid goals.
3. Identify 5 key elements of the position statement.
4. Discuss how to apply the Standards in the clinical setting and in preparation for exam success.

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 health care providers interested in staying up to date on current practices of care for people with prediabetes, diabetes and other related conditions.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information

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Studying for the CDCES Exam? Enroll in our

CDCES Deluxe Prep Bundle | 30+ Online Courses + Bonus Items | 47 CEs

Included in this bundle

• Level 1 focuses on the fundamentals and introduces each topic area for the exam.
• Level 2 deep dives into the ADA Standards of Care, 
• Level 3 AKA Boot Camp is a more accelerated level that focuses on test simulation for finding the best answer to get you to the finish line of your study path.
• Technology Toolkit which gives information on pumps, sensors, and calculations,
• Test Taking Toolkit includes over 220 practice questions for test simulation plus a webinar where Coach Beverly provides test-taking tips based on her experience taking the certification exam six times. 
• ADCES Review Guide for the Diabetes Care and Education Specialist Exam – 5th Edition – Revised – The ADCES Review Guide is a fantastic independent study tool and comprehensive resource for the Diabetes Care and Education Specialist Exam. This book includes 480 + multiple-choice questions and strategies for preparing for and taking the exam with an answer key with rationales for all questions! 
• Medication PocketCard – Our four-sided medication accordion Pocketcards were designed by Coach Beverly Thomassian to assist in clinical practice and exam preparation.
• Tote Bag

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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.

As the shortest day of the year, Winter Solstice marks a turning point in the rhythms of life. Tomorrow, the sun will start shining longer and longer each day, bringing increased illumination and the promise of new growth and hope. Thank you for being a messenger of hope and light for people living with diabetes. Love, Coach Beverly

The Buddha’s Last Instruction by Mary Oliver

“Make of yourself a light,”
said the Buddha,
before he died.
I think of this every morning
as the east begins
to tear off its many clouds
of darkness, to send up the first
signal — a white fan
streaked with pink and violet,
even green.
An old man, he lay down
between two sala trees,
and he might have said anything,
knowing it was his final hour.
The light burns upward,
it thickens and settles over the fields.
Around him, the villagers gathered
and stretched forward to listen.
Even before the sun itself
hangs, disattached, in the blue air,
I am touched everywhere
by its ocean of yellow waves.
No doubt he thought of everything
that had happened in his difficult life.
And then I feel the sun itself
as it blazes over the hills,
like a million flowers on fire —
clearly I’m not needed,
yet I feel myself turning
into something of inexplicable value.
Slowly, beneath the branches,
he raised his head.

1. In general, insulin pens expire after 10-14 days at room temperature.
2. Insulin kept for more than 28 days at room temperature needs to be discarded.
3. JR can put the degludec (Tresiba) back in the refrigerator and use until the expiration date.
4. Degludec (Tresiba) can be safely stored at room temperature for up to 56 days.

Click Here to Test your Knowledge

---

Studying for the CDCES Exam? Enroll in our

CDCES Deluxe Prep Bundle | 30+ Online Courses + Bonus Items | 47 CEs

Included in this bundle

• Level 1 focuses on the fundamentals and introduces each topic area for the exam.
• Level 2 deep dives into the ADA Standards of Care, 
• Level 3 AKA Boot Camp is a more accelerated level that focuses on test simulation for finding the best answer to get you to the finish line of your study path.
• Technology Toolkit which gives information on pumps, sensors, and calculations,
• Test Taking Toolkit includes over 220 practice questions for test simulation plus a webinar where Coach Beverly provides test-taking tips based on her experience taking the certification exam six times. 
• ADCES Review Guide for the Diabetes Care and Education Specialist Exam – 5th Edition – Revised – The ADCES Review Guide is a fantastic independent study tool and comprehensive resource for the Diabetes Care and Education Specialist Exam. This book includes 480 + multiple-choice questions and strategies for preparing for and taking the exam with an answer key with rationales for all questions! 
• Medication PocketCard – Our four-sided medication accordion Pocketcards were designed by Coach Beverly Thomassian to assist in clinical practice and exam preparation.
• Tote Bag

---

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.

Upcoming Webinar – Join Coach Beverly on December 20th

How to Assess and Promote Well-Being: From Population Health to a Person-Centered Approach Standards | Level 2 | 1.5 CEs

Join us live on December 20, 2022, at 11:30am PST 

This presentation will include 2023 updates from the ADA Standards of Care. This course offers critical content that will help with certification exam success. Coach Beverly will delve into Social Determinants of health, assessment strategies, and behavior change approaches.
She will explore the psychosocial issues that can discourage individuals from adopting healthier behaviors and provides strategies to identify and overcome these barriers. Life studies are used to apply theory to real-life situations. A great course for anyone in the field of diabetes education or for those looking for a new perspective on assessment and coping strategies.

Intended Audience:  An important course for health care professionals working toward certification, that includes a comprehensive review of the components of population health and individual assessment.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information

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ADA Standards of Medical Care 2023 Update | Now Available on our CDCES Coach App

This time of year is always exciting as the new ADA Standards of Care are released!

While the hard copies won’t be available until the new year, you can start reviewing the new standards now in our CDCES Coach App!

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Here are some highlights of changes outlined by the ADA:

• Emphasis on supporting higher weight loss (up to 15%) based on the efficacy of and access to newer medications when appropriate
• New hypertension diagnosis cut-offs – Hypertension is now defined as a systolic blood pressure more than or equal to 130 mmHg or a diastolic blood pressure more than or equal to 80 mmHg.
• New recommendations related to sleep health and physical activity in people with diabetes
• Broad consideration of social determinants of health in guiding design and delivery of care
• The expanded role of SGLT2 inhibitor use in preserved and reduced heart failure ejection fraction
• The role of finerenone in individuals with diabetes and chronic kidney disease with albuminuria
• New lipid management recommendations suggesting lower LDL goals for high-risk individuals

You can now pre-order a copy for yourself! We will ship it out to you once we receive them sometime in January/February 2023.

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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.

For last week’s practice question, we quizzed test takers on Rezvoglar insulin. 75% 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:

RZ takes 30 units of glargine (Lantus) each night. However, when they went to the pharmacy to pick up their prescription, they received glargine insulin Rezvoglar instead of their usual Lantus.

RZ asks how the pharmacy can give them a different brand of insulin without checking first? After addressing their emotional response, you provide the following, most accurate Information.

Answer Choices:

1. Rezvoglar is the generic version of (glargine) Lantus.
2. Rezvoglar is an interchangeable biosimilar insulin.
3. Rezvoglar can not be switched for glargine (Lantus) without provider approval.
4. Rezvoglar is a rapid acting human biosimilar insulin analog

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Getting to the Best Answer

Answer 1 is incorrect. 12.73% chose this answer, “Rezvoglar is the generic version of (glargine) Lantus.” This is a very tempting answer, but since insulin is a biologic medication, (biologic medications are large, complex molecules, often made from living cells or tissue) the term “generic” is replaced with “biosimilar”. In addition, the better answer below is more accurate, and offers additional information.

Answer 2 is correct. 74.97% of you chose this answer, “Rezvoglar is an interchangeable biosimilar insulin.” YES, GREAT JOB. The FDA just announced that Rezvoglar has also been approved as an interchangeable biosimilar along with Semglee. An “interchangeable biosimilar,” means that pharmacists can substitute a person’s Lantus prescription with these cheaper alternatives without needing to consult the healthcare prescriber.

Answer 3 is incorrect. 9.17% of respondents chose this answer, “Rezvoglar can not be switched for glargine (Lantus) without provider approval.” With recent FDA approval, Rezvoglar is now an “interchangeable biosimilar,” which means that pharmacists can substitute a person’s Lantus prescription with this cheaper alternative without needing to consult the healthcare prescriber.

Finally, Answer 4 is incorrect. 3.13% chose this answer, “Rezvoglar is a rapid-acting human biosimilar insulin analog.” Rezvoglar is the biosimilar of basal insulin glargine.

Thank you so much for reading this “Rationale of the Week”.

Newly Approved Biosimilar Interchangeable Basal Insulin – PocketCard Update

Under basal insulin glargine, there are now 3 biosimilars listed; Basaglar, Semglee and Rezvoglar. The FDA just announced that Rezvoglar has also been approved as an interchangeable biosimilar along with Semglee. An “interchangeable biosimilar,” means that pharmacists can substitute a person’s Lantus prescription with these cheaper alternatives without needing to consult the healthcare prescriber.

Get Your Own PocketCard
These updates are now posted on the latest version of our Insulin PocketCards, which are available for FREE download, or on our CDCES Coach App. You can also purchase your very own 2023 laminated version and they make perfect gifts for team members.

 

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Want to learn more about this question? Join us for our

Diabetes Fundamentals 2023 Updates | Level 1
$119 | 9+ CEs

Updates air live between Jan 10, 2023-Jan 26, 2023, at 11:30 am PST

This bundle is specifically designed for healthcare professionals who want to learn more about diabetes fundamentals for their clinical practice or for those who are studying for the Certified Diabetes Care and Education Specialist (CDCES) exam.

2023 Webinar Dates

1. January 10, 2023 – Class 1 – Getting to the Nitty Gritty 1.5 CEs
2. January 12, 2023 – Class 2 – Nutrition and Exercise 1.5 CEs
3. January 17, 2023 – Class 3 – Meds Overview for Type 2 – 1.5 CEs
4. January 19, 2023 – Class 4 – Insulin Therapy & Pattern Management 1.5 CEs
5. January 24, 2023 – Class 5 – Goals of Care – 1.5 CEs
6. January 26, 2023 – Class 6 – Hypoglycemia, Sick Days, Monitoring, Foot Care 1.5 CEs

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 CDCES Certification Exam.

 

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Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

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.

1. Hypertension is now defined as a systolic blood pressure greater than or equal to 130 or a diastolic blood pressure greater than or equal to 80.
2. Hypertension is now defined as a systolic blood pressure greater than or equal to 130 and a diastolic blood pressure greater than or equal to 80.
3. Hypertension is now defined as a systolic blood pressure greater than or equal to 140 or a diastolic blood pressure greater than or equal to 90.
4. Hypertension is now defined as a systolic blood pressure greater than or equal to 140 or a diastolic blood pressure greater than or equal to 80.

Click Here to Test your Knowledge

---

Want to learn more about this question? Join us for our

Level 2 | ADA Standards of Care CE Course | 2.0 CEs

Updates air live between Feb. 2, 2023, at 11:30 am PST

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2023 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for healthcare professionals involved in diabetes care and education.

Objectives:

1. List significant changes and updates to the 2023 ADA Standards of Medical Care.
2. State 3 updates on new blood pressure and lipid goals.
3. Identify 5 key elements of the position statement.
4. Discuss how to apply the Standards in the clinical setting and in preparation for exam success.

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 health care providers interested in staying up to date on current practices of care for people with prediabetes, diabetes and other related conditions.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information

---

Studying for the CDCES Exam? Enroll in our

CDCES Deluxe Prep Bundle | 30+ Online Courses + Bonus Items | 47 CEs

Included in this bundle

• Level 1 focuses on the fundamentals and introduces each topic area for the exam.
• Level 2 deep dives into the ADA Standards of Care, 
• Level 3 AKA Boot Camp is a more accelerated level that focuses on test simulation for finding the best answer to get you to the finish line of your study path.
• Technology Toolkit which gives information on pumps, sensors, and calculations,
• Test Taking Toolkit includes over 220 practice questions for test simulation plus a webinar where Coach Beverly provides test-taking tips based on her experience taking the certification exam six times. 
• ADCES Review Guide for the Diabetes Care and Education Specialist Exam – 5th Edition – Revised – The ADCES Review Guide is a fantastic independent study tool and comprehensive resource for the Diabetes Care and Education Specialist Exam. This book includes 480 + multiple-choice questions and strategies for preparing for and taking the exam with an answer key with rationales for all questions! 
• Medication PocketCard – Our four-sided medication accordion Pocketcards were designed by Coach Beverly Thomassian to assist in clinical practice and exam preparation.
• Tote Bag

---

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.