Question of the Week | Best Hormone Therapy Approach for T2D?
Which statement accurately reflects current guidelines on hormone therapy (HT) in postmenopausal individuals with type 2 diabetes?
- Oral estrogen is preferred over transdermal forms due to better metabolic outcomes.
- Progesterone levels increase post-menopause, exacerbating insulin resistance.
- Transdermal estrogen may improve insulin sensitivity and carries a lower thrombotic risk compared to oral estrogen.
- Testosterone levels rise during menopause, leading to increased central adiposity.
Want to learn more about this question?
Join us live on August 27th for our
Level 5: Hot Flashes & Hyperglycemia: What Clinicians Need to Know
Join us live on August 27th, 2025, at 11:30 am PST to watch our brand new webinar, Hot Flashes & Hyperglycemia: What Clinicians Need to Know by Dr. Jill Schramm, DNP, FNP-C, BC-ADM, CDCES
The intersection of menopause and diabetes is often underrecognized in clinical care, yet people with diabetes in menopausal transition face unique metabolic, hormonal, and lifestyle changes that can significantly impact glycemic control. This session explores the physiological shifts of menopause, the implications for insulin resistance, and evidence-based strategies for individualized care. Attendees will leave with practical guidance on hormone therapy, lifestyle management, and education tools to improve outcomes for people with diabetes navigating both diabetes and the menopausal transition.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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.
Rationale of the Week | CGM Timing Post-T1D Diagnosis: ADA 2025
For last week’s practice question, we quizzed participants on CGM Timing Post-T1D Diagnosis: ADA 2025. 95% 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: JT, a 17-year-old recently hospitalized with a new diagnosis of type 1 diabetes, is using
Multiple Daily Injections (MDI) therapy. JT uses fingerstick blood glucose monitoring but
wants to move to a CGM. JT’s mother wants to know how long fingerstick monitoring must
be used before a CGM can be started. According to the ADA 2025 Standards of Care, when
can a CGM be initiated after a type 1 diabetes diagnosis?
Answer Choices:
- CGM is to be initiated when an individual with type 1 diabetes does not meet glycemic
targets. - CGM is to be initiated only when an individual with type 1 diabetes is started on
continuous subcutaneous insulin infusion (CSII) therapy. - CGM can be initiated when an individual with type 1 diabetes is ready and able, and the individual or caregiver has been educated on its use, even at diagnosis.
- CGM is to be initiated when an individual with type 1 diabetes is over the age of 18.
Getting to the Best Answer
Answer 1 is incorrect. 1% chose this answer, “CGM is to be initiated when an individual with type 1 diabetes does not meet glycemic targets”. Since CGM is not used only for those with elevated glucose levels, this is not the best answer.
Answer 2 is incorrect. 1% of you chose this answer, “CGM is to be initiated only when an individual with type 1 diabetes is started on continuous subcutaneous insulin infusion (CSII) therapy”. Actually, CGM technology can be used with or without CSII (either standard pump or AID systems).
Answer 3 is correct. About 95% of respondents chose this, “CGM can be initiated when an individual with type 1 diabetes is ready and able, and the individual or caregiver has been educated on its use, even at diagnosis.” GREAT JOB! According to the American Diabetes Association 2025 Standards of Care, CGM technology can be initiated in any person living with diabetes on insulin therapy as early as diagnosis. The diabetes education specialist will use an individualized approach in choosing the most appropriate CGM technology and educating the individual and caregiver on how to use it. “
Finally, Answer 4 is incorrect. 1% chose this answer, “CGM is to be initiated when an individual with type 1 diabetes is over the age of 18.” According to the ADA 2025 Standards of Care, CGM technology should be offered to any adult or youth using insulin therapy. Some CGM devices are approved for use in the pediatric population (refer to each specific CGM for approval for use in children).
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!
Join us for this upcoming ADA Standards Webinar!
Level 2: From Tots to Teens with Diabetes
Join us live today June 12, 2025, at 11:30 am PST
This course is part of Level 2 – Standards of Care.
Course Overview:
This course covers updated care goals and guidelines for children with type 1 or type 2 diabetes. Topics include clinical presentation, developmentally appropriate care, complication prevention, and family support.
Learn anytime, anywhere with 1-year access. Each course includes a video, podcast, practice test, and resources.
Objectives:
-
Identify care goals for kids with Type 1 and Type 2 diabetes
-
Outline strategies to prevent complications
-
Emphasize positive psychosocial support
Learning Outcome:
Gain a thorough understanding of individualized care and standards for pediatric diabetes management.
Buy individually for $29 or get the full Level 2 Bundle and save 45% (discount applied). Don’t worry if you cannot attend, the course includes access to the recording for one year!
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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.
Helping People Find Their “Why” Through Self-Efficacy
As a diabetes education specialist, one of the most powerful tools I’ve found in supporting lasting lifestyle change is helping individuals uncover their personal “why”, the deeper reason they want to improve or maintain their health.
Whether its avoiding complications experienced by their family members, staying active to travel the world, or simply feeling better day-to-day, connecting behavior change to meaningful personal values gives purpose to the daily decisions that diabetes management demands. This internal purpose often drives more sustainable outcomes than external pressures or goals set by others.
A key component of this approach is the concept of self-efficacy. Unlike other social-cognitive theories examining how beliefs, social norms, and expectations influence behavior, the self-efficacy model specifically focuses on an individual’s belief and sense of control in their ability to take action and influence outcomes.¹
Importance of Self-Efficacy
Self-efficacy can influence coping, motivation and management of diabetes care needs and is directly correlated to improved A1c outcomes.² It is not just about knowing what to do or believing something is important—it’s about believing you can do it.
In diabetes care, self-efficacy is associated with increased engagement in self-care activities², but can be impacted by several factors. Emotional distress, including depression, anxiety, or diabetes-related burnout, can also reduce a person’s confidence in their ability to manage their condition.
Negative past experiences, such as repeated failures with weight loss or glycemic management, can lead to feelings of helplessness and discourage future efforts. Additionally, lack of support, confusion about care needs, or inconsistent healthcare access can further erode a sense of control and self-efficacy.
Recognizing Systemic Barriers & Building on Wins
Understanding that systemic barriers may be greater than an individual’s responsibility for change, we can appropriately address and build self-efficacy using a variety of strategies. One effective strategy is to build on small wins.
When individuals recognize that their efforts make a difference, no matter how small, their confidence grows. Using reflection and supporting self-acknowledgment of the changes that led to achievements reinforces the idea that change is possible, and progress is happening. This practice can be supported by helping individuals become aware of their mindset and self-talk.³ Using strength-based coaching, focusing on strengths and reframing negative thoughts, individuals can overcome self-doubt and build greater confidence in their ability to manage diabetes effectively.
Another effective strategy is using motivational interviewing techniques to help individuals explore their goals and values.⁴ Open-ended questions like, “What matters most to you about your health?” or “What would success look like for you?” can open conversations that help individuals connect the dots between their personal motivations and diabetes care. When the goals come from within, individuals are more likely to initiate and sustain behavior change further building self-efficacy.
Importance of Peer Support
Lastly, peer support and modeling can enhance self-efficacy, especially when applied to cultural needs.² Whether it’s engaging with community health workers and peers, a diabetes support group, online community, or shared stories during appointments, seeing others with diabetes manage their condition successfully can normalize challenges and help make goals seem more attainable. Supporting individuals in identifying their “why” becomes even more potent when coupled with systemic strategies and fostering interventions that increase ability to apply change. Self-efficacy is fluid and can be reinforced and cultivated through consistent, compassionate support. By facilitating individuals with diabetes to reflect, build on their strengths, and gain confidence through action and interactions, we can empower self-management.
- Juarez LD, Presley CA, Howell CR, et al. The Mediating Role of Self-Efficacy in the Association Between Diabetes Education and Support and Self-Care Management. Health Education & Behavior. 2021;49(4):689-696.
- Ataya, J., Soqia, J., Albani, N. et al. The role of self-efficacy in managing type 2 diabetes and emotional well-being: a cross-sectional study. BMC Public Health. 2024; 24: 3471. https://doi.org/10.1186/s12889-024-21050-2
- Lo, C.J., Lee, L., Yu, W. et al. Mindsets and self-efficacy beliefs among individuals with type 2 diabetes. Sci Rep. 2023; 13: 20383. https://doi.org/10.1038/s41598-023-47617-4
- Bilgin A, Muz G, Yuce GE. The effect of motivational interviewing on metabolic control and psychosocial variables in individuals diagnosed with diabetes: Systematic review and meta-analysis. Patient Education and Counseling. 2022;105(9): 2806-2823. https://doi.org/10.1016/j.pec.2022.04.008
ReVive 5 Diabetes Training Program: A Person-Centered Approach to Diabetes Distress & Glucose Management
Join us live on July 15th and July 22nd, 2025 at 9:00 am PST
6+ CEs with Expanded Accreditation!
Join experts Larry Fisher, Ph.D., ABPP, Susan Guzman, Ph.D., and Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM, for this transformative two-part training on the ReVive 5 framework—an evidence-based approach that integrates emotional well-being and glucose data into person-centered diabetes care.
Grounded in the results of the EMBARK Trial, this program emphasizes the urgent need to assess and address diabetes distress, now recognized in the ADA Standards of Care as a critical component of care. You’ll gain practical tools and strategies used in the trial to support emotional well-being, meet clinical standards, and empower individuals on their diabetes journey.
Program Objectives:
Upon completion of this activity, participants will be able to:
- Identify the key differences between diabetes distress and depression and explain their impact on self-care behaviors.
- Apply evidence-based communication strategies to respond to diabetes distress screening results.
- Demonstrate how to analyze glucose patterns using meter and sensor data.
- Utilize the ReVive 5-step approach to integrate emotional and glucose management into diabetes care.
Team of Experts:
ReVive 5 is taught by a team of 3 Interdisciplinary Experts:
Lawrence Fisher, Ph.D., ABPP
Professor Emeritus, UCSF
Susan Guzman, PhD
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
CEO of DiabetesEd Services
Faculty Bios & Disclosures
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Lawrence Fisher, Ph.D., ABPP, Professor Emeritus, UCSF
- Consultant, advisor, and speaker for Eli Lilly
Speaker Interview:
Bio:
Dr. Fisher has been a professor in the Department of Family & Community Medicine at the University of California, San Francisco for over 25 years, and he is the Director of The Behavioral Diabetes Research Group at UCSF.
He has a Diplomate in Clinical Psychology from the American Board of Professional Psychology and is a former Associate Editor of Diabetes Care. He has conducted multiple cross-sectional and longitudinal NIH- and ADA-supported clinical research with adults with diabetes and their families.
His recent work focuses on diabetes distress and depression, disease management, and how adults and families struggle over time to manage chronic health conditions. He has won two major UCSF School of Medicine teaching awards, was nominated for the UCSF Postdoctoral Scholars Association Outstanding Mentorship Award, and has received a certificate from the American Psychological Association in “Recognition for Substantial Contributions to the Field of Family Psychology and Health.”
In 2012 he received the Richard Rubin Award from the American Diabetes Association. He maintains an active clinical practice at UCSF, has published over 190 peer-reviewed articles on diabetes and related topics, and frequently speaks to both professional and lay groups at local, national, and international meetings and workshops.
Susan Guzman, PhD
- Consultant, advisor, and speaker for Abbot Labratories and Embecta
Dr. Guzman is a clinical psychologist specializing in diabetes. In 2003, Dr. Guzman co-founded the Behavioral Diabetes Institute (BDI), the first non-profit organization devoted to the emotional and behavioral aspects of living with diabetes.
At BDI, she serves as the Director of Clinical Education, developing and leading programs for people with diabetes and healthcare professionals. She has helped develop and facilitate diabetes distress group interventions for two NIH-funded research studies for adults with type 1 diabetes.
Dr. Guzman is passionate about helping to change the conversations in diabetes away from shame, blame, and judgment to those based on facts, empathy, and engagement. She has been part of a joint ADA/ADCES effort to address problematic language and messages in diabetes.
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADMBeverly Thomassian has no financial disclosures
Speaker Interview:
Bio:
Expanded Accreditation
Activity Start and End Date: 7/15/2025 to 7/22/2027
Estimated time to complete the activity: 6 hours and 15 minutes
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 6.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 6.25 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 6.25 contact hour(s) (.625] CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – UAN JA4008073-9999-25-198-H01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 6.25 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 6.25 Interprofessional Continuing Education (IPCE) credit for learning and change.
Disclosure of Unlabeled Use:
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer:
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Instructions for Credit
Participation in this self-study activity should be completed in approximately 6 hours and 15 minutes. To successfully complete this activity and receive CE credit, learners must follow these steps during the period from 7/15/2025 to 7/22/2027.
- Review the objectives and disclosures
- Study the educational content in Online University
- After review of content, a module within the course in the Online University will list a link to Partners for Advancing Clinical Education’s website
- Visit Partners for Advancing Clinical Education website listed in course in the Online University
- Complete the activity evaluation through Partners for Advancing Clinical Education website
For additional information about the accreditation of this activity, please visit https://partnersed.com.
Question of the Week | T1D and Artificial Sweeteners: Safe Limits
Sam is a 28-year-old with type 1 diabetes who reports drinking six diet sodas per day,
believing they help manage blood glucose. Sam asks if this is safe or if they should
reduce consumption. What would be an appropriate response based on the 2025 ADA
Standards of Care?
- You should avoid diet soda and all non-nutritive sweeteners because they’re linked to cancer and heart disease.
- Diet sodas are completely safe, so there’s no reason to change your intake.
- While non-nutritive sweeteners are FDA-approved, let’s discuss your current intake concerns, and whether unsweetened beverages may be a better option.
- Switch to natural sugars like honey or agave syrup since they are healthier than artificial sweeteners.
Want to learn more about this question?
This four-hour course highlights the latest ADA evidence-based nutrition and exercise guidelines. Our nutrition expert, Christine Craig, MS, RD, CDCES, provides strategies to apply this important information to individuals living with diabetes. She includes in-depth discussions on different approaches to person-centered meal planning and the benefits and limitations of each. If you are getting ready to take your diabetes certification exam, this course provides essential content for exam success.
Topics addressed by Christine Craig, MS, RD, CDCES
-Medical Nutrition Therapy Updates and Critical Content
-Describe person-centered nutrition issues based on assessment and clinic data.
-Explore national guidelines for medical nutrition therapy and how to individualize interventions from a person-centered perspective.
-State how to customize nutritional approaches in people living with complications of diabetes.
-How to Eat by the Numbers and Meal Planning Approaches
-Describe the impact of micro and macronutrients on health.
-List different meal planning approaches and the pros and cons of each.
-Describe how to help people with diabetes to read labels and be thoughtful consumers.
-Keeping Well Through Activity and Nutrition
-Describe activity benefits, precautions, and recommendations
Fee: $69.00/ 4.25 CEs
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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.
Upcoming Webinars this Week!
Live Webinar – Mindful Eating for Successful Diabetes Management
📅 June 11, 2025 | 🕚 11:30 AM PST
Join Evgeniya Evans, MS, RDN, CDCES, for a powerful, practice-based webinar designed for healthcare professionals. Discover how to integrate mindful eating strategies into diabetes care to support improved glycemic outcomes, emotional well-being, and sustainable lifestyle changes.
You’ll explore evidence-based tools, cultural adaptations, and real-world techniques for helping individuals build a healthier relationship with food.
✅ Practical strategies
✅ CE-focused learning
✅ Tools you can use immediately in your practice
Reserve your spot now and empower your care recipient with mindful, meaningful nutrition care. Includes video, podcast, quiz, and resources—available on-demand for 1 year.
Live Webinar – From Tots to Teens: Pediatric Diabetes Standards
📅 June 12, 2025 | 🕚 11:30 AM PST | 🎓 1.75 CEs
Join us for this Level 2 course focused on the unique needs of children and teens with diabetes. Taught by nationally recognized expert Beverly Thomassian, RN, MPH, CDCES, BC-ADM, this session will guide you through updated guidelines for Type 1 and Type 2 diabetes in youth—covering clinical care, growth milestones, psychosocial considerations, and strategies to prevent complications.
💡 Designed for healthcare professionals working with pediatric populations
📘 Includes standards of care, goals of therapy, and age-appropriate approaches
🧠 Great prep for certification or to strengthen your clinical knowledge
Enroll for $29 or save 45% with the Level 2 bundle. Includes video, podcast, quiz, and resources—available on-demand for 1 year.
Live in San Diego
DiabetesEd Training Seminar
Join us live October 22nd – 23rd, 2025!
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Team of Experts:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
CEO of DiabetesEd Services
Christine Craig, MS, RD, CDCES
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Christine Craig, MS, RD, CDCES – CEO of Nutrition for Daily LivingDisclosures:
Christine Craig has the following relevant financial relationships:
- Independent Contractor for Tandem Diabetes and Medtronic
Bio:
Expanded Accreditation
Activity Start and End Date: 6/20/25 to 6/20/2027
Estimated time to complete the activity: 19 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 19.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 19.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 19.50 contact hour(s) (1.950 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-188-H01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 19.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 19.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
Disclosure of Unlabeled Use:
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer:
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Instructions for Credit
Participation in this self-study activity should be completed in approximately 19 hours and 30 minutes. To successfully complete this activity and receive CE credit, learners must follow these steps during the period from 6/20/2025 through 6/20/2027.
- Review the objectives and disclosures
- Study the educational content in Online University
- After review of content, a module within the course in the Online University will list a link to Partners for Advancing Clinical Education’s website
- Visit Partners for Advancing Clinical Education website listed in course in the Online University
- Complete the activity evaluation through Partners for Advancing Clinical Education website
For additional information about the accreditation of this activity, please visit https://partnersed.com.
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.
Rationale of the Week | DKA Prevention After T1D Diagnosis
For last week’s practice question, we quizzed participants on DKA Prevention After T1D Diagnosis. 52% 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: A 10-year-old child with newly diagnosed type 1 diabetes is being discharged from the hospital. Which of the following components is most critical to include in the initial outpatient diabetes management plan to reduce the risk of diabetic ketoacidosis (DKA) and hospital readmission?
Answer Choices:
- Initiate basal insulin therapy and MNT instruction, with follow-up in two weeks.
- Provide basic carbohydrate counting and bolus insulin instruction with a follow-up appointment within 30 days.
- Establish follow up with a specialist within a week and provide actions to take in case of glucose emergencies.
- Prescribe continuous glucose monitoring (CGM) and glucagon rescue medication and ask family to schedule a follow-up appointment after the sensor is delivered and set up.
Getting to the Best Answer
Answer 1 is incorrect. 21% chose this answer, “Initiate basal insulin therapy and MNT instruction, with follow-up in two weeks.” Basal insulin alone is insufficient; children require both basal and bolus insulin to mimic physiologic insulin needs and prevent DKA.
Answer 2 is incorrect. 13% of you chose this answer, “Provide basic carbohydrate counting and bolus insulin instruction with a follow-up appointment within 30 days.” Delayed follow-up increases the risk of complications. Carbohydrate counting and bolus insulin are important, but must be paired with timely, ongoing support.
Answer 3 is correct. About 52% of respondents chose this, “Establish follow up with a specialist within a week and provide actions to take in case of glucose emergencies.” Early involvement of a diabetes specialist and problem solving in case of glucose crises, significantly reduce the risk of DKA and readmission. Frequent follow-up in the first week is associated with better outcomes.
Finally, Answer 4 is incorrect. 13% chose this answer, “Prescribe continuous glucose monitoring (CGM) and glucagon rescue medication and ask family to schedule a follow-up appointment after the sensor is delivered and set up.” While CGM is valuable, delaying education and clinical engagement is risky; immediate education and care planning are essential.
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!
Join us live on June 11th @ 11:30am PST!
Level 5 | Mindful Eating for Successful Diabetes Management
Join us live on June 11, 2025, at 11:30 am PST to watch our brand new webinar, Mindful Eating for Successful Diabetes Management by Evgeniya Evans, MS, RDN, CDCES
This engaging and practical webinar, developed by Evgeniya 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.
All hours earned count toward your CDCES Accreditation Information
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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.
Next Level Libre: The Latest CGM Updates You Need to Know
Abbott has recently announced that as of September 30, 2025, the Libre 2 and Libre 3 CGM systems will be discontinued and replaced with the Libre 2+ and Libre 3+ CGM systems. As a diabetes education specialist, you wear many hats, including diabetes technology expert. Education, communication, and collaboration with those living with diabetes are the keys to a smooth and successful transition into updated technology.
Over 7 million people living with diabetes worldwide use a Libre Continuous Glucose Monitoring (CGM) system (1). The American Diabetes Association (ADA) 2025 Standards of Care recommends CGM as the standard of care for glucose monitoring for those on insulin therapy. The ADA also notes that CGM can be considered for those with diabetes who do not use insulin. (2)
Make Room for the Libre 2+ and Libre 3+ Systems
Since the early days of CGM technology, the Libre CGM systems have undergone several changes, and they recently announced the latest round of system improvements. They will be replaced with the Libre 2+ and Libre 3+ CGM systems.
What changes with New Libre 2+ and 3+:
- Selected insulin pump compatibility
- 15-day wear time (previously 14-day wear time)
- Approved for ages 2 years and older (previously approved for ages 4 years and older)
- More than 1000 mg of Vitamin C per day may affect glucose data (previous Vitamin C limit was 500 mg/day)
What stays the same:
- A handheld receiver (if needed for those without smartphone compatibility)
- High and low blood glucose alarms
- Sharing capability
- Size of sensors and application process
- 60-minute warm-up time
Action Needed – New Prescription
Individuals using these devices are advised to contact their healthcare provider to request a new prescription for the updated sensors. After September 30, 2025, any leftover 2 or 3 systems can still be used until their expiration date. The diabetes education specialist plays a crucial role in creating a plan to help navigate this technology transition.
New Universal Libre App
A new, universal updated phone app was released in April 2025. This changes the need for separate Libre 2 and Libre 3 apps to a universal Libre app compatible with the Libre 2, Libre 3, Libre 2+, and Libre 3+ sensors. The universal Libre app will remove the need for separate app downloads for those switching between the currently available Libre sensors. Additional features of the updated app include an easier-to-navigate platform, and users can silence alarms for a customized timeframe of up to six hours (3,4).
FreeStyle Libre 2 and FreeStyle Libre 2 Plus Sensor users will receive real-time glucose readings sent automatically to their smartphone when used with the Libre app. The Libre 2 and 2+ users will only need to scan the sensor to backfill and recover glucose data to fill in gaps on the home screen graph during periods of signal loss.
Keeping You Connected
Managing a chronic illness such as diabetes takes a team effort between those living with diabetes, the healthcare team, and family or caregivers. The LibreLinkUp app invites family members or caregivers who are helping with diabetes management to have access to glucose readings and alarms. Libre View is a cloud-based connected system between the person living with diabetes and the healthcare team. Using the Libre phone app, clients can permit healthcare providers to access their Libre CGM data to assist with creating an individualized plan of care. Abbot has also announced a collaboration with the Epic electronic medical records (EMR) system for data integration from LibreView into the EMR (1).
Libre 2+ and Libre 3+ Pump Integration
Libre 2+ and Libre 3+ can now integrate with selected automated insulin delivery (AID) systems. This will allow those using a Libre CGM to use an AID insulin pump as part of their glucose management plan. (5)
Here is a list of the current insulin pump compatibility:
- Libre 2+
-
- Omnipod 5 ® (Omnipod 5 app)
- Tandem t: slim X2 ™ (t:connect mobile app)
- Libre 3+
-
- Beta Bionics iLet Bionic Pancreas (iLet mobile app)
Over-the-Counter Libre Options
Over-the-counter (OTC) CGM is now an option for diabetes management. It is also available for those without diabetes who want to know more about glucose fluctuations. Libre now offers two OTC options, gaining approval in the US for use in 2024.
Libre Rio is an OTC CGM FDA approved for glycemic monitoring in adults 18 years and older who are not on insulin. This device can provide insightful data for those living with diabetes or prediabetes.
Libre Lingo is an OTC CGM in the health and wellness space, which is FDA approved for monitoring glucose variations to gain insight into the metabolic response to food and activity in those 18 years and older. (6)
The Bottom Line for Clinical Practice
Helping those living with diabetes navigate the changes to the Libre systems and apps can reduce frustration and data gaps. As diabetes education specialists and technology experts, you play a key role in preparing clients for upcoming changes to their diabetes technology. Understanding the differences between the Libre devices and what features are available will help create an individualized approach to diabetes care and education. If you want more information on improving your CGM data interpretation skills, check out the latest Tech Data Toolkit webinar.
Addendum published on 6/15/25:
It has come to our attention that Libre 2 and Libre 2+ no longer require scanning when using the Libre app to receive glucose data. Scanning is required to backfill glucose data when there is a signal loss. Intermittent scanning is still required to obtain glucose data when using the Libre 2 or 2+ with the receiver. The article has been corrected with this updated information, and we greatly apologize for any confusion.
Welcome Sarah Beattie, Expert Contributor
We are thrilled to welcome Sarah Beattie, DNP, APRN-CNP, CDCES, diabetes content expert to our team. As a Nurse Practitioner in a busy Endocrinology Clinic, Dr. Beattie is passionate about improving diabetes care. In addition, she creates engaging and educational content for healthcare providers as the owner of DNP Health Writer, LLC.
References
- Abbot integrates Libre’s data with Epic’s electronic health record system, providing healthcare professionals seamless glucose monitoring information. (2025, April 9). Abbot. Retrieved May 8, 2025, from https://abbott.mediaroom.com/2025-04-29-Abbott-Integrates-Libres-Data-with-Epics-Electronic-Health-Record-System,-Providing-Healthcare-Professionals-Seamless-Glucose-Monitoring-Information#:~:text=About%20FreeStyle%20Libre:,more%20than%2040%20countries7
- American Diabetes Association Professional Practice Committee. (2025). Diabetes technology: Standards of care in diabetes – 2025. Diabetes Care, 48 (supplement 1), S146-S166. https://doi.org/10.2337/dc25-S007
- Abbot. (n. d.). Freestyle Libre apps. Abbot. https://www.freestyle.abbott/us-en/products/freestyle-libre-app.html
- HME News Staff. (2025, April 21). Abbot launches Libre app. HME News. https://www.hmenews.com/article/abbott-launches-libre-app
- Abbot. (n. d.). Compatible insulin pumps. Abbot. https://www.freestyle.abbott/us-en/products/insulin-pump-compatibility.html
- Bender, C., Vestergaard, P., & Cichosz, S. L. (2025). The history, evolution and future of continuous glucose monitoring (CGM). Diabetology, 6(3), 17. https://doi.org/10.3390/diabetology6030017
Tech Data Toolkit is ready for OnDemand Viewing!
Gain confidence in interpreting the Glucose Profile Report (AGP) & CGM data using a
person-centered approach
As diabetes technology is becoming commonplace in our practice, figuring out how to make sense of all the data can seem overwhelming. Join Diana Issacs and Coach Beverly for a truly unique learning experience.
Topics include:
- Review CGM key metrics and individualize time in-range goals
- Learn how to recognize patterns with the AGP report efficiently
- Utilize the AGP report as a discussion guide when meeting with a person with diabetes
- Recommend lifestyle and medication adjustments based on CGM data
- Strategies to recognize the expertise of the individual and collaborate on person-centered problem solving.
Question of the Week | CGM Timing After Type 1 Diagnosis
JT, a 17-year-old recently hospitalized with a new diagnosis of type 1 diabetes, is using Multiple Daily Injections (MDI) therapy. JT uses fingerstick blood glucose monitoring but wants to move to a CGM. JT’s mother wants to know how long fingerstick monitoring must be used before a CGM can be started. According to the ADA 2025 Standards of Care, when can a CGM be initiated after a type 1 diabetes diagnosis?
- CGM is to be initiated when an individual with type 1 diabetes does not meet glycemic targets.
- CGM is to be initiated only when an individual with type 1 diabetes is started on continuous subcutaneous insulin infusion (CSII) therapy.
- CGM can be initiated when an individual with type 1 diabetes is ready and able, and the individual or caregiver has been educated on its use, even at diagnosis.
- CGM is to be initiated when an individual with type 1 diabetes is over the age of 18.
Tech Data Toolkit – Recorded and Ready to Watch!
Gain confidence in interpreting the Glucose Profile Report (AGP) & CGM data using a
person-centered approach
As diabetes technology is becoming commonplace in our practice, figuring out how to make sense of all the data can seem overwhelming. Join Diana Issacs and Coach Beverly for a truly unique learning experience.
Topics include:
- Review CGM key metrics and individualize time in-range goals
- Learn how to recognize patterns with the AGP report efficiently
- Utilize the AGP report as a discussion guide when meeting with a person with diabetes
- Recommend lifestyle and medication adjustments based on CGM data
- Strategies to recognize the expertise of the individual and collaborate on person-centered problem solving.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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.
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