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Rationale of the Week | What is the Right LDL Target for RZ?

For last week’s practice question, we quizzed participants on what is the right LDL target. 37% 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 is 47 years old with type 2 diabetes and hypertension with a UACR of 199 mg/g.  RZ takes metformin 1000 mg BID, plus lisinopril 20mg daily.  RZ most recent LDL Cholesterol was 130 mg/dL. The provider writes an order for DASH meal planning education and initiation of atorvastatin 40mg.  

Based on the most recent ADA Standards, what is the LDL Cholesterol target for RZ?

Answer Choices:

  1. LDL less than 100 mg/dL.
  2. Lower LDL by 30%.
  3. LDL target of 65 mg/dL or less.
  4. Determine LDL target based on ASCVD calculations.

Getting to the Best Answer

Answer 1 is incorrect. 25.97% chose this answer, “LDL less than 100 mg/dL.” This is a juicy answer since it is the OLD LDL goal from several years ago. But the new 2023 lipid guidelines have even more intense goals for high-risk individuals. Since RZ has diabetes, hypertension, and albuminuria (UACR >30mg/g), they have an elevated risk of ASCVD. Given their risk status, the 2023 guidelines recommend reducing LDL by at least 50% of baseline and target LDL cholesterol to less than 70 mg/dL (see slide below).

Answer 2 is incorrect. 16.63% of you chose this answer, “Lower LDL by 30%.” Another juicy answer. Given RZ’s risk status, the 2023 guidelines recommend reducing LDL by at least 50% of baseline and target LDL cholesterol to less than 70 mg/dL. (see slide below).

Answer 3 is correct. 37.01% of respondents chose this answer, “LDL target of 65 mg/dL or less.” GREAT JOB! Since RZ has diabetes, hypertension, and albuminuria (UACR >30mg/g), they have an elevated risk of ASCVD. Given their risk status, the 2023 guidelines recommend reducing LDL by at least 50% of baseline and target LDL cholesterol to less than 70 mg/dL. Since RZ’s current LDL is 130, the goal is to reduce the LDL by at least 50% (LDL of 65mg/dL) AND less than 70 mg/dL by using a high-intensity statin and lifestyle therapy, (see slide below).

Finally, Answer 4 is incorrect. 20.38% chose this answer, “Determine LDL target based on ASCVD calculations.” Although this information would be helpful, it wouldn’t change the lipid goals. Given their risk status, the 2023 guidelines recommend reducing LDL by at least 50% of baseline and target LDL cholesterol to less than 70 mg/dL, (see slide below).

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

We also invite you to join our Online Courses for more information (see info below)
Hope you can join our ADA Standards of Care Webinar Update in February and our other Level 2 Courses.


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


Preparing for Diabetes Certification Exam? Enroll in our Level 3 – Boot Camp 2023 Updates

Level 3 | DiabetesEd Specialist Boot Camp | 12+ CEs

Can’t join all the sessions live? No problem. Your registration guarantees you access to the recorded lectures for a full year.

This bundle is specifically designed for healthcare professionals who are studying for the Board Certified in Advanced Diabetes Management (BC-ADM) or the Certified Diabetes Care and Education Specialist (CDCES) certification 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 BC-ADM or the CDCES certification Exam.

2023 Webinar Updates

  1. February 7, 2023 – Class 1 – Diabetes – Not Just Hyperglycemia 1.75 CEs
  2. February 9, 2023 – Class 2 – Standards of Care & Cardiovascular Goals 1.8 CEs
  3. February 14, 2023 – Class 3 – Meds for Type 2 – What you need to know 1.5
  4. February 16, 2023 – Class 4 – Insulin Therapy – From Basal/Bolus to Pattern Management 1.5 CEs
  5. February 21, 2023 – Class 5 – Insulin Intensive – Monitoring, Sick Days, Lower
  6. February 23, 2023 – Class 6 – Exercise and Medical Nutrition Therapy 1.5 CEs
  7. February 28, 2023 – Class 7 – Screening, Prevention, and Treatment of Microvascular Complications
  8. March 2, 2023 – Class 8 – Coping and Behavior Change 1.5 CEs
  9. March 9, 2023 – Class 9 – Test-Taking Coach Session (48 Questions) No CE

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 CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

Diabetes Fundamentals 2023 Series | Begins tomorrow – It’s not too late to register!

Our Level 1 | Diabetes Fundamentals 2023 Series starts tomorrow!

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 Series 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

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 CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

Upcoming Webinar – Cancer & Diabetes | Airs Oct. 26th

Join us for our upcoming
Level 4 | Cancer and Diabetes | 1.25 CEs

Airs live on Wednesday, October 26th at 11:30 am PST

Diabetes Education Services Online University Courses are an excellent way to study for your exam anytime and anywhere that is convenient for you. You will have immediate access to your courses for 1 year after your purchase date. Each individual online course includes a: video presentation, podcast, practice test, and additional resources.

People with cancer often experience hyperglycemia secondary to treatment, which can increase the risk of infection and compromise their nutritional status. In addition, recent research has identified the link between diabetes and cancer. Join us to learn more about this unexpected link and treatment strategies for steroid-induced hyperglycemia using a case study approach.

Objectives:

  1. Discuss the relationship between cancer, hyperglycemia, and insulin resistance.
  2. State 3 benefits of normalizing glucose levels during chemotherapy.
  3. Using a case study approach, discuss strategies to improve glucose levels and quality of life.

Intended Audience: These courses are knowledge-based activities designed for individuals or groups of diabetes educators, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in enhancing their knowledge of diabetes management for people with cancer.


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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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.

Do you have to be a Mental Health Expert to Tackle Diabetes Distress?

We asked Dr. Lawrence Fisher (see bio below), lead researcher and clinician in the Embark Trial to share his insights on providing best care to people with diabetes. Learn more by joining our ReVive 5 Diabetes Training Program where the team shares evidence-based tools and the step-by step approach utilized in the Embark Study.


Do you have to be a mental health expert to address diabetes distress?

Dr. Lawrence Fisher

Definitely not.

We believe that addressing the emotional side of diabetes is part of comprehensive diabetes care. It is part of living with and managing diabetes over time. Ideally, emotional care is incorporated into regular diabetes check-ups and problem-solving encounters.

Diabetes health care professionals have unique insights into the daily struggles that people living with diabetes experience. They have tremendous awareness, understanding and knowledge about diabetes self-management, including the distress that many people with diabetes experience with varying degrees over a lifetime. Diabetes specialists realize that recognizing and addressing distress is an integral part of providing care and helping people manage their lives around diabetes.


Frankly, there is no other option – Diabetes care professionals are the front line clinicians when it comes to helping people manage their diabetes, and that includes the emotional side of diabetes as well.


However, addressing diabetes distress effectively can be challenging, even for the most experienced diabetes health care professional.  After all, most clinicians don’t receive formal training to address the emotional part of diabetes self-management.  It makes sense that some additional training and support would be of benefit. That is why we need training programs like ReVive 5, so health care professionals have a safe place to increase their comfort level, enhance their skills, and learn time-efficient strategies that can be applied in clinical practice.

In addition, very few mental health professionals have any experience with diabetes and we have learned that very few people with diabetes follow through on referrals to mental health professionals. Frankly, there is no other option – Diabetes care professionals are the front line clinicians when it comes to helping people manage their diabetes, and that includes the emotional side of diabetes as well.

We also asked, How does addressing diabetes distress impact glucose levels?

This straightforward question has a relatively complex answer – like most things in clinical care. Many studies have shown that there is a modest but significant correlation between distress and A1C – the higher the distress, the higher the A1C and vice versa. But this is an ‘association’ and it DOES NOT mean that one CAUSES the other. We believe that the only modest association between distress and A1C can be explained, at least in part, by examining two related issues.

First, there is a relatively high rate of distress among people with diabetes with A1C levels of 7% or less. The distress that some people in this A1C range feel are associated with fears of hypoglycemia and struggles with eating. In fact, in a recent study, we discovered that about a quarter of participants with an A1C of 7% or less reported significantly elevated levels of diabetes distress. So even people who are reaching target glucose levels can experience significant levels of distress.

The second reason is really interesting, and it has implications for intervention. As mentioned above, in two recent studies, we reported a significant but modest association between distress and A1C. But as we delved into the findings, we discovered that reductions in distress associated with a clinical intervention were only ‘indirectly’ linked with reductions in A1C.

Most importantly, we found that reductions in distress were highly related to improvements in diabetes self-management, which, in turn, were significantly related to reductions in A1C. To say it simply, the reductions in distress were due to improvements in self-management behaviors which led to reductions in A1C. This is a critical point – because it suggests that health care providers can have the biggest impact by combining distress reduction AND management interventions to improve glucose management as well as help people improve their quality of life.

ReVive 5 Diabetes Training Program Expert Faculty

Dr. Lawrence Fisher’s most 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 served as 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 conducted multiple cross-sectional and longitudinal NIH- and ADA-supported clinical research with adults with diabetes and their families. 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


Join us to gain the confidence and learn the skills needed to support people with diabetes to move forward in their self management and discover the expert within.

Speakers Interviews – Learn more about the ReVive 5 Team

    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.

    Join us in Congratulating our Flower Scholarship Recipients!

    We are excited to announce our DiabetesEd Flower Scholarship Recipients!

    Flower Scholar Recipients Fall 2022

    The Diabetes Educator Flower Scholarship is awarded to 2 individuals each year. This scholarship awards two deserving applicants the opportunity to attend our DiabetesEd Specialist Virtual Conference on October 12-14, 2022 free of charge. This gift of recognition is donated by a generous diabetes nurse specialist who believes that the health of our future depends on supporting diabetes educators in providing care in underserved communities.

    The Flower Scholarship’s vision is to increase diversity in the diabetes education workforce by supporting diabetes nurse educators who come from underserved communities. 

    It is always a very difficult decision for all of the judges. We read each application in careful detail considering the applicant’s impact on underserved communities, building bridges to improve access, volunteerism, financial need and readiness to take the CDCES exam. Read more about Ms. Owens and Ms. Hillman below.


    Our “Flower” recipients are Janeka Owens & Patricia Hillman
     Congratulations from all of us at Diabetes Education Services!

    Janeka Owens is a recipient of our “Flower Scholarship” because of her belief that “Diversity and representation matter in diabetes education”. She turns this belief into action in her work as a Nurse Educator in a hospital and in an outpatient Population Health Department in Pensacola, Florida. In addition to providing individual education, Janeka also provides group classes to both insured and uninsured individuals. She assists with hospital discharges and care management for individuals experiencing food and medical insecurity and makes sure they are connected with community health centers to receive ongoing care. Janeka goes on to say that, “representation is important to improve outcomes, build stronger communities and overall restore trust in health care”. Thank you, Janeka, for being a trusted health care provider and advocating to improve access to diabetes self-management and support programs for your community members.  


    Patricia Hillman is also a Flower Scholarship Recipient. She provides diabetes care at a federally qualified health center in an underserved community. Many of the people she serves have no insurance and struggle to manage their diabetes. Patricia works directly with her Maternal/Fetal physician to co-manage people during pregnancy and often follows up with high-risk individuals on weekends. Many of the clients she serves, have limited resources, and lack insurance coverage. Patricia goes out her way to make sure they have needed resources and that they can easily access her with questions and concerns. Patricia has created a library of information in English, Spanish and Creole to meet community needs and create bridges of understanding.  She often accompanies those who have not yet learned English to the pharmacy to assist with language barriers and ensure they get the supplies they need. Patricia plans to apply the knowledge garnered from the course to continue empowering her community.

    Congratulations to Janeka and PatriciaYou both are Flower Scholarship Recipients!


    Want to Join Janeka and Patricia at our Virtual DiabetesEd Training Conference?

    Enroll Now!

    Airs October 12-14th, 2022

    Join us LIVE for this Virtual Training Conference and enjoy a sense of community!

    Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.

    Download Course Flyer | Download Schedule

    If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.

    Team of expert faculty includes:

    • Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES – Educator of the Year, 2020
    • Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
    • Ashley LaBrier, MS, RD, CDCES, Diabetes Program Coordinator

    Two Registration Options

    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!

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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.

    Certification Help – 2 FREE Webinars to Prep for CDCES or BC-ADM

    Coach Beverly and Bryanna are here to Help

    If you are considering taking the CDCES or BC-ADM Exam, we have great news. We are offering 2 different webinars that provide you with the study prep information and tools you need to propel across the finish line.

    As health care professionals, we value your limited study time by offering evidence-based content carefully crafted for exam success with direct application to your clinical practice. Please let us know if we can be of any help on your journey!

    Warmly, Coach Beverly and Bryanna

    Preparing for BC-ADM FREE Webinar
    September 20th at 11:30am PST

    Register for BC-ADM Webinar | September 20, 2022

    BC-ADM 2022 Note Taking Handout

    Complete BC-ADM Resource Page

    We hope you can join us live. But, if not, no worries.
    We will send you a link to the recorded version within 24 hours of airing.


    Preparing for the CDCES Exam FREE Webinar
    September 22 at 11:30am PST

    This course will transform your test anxiety into calm self-confidence and test-taking readiness.

    Join Coach Bev Live – September 22, 2022 at 11:30am

    2022 PowerPoint Note-Taking Handouts

    Complete CDCES Resource Page

    We hope you can join us live. But, if not, no worries.
    We will send you a link to the recorded version within 24 hours of airing.


    Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator who has passed her CDCES Exam 6 times and first earned her BC-ADM credential 20 years ago. She is a nationally recognized diabetes expert for over 25 years.


    Virtual and Online Certification Education Options

    3 Day Intensive: Virtual DiabetesEd Specialist Conference |Oct. 12-14th
    This Virtual Training Conference streams LIVE in October. Invite your friends to enjoy a group discount. Plus, save on travel costs and enjoy conference interactivity through demonstrations, games and Q&A sessions. Our Deluxe Conference Package includes a 100+ page printed syllabus, Med PocketCards, ADA Standards and swag. This advanced level course features 3 expert speakers who translate the ADA Standards, Meds, Technology, Complications, Nutrition Therapy and more. Join us to get recharged or to prepare for certification.

    Self-Study Online Certification Bundles: 

    • CDCES Exam Prep Bundle
    • BC-ADM Exam Prep Bundle

    These courses are designed to walk participants through the knowledge needed to succeed at either the CDCES or BC-ADM certification exams. Viewed at your convenience and pace, each module contains poll questions, case studies and real life situations that prepare participants for clinical situations as well as the exams. Students consistently state that our online courses not only helped them achieve certification, they also provided valuable insights into providing effective diabetes care. See more info below.

    All hours earned count toward your CDCES Accreditation Information

    Free Certification Resources


    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.

    You’re invited to our Upcoming Webinars!

    See Full Calendar for Diabetes Education Services Webinars and Seminars


    Starting your journey to becoming a CDCES?

    Join us live August 10th at 11:30 am PST for our

    Preparing for the CDCES Exam FREE Webinar

    This course will transform your test anxiety into calm self-confidence and test taking readiness.

    Can’t join us live?
    Don’t worry, register and we will send you a link to the recorded version.

    Webinar Topics

    Read More: Preparing for CDCES Exam Webinar Topics

    Preparing for the CDCES Exam |
    FREE Webinar

    • Exam requirement updates for 2022.
    • Exam eligibility and test format
    • Strategies to succeed along with a review of study tips and test-taking tactics.
    • We will review sample test questions and the reasoning behind choosing the right answers.
    • Learn how to focus your time and prepare to take the CDCES Exam. We provide plenty of sample test questions and test-taking tips!
    2021 PowerPoint Handouts


    What is a Certified Diabetes Care and Education Specialist?

    Read More: What is a CDCES?

    First awarded in 1986, as Certified Diabetes Educator (CDE) credential and in 2020 with a new name: Certified Diabetes Care and Education Specialist (CDCES) to more accurately reflect the specialty. CDCES has become a standard of excellence for the delivery of quality diabetes education. Those who hold this certification are known to possess comprehensive knowledge of and experience in diabetes prevention, management, and prediabetes.

    Becoming a Certified Diabetes Care and Education Specialist (CDCES) is one of the best professional and personal decisions I have ever made.” – Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM


    Why become a CDCES?
    Three Reasons from Coach Beverly

    Read More: 3 Reasons to Become a CDCES

    The best part of becoming a CDCES is working with my colleagues and people living with diabetes. As diabetes educators, we hear compelling and beautiful life stories. I am astounded by the barriers they face and inspired by their adaptability, problem-solving skills, and resilience.

    – Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM

    Reason 1: CDCES is a widely recognized certification by employers and health care professionals throughout the U.S.  This credential demonstrates a specialized and in-depth knowledge in the prevention and treatment of individuals living with pre-diabetes and diabetes.

    Reason 2: Currently, 10% of people in the U.S. have diabetes and another 35% have pre-diabetes which means 45% of Americans are running around with elevated blood glucose levels.  Given this epidemic, there will be plenty of future job opportunities.

    Reason 3: Having my CDCES along with my nursing degree, has opened many doors of opportunity; from working as an inpatient Diabetes Nurse Specialist in a hospital to working as a Manager of Diabetes Education in the outpatient setting to starting my own consulting company.


    CDCES Online Prep Bundle (Levels 1, 2, and 3) +

    ADCES Review Guide with 480+ Practice Questions

    This bundle includes our CDCES Online Prep Bundle (featured above) plus the ADCES Review Guide.

    The online bundle includes Level 1, Level 2, and Level 3 (Boot Camp), plus two bonus courses. The ADCES Review Guide offers over 480+ practice questions and is a fantastic independent study tool and comprehensive resource for the Diabetes Care and Education Specialist Exam.


    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.


    Announcing our Special Scholarship Recipient – Judith Paul

    When Judith reached out to us for guidance to achieve her dream of becoming a CDCES, her sincerity and passion for improving diabetes care were immediately evident.

    Judith contacted us last winter as she was preparing to take the CDCES exam. Through our phone conversations, her passion for Diabetes Care stood out.; she is inquisitive, enthusiastic, and has a strong desire to provide the best diabetes care possible.

    Through our conversations, I got to know Judith very well. She had moved here several years ago from Haiti with a goal to become an RN, and eventually a Diabetes Educator. For Judith, diabetes is very dear to her heart as she has close family members who live with diabetes. She saw firsthand the devastating effects it can have when someone doesn’t receive adequate care.

    Judith Paul embodies what it means to be a Diabetes Advocate

    Becoming a CDCES is not an easy journey for anyone. A health care professional has to demonstrate 1000 hours of diabetes self-management work experience, earn CE’s, apply online and pay the testing fee of $350. Then there is the grueling four-hour exam, with complicated questions that use precise and nuanced language. Preparing for the exam requires months of dedicated study and preparation.

    Making a Difference Scholarship

    As I got to know Judith more, I felt should we be a great candidate for our “Making a Difference” Scholarship. We usually only offer this award once a year in the Spring to candidates who are making significant contributions to improving diabetes care in their community, but Judith’s desire and determination won our hearts. We awarded Judith free access to our CDCES Prep Bundle, to support her dream to become a Certified Diabetes Care and Education Specialist. Judith fully immersed herself in her studies. Over time, I could hear the changes in her language as she moved towards a more person-centered approach.

    After months of dedicated studying, she passed her CDCES Exam this June!

    We are so proud of you, Judith, and know that you are going to continue being a fantastic model for your colleagues to provide outstanding care for people living with diabetes!


    Judith’s Story in Her Own Words

    I am so excited to let Diabetes Education Services know that I recently passed the CDCES exam! I have dreamed of becoming a CDCES since 2017 and my thanks go to coach Beverly and Bryana for helping me make my dream a reality. My passion about diabetes education and those living with the disease drove me, along with my desire to share accurate and compelling information with patients and colleagues to help improve care.

    I heard about Diabetes Education Services from a co-worker in December 2021 when I spoke with Bryanna. She was very professional, intelligent, kind, and helpful. She explained the program in detail and answered all of my questions and she provided me with information about the classes, online courses, free resources, App access, and much more. I am beyond grateful for all the support I received from coach Beverly and Bryanna. Coach Beverly made learning so fun and easy to understand. She teaches exactly the way I learn. I always looked forward to attending classes, listening to the webinar, podcast, and taking the quizzes. Her passion, knowledge and love for people living with diabetes are exceptional and she has inspired me even more. I have become more passionate, caring, and knowledgeable and I found myself talking to patients more effectively thanks to her example. Where I used to say “diabetic”, “obesity”, or “blood glucose not in control”, now I use phrases like “people with diabetes”, “participant with excess weight”, “blood glucose above target”, etc.

    I found the CDCES exam so EASY because of the coaching program and your teaching style was exactly what I needed to be successful. You provided me with all the tools and resources that I needed. Coach Beverly’s program has the WHOLE package for people like me who need to learn about special situations such as pregnancy or pediatric, and also about diabetes technology. I learned test-taking strategies like choosing the best answers by using a process of elimination. I have attended other diabetes courses in the past, but I had never felt ready for the exam until I attended your program. During the exam I felt ready, confident, calm, and well prepared and I smiled as I heard Coach Beverly’s voice in my head. Coach Beverly not only teaches what you need to know to be successful in the CDCES exam, but also, she teaches how to be an excellent diabetes educator. Throughout the entire program, I felt like I had my own, personal coach and tutor. Beverly and Bryanna always responded to my emails and my last-minute questions in a timely manner.

    Again, THANK YOU Coach Beverly, Bryanna, and all of the Diabetes Education Services staff for helping me make my dream a reality. As a person with a strong family history of diabetes, passing the CDCES exam is a HUGE personal accomplishment for me, and I could NOT have earned this certification without the Diabetes Education Services program. I plan to use Diabetes Education Services to obtain my CEUs and to polish my skills.

    If someone is considering becoming a CDCES, they should absolutely consider this program. The designations CDCES after my name came from hard work and with help and support from Diabetes Education Services. Thank you, and I highly recommend you.

    Judith Paul, BSN, RN, CCM, CDCES


    Starting your journey to becoming a CDCES?

    Join us live August 10th at 11:30 am PST for our

    Preparing for the CDCES Exam FREE Webinar

    This course will transform your test anxiety into calm self-confidence and test taking readiness.

    Can’t join us live?
    Don’t worry, register and we will send you a link to the recorded version.

    Webinar Topics

    Read More: Preparing for CDCES Exam Webinar Topics

    Preparing for the CDCES Exam |
    FREE Webinar

    • Exam requirement updates for 2022.
    • Exam eligibility and test format
    • Strategies to succeed along with a review of study tips and test-taking tactics.
    • We will review sample test questions and the reasoning behind choosing the right answers.
    • Learn how to focus your time and prepare to take the CDCES Exam. We provide plenty of sample test questions and test-taking tips!
    2021 PowerPoint Handouts


    What is a Certified Diabetes Care and Education Specialist?

    Read More: What is a CDCES?

    First awarded in 1986, as Certified Diabetes Educator (CDE) credential and in 2020 with a new name: Certified Diabetes Care and Education Specialist (CDCES) to more accurately reflect the specialty. CDCES has become a standard of excellence for the delivery of quality diabetes education. Those who hold this certification are known to possess comprehensive knowledge of and experience in diabetes prevention, management, and prediabetes.

    Becoming a Certified Diabetes Care and Education Specialist (CDCES) is one of the best professional and personal decisions I have ever made.” – Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM


    Why become a CDCES?
    Three Reasons from Coach Beverly

    Read More: 3 Reasons to Become a CDCES

    The best part of becoming a CDCES is working with my colleagues and people living with diabetes. As diabetes educators, we hear compelling and beautiful life stories. I am astounded by the barriers they face and inspired by their adaptability, problem-solving skills, and resilience.

    – Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM

    Reason 1: CDCES is a widely recognized certification by employers and health care professionals throughout the U.S.  This credential demonstrates a specialized and in-depth knowledge in the prevention and treatment of individuals living with pre-diabetes and diabetes.

    Reason 2: Currently, 10% of people in the U.S. have diabetes and another 35% have pre-diabetes which means 45% of Americans are running around with elevated blood glucose levels.  Given this epidemic, there will be plenty of future job opportunities.

    Reason 3: Having my CDCES along with my nursing degree, has opened many doors of opportunity; from working as an inpatient Diabetes Nurse Specialist in a hospital to working as a Manager of Diabetes Education in the outpatient setting to starting my own consulting company.


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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.