Join us Aug 20, 2020 @ 11:30 – 12:40 p.m. PST

Many of you are curious about the steps involved in becoming a BC-ADM. Thank you for reaching out to us with your questions about eligibility and study strategies. Coach Beverly will be providing answers to your questions interwoven with her own journey to achieve her Board Certification in Advanced Diabetes Management (BC-ADM).

Becoming Board Certified in Advanced Diabetes Management (BC-ADM) is an excellent professional goal for diabetes specialists with an advanced degree in their field and a professional license as an advanced practice nurse, registered dietitian, or registered pharmacist or provider.

The person holding the BC-ADM credential skillfully manages complex patient needs and assists patients with their therapeutic problem-solving. Within their scope of practice, healthcare professionals who hold the BC-ADM certification:

• Adjust medications
• Treat and monitor acute and chronic complications and other comorbidities
• Counsel patients on lifestyle modifications
• Address psychosocial issues
• Participate in research and mentoring

The scope of advanced diabetes practice includes clinical management skills such as medication adjustment, medical nutrition therapy, exercise planning, counseling for behavior management, and psycho-social issues. There is a focus on research, national standards, medical management of diabetes, and co-conditions, with a person-centered care approach.

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Preparing for the BC-ADM Exam |
FREE Webinar

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

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This free webinar will review BC-ADM requirements for the current year.

Coach Beverly will discuss:

• exam eligibility and test format,
• strategies to succeed
• study tips and test-taking tactics.

She will also review sample test questions and reasoning behind choosing the right answers. We hope you can join us.

Aug 20, 2020 @ 11:30 – 12:40 p.m. PST

For more information on Preparing for the BC-ADM exam, visit our BC-ADM exam prep resource page.

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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.
**To satisfy the requirement for renewal of certification by continuing education for the Certification Board for Diabetes Care & Education (CBDCE), continuing education activities must be applicable to diabetes and approved by a provider on the CBDCE List of Recognized Providers (www.ncbde.org). CBDCE does not approve of continuing education. Diabetes Education Services is accredited/approved by the Commission of Dietetic Registration which is on the list of CBDCE Recognized Providers.”

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Many people with diabetes seek out natural remedies to improve blood glucose and lipid levels. Supplements can be costly and are not reviewed for efficacy and safety by the Food and Drug Administration.

As diabetes specialist, we want to provide our clients with evidence-based information regarding supplement use so we can make recommendations and assist our clients with informed decision making.

Evaluation Chart of Supplements for Glucose and Lipids

To download this Supplement Safety Rating Chart, click here to view a detailed evaluation chart of “Recommended” to “Not Recommended – High Risk” supplements. Thank you, Cleveland Clinic, for creating an evidence-based review that we can share with our community!

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To learn more about the latest in diabetes and nutrition, you are invited to purchase our Virtual Medical Nutrition Therapy Presentation and Earn 4.0 CEs Get ready to be “awed” by a nationally recognized nutrition expert, Dana Armstrong, as she provides a insightful review of the latest research and findings in diabetes and nutrition therapy.

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How long does glulisine last in pumps? What insulins can people buy without a prescription? What is the longest lasting insulin? If you want to learn the answers to these questions an more, we are here to help!

With the high price of insulin, many people with diabetes are reluctant to throw half-used bottles or pens of insulin away.

With the pandemic and ongoing insulin pricing issues, many people are struggling to pay for their insulin. Armed with information, we can help people maximize their insulin use and optimize their choices.

By knowing how long different insulin formulations last when kept at room temperature (temps up to 86 degrees), we can help people use their insulin as long as it is safe and recommended.

We usually say insulin is good for about 28 days. This is correct for many insulins, but not all.

For example, a vial of Human Regular insulin is good at room temp for 42 days. Degludec (Tresiba) is good for 56 days and Novolin 70/30 vial is good for 42 days. Glulisine (Apidra) expires after 2 days in an insulin pump, but lasts for 28 days in a vial.

See our new and exciting Insulin Storage Cheat Sheet for all kinds of important details on storage and more!

In addition, did you know that there are 3 insulins that do not require a prescription in most states? Regular, NPH and Regular/NPH combo insulins require no prescription.

Regular insulin as a back-up

A recent client ran out of their aspart insulin, was low on cash and out of town. They walked into a local Walmart, without a prescription, and paid $25 cash for a vial of regular insulin. This is incredibly important information to share with clients as a back up in case of emergency.

How many times have you launched into a google search or scoured insulin package inserts to find out the following questions or something like it?

• How long does this insulin last in a pump?
• What is the max dose of insulin this pump will deliver?
• How many pens come in a box and how many units per pen\?

Our Insulin Storage Cheat Sheet answers these questions and more!

Special thanks to Jackson Thomassian for compiling the first drafts of these sheets and to Diana Isaacs, PharmD for her inspiration.

Even though Coach Beverly has reviewed and edited these sheets dozens of times, she knows there is always room for improvement. Please let us know if you see content that needs updating. In appreciation, Beverly

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Summer camps can offer many benefits for children living with diabetes.

For many children, summer camp is a great opportunity for making connections, staying active, and offering continuous learning throughout the months they’re not in school.

However, according to a recent study, Black and Latino children are often underrepresented at summer camps.

“Racial disparities exist in many aspects of diabetes care and outcomes, including diabetes camp attendance. Therefore, we need to identify what the barriers are and address them to make camp attendance more inclusive,” Risa M. Wolf, MD, assistant professor of pediatrics at Johns Hopkins Medicine, told Healio.

Wolf and colleagues evaluated the 2018 summer camp registrations of 48 different ADA summer camp programs. From these registrations, they evaluated the “racial and ethnic makeup, continuous glucose monitor usage, insulin delivery technique, camp type, and financial aid requirements.”

Their Findings

• 83.7% of the 5,256 campers were white.
• Day camps vs. residential camps: 31.9% of Hispanic children, 23.3% of Black children, and 20% of white children attended day camps vs. residential camps.
• Financial aid: 65.6% of Black children, 48.1% of Hispanic children, and 24.3% of white children applied for financial aid to attend the camp.
• Pump Insulin Delivery: 76.4% of white children, 60.3% of Hispanic children, and 39.1% of Black children used a pump for insulin delivery.
• CGM Insulin Delivery: 61% of white children, 46.1% of Hispanic children, and 23.4% of Black children used CGMs for insulin delivery. 

From this analysis, we see much more representation of white children in summer camps, who are also less likely to need financial assistance to attend summer camps. Overall, white children hare more likely to use pumps and CGMs for insulin delivery, which is often more accessible to people from higher socioeconomic backgrounds.

To make summer camps more obtainable for all, last year the ADA created a summer camp in Baltimore that had lower registration costs. This resulted in 31% of Black and Latino children in attendance (a 14.7% increase). While this year, due to COVID, the ADA is offering a virtual summer camp, known as Imagine Camp, which is free to join

Additionally, DiabetesEd Services will be developing a program in which we offer scholarships to cover the fees for future summer camps.

Written by Bryanna, our Director of Operations & Customer Happiness

To read more click here for the Helio article and click here for the study.

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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

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. Metformin or SGLT-2 Inhibitor
2. Basal insulin or sulfonylurea
3. Liraglutide (Victoza) or Metformin
4. Basal-bolus insulin

Click here to test your knowledge!

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Watch for FREE or purchase to earn CEs!

From Tots to Teens Standards 2020
Join Live Stream July 15th at 11:30 am (PST)
1.5 CEs | $29.00 or No CEs | Free

Perfect for those planning to take the CDCES or BC-ADM or for those seeking an update.

Coach Beverly is extending a special invitation to join this webinar on the latest standards for toddlers to teens living with diabetes.

This course includes updated goals and guidelines for children living with type 1 or type 2 diabetes.

This webinar will address:

• special issues to be aware of when working with children with diabetes and their families. 
• clinical presentation of diabetes
• goals of care, management strategies

Register for FREE recorded webinar (no CEs).

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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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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

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.

Our new Glucagon PocketCards are available for Pre-order or FREE Download

There are 3 glucagon rescue medications to choose from! Our two-sided Glucagon Pocketcard, designed by Coach Beverly Thomassian, is a perfect decision aid and teaching tool designed for sharing with colleagues and people with diabetes alike.

This card can serve as a decision tool when discussing the pros and cons of the currently available rescue medications with providers and people living with diabetes.

Plus, this card highlights prevention and treatment options for hypoglycemia. It is also an excellent study tool for certification exam preparation.

• Glucagon Pocket Card
  • Front side: Our new Glucagon PocketCard compares and contrasts the delivery system, dosing, age range, route, and storage of the currently available rescue meds all in one card. 
    
• Teaching Tool 
  • Backside: This teaching tool provides step-wise instruction on how to identify, treat, and prevent hypoglycemia.  It also describes the 3 levels of hypoglycemia and includes a list of factors that can increase the risk of hypoglycemia. 

This Diabetes Glucagon PocketCard is perfect for all Diabetes Care and Education Specialists.

Get yours today!

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View or Download Glucagon PocketCard

View it for FREE anytime on our CDCES Coach App! Access by clicking on the PocketCard on our apps home screen.

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Download Glucagon PocketCard for FREE on our PocketCard Page.

Glucagon Rescue Medications require a prescription. Check expiration dates before using them. This information on the Glucagon PocketCard is for educational purposes only. Please consult package inserts for detailed instructions.

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What is Glucagon and How Does it Work?

Glucagon is a counter-regulatory hormone secreted by the pancreas when blood sugars are dipping or during periods of emotional or physical stress. This hormone liberates stored glycogen from the liver, causing an upward surge in circulating glucose.

When people become hypoglycemic, there is not enough circulating glucagon available to drive more glucose release. Glucagon rescue medications increase glucagon levels enough to stimulate further glucose release from glycogen stores in the body.

While administering glucagon is life-saving, it also depletes the body of its glycogen reserves and can lead to further hypoglycemia if it is not replaced quickly. It is so important to replace glycogen stores by consuming carbohydrates as soon as it is safe.

Emergency Action Steps

Glucagon rescue medications raise blood sugar by at least 20 mg/dl and should start working within 15 minutes.

• After administration, make sure to seek medical help and roll person on their side since glucagon can cause nausea and vomiting.
• If no response after 15 minutes, administer a second dose.
• After the person gains consciousness and can safely swallow, administer food or beverage containing at 15 -30 gms of carbohydrate until blood sugars are back in a safe range. Then follow-up with the usual meal.
  
  15 gms of carbohydrate ideas:
  • 4-8 ounces of juice or sugary beverage;
  • A piece of fruit, a handful of raisins, tablespoons of honey or corn syrup;
  • 4 glucose tabs, glucose gel, or GU energy gel.

Teaching Resources

Hypoglycemia and Hyperglycemia Education Teaching Sheet » This handout is one of my favorites. Cartoon characters depict the signs and symptoms of low and high blood sugars and then detail steps to take.  

Medication Wallet Card PDF » pocket sized document that includes contact info, list of medications and critical health data.

Medication Wallet Card in WORD » Add your program’s logo and provide your clients with a useful, customized document that includes contact info, list of medications and critical health data.  

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Click here to view our Top 3 Blogs Newsletter

Happy Wednesday Diabetes Community!

We are excited to announce our new feature; Top 3 blog posts of the Month.

Coach Beverly and team are committed to keeping you apprised of the latest findings in diabetes.

We promise to keep this end-of-the-month wrap-up announcement short and sweet while providing links to references so you can dig deeper.

As part of our commitment to sharing information, we are offering FREE webinar viewing of our Level 2 Standards Intensive Series. See upcoming topics and dates below.

Our top 3 blogs this month include the recall of some long-acting metformin brands, Medicare’s $35 monthly cap on insulin starting in 2021, and the rationale for this month’s most popular question of the week.

Happy early July 4^th weekend. Please stay safe and take good care.

Coach Beverly

Click here to view our Top 3 Blogs Newsletter

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Check out our new bundle!

Level 3 | Boot Camp + Expert Team Bundle
Join us live starting September 16th!

When you join our DiabetesEd Certification Boot Camp, it’s like having your own online coaching staff.

?In each webinar, either Coach Beverly, Dr. Isaacs, or Ms. Armstrong, highlight the critical content of each topic area, so you can focus your study time most efficiently. They also launch multiple poll questions to help participants focus on key concepts and assess their knowledge while learning the best test-taking strategies. 

Mastery of this content is critical to ensure certification exam success and to improve clinical outcomes.

Click here to download Level 3 + Expert Bundle flyer

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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

If we consider why certain groups are at increased risk for diabetes, heart attack, stroke, cancers and other health issues, we can look back in time to their childhood for answers.

Children who experience more Adverse Childhood Experiences, also referred to as ACEs, are more likely to suffer with chronic health issues as adults.

Research has show that adverse childhood experiences (ACE) do not affect all children equally.

In the United States, those from marginalized identities are much more likely to have experienced early childhood trauma, which can have lasting effects on one’s health.

The more adverse experiences that happen before the age of 18, the more likely adults are likely to express a wide array of chronic health problems including: diabetes, overweight, cancers, hypertension, stroke, heart attack, mental health issues, substance use, and more.

ACEs are a societal issue.

Due to the complex intersections identity, socioeconomic status, and healthcare access, marginalized individuals are much more impacted by ACE.

This puts certain individuals at higher risk of future chronic conditions in adulthood, like diabetes. These inequities are a by-product of social determinants of health and the impact on individuals and communities. As diabetes advocates, we are compelled to reflect on these intersections to improve health outcomes.

The World Health Organization describes the social determinants of health as “the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources.”

We need to explore and address the social determinants of health to fight for health equity for all people.

This unfair distribution of access and services results in the unfair but avoidable differences in health status seen between different neighborhoods, zip codes, and even states.

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Health Equity Defined

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Strategies to Improve Health by Strengthening Communities

Achieving equity will take time and is complicated by a long history of institutionalized racism, sexism, and other prejudices. We need to make legislative adjustments that compel corporations, educational systems, health care agencies, and local governments to assure equitable access to services to those who have been historically excluded.

Start with our children. If societies are structured to help children feel safe and protected, they will enter adulthood healthier and more prepared to perpetuate health for future generations. I highly recommend all those involved in diabetes education listen to this groundbreaking video which explores the science between childhood trauma and health: Nadine Burke Harris, MD TED Talk on How Childhood Trauma affects health.

ACE-Aware Training Program: The other obvious place to direct our energy is with our adult clients who are living with prediabetes or diabetes. We know that many of them may be having difficulty making behavior changes and engaging with their health care due to adversity experienced in childhood. Let’s set up or health care facilities to provide Trauma-Informed Care. If you would like to learn more about this topic, I encourage you to get started in this free training worth 2.0 CEs. Becoming ACE-Aware Training Program. I completed this program a few months ago and found it compelling and instructive.

A Practitioner’s Guide to Advancing Health Equity CDC PDF

• The Practitioner’s Guide to Advancing Health Equity can help public health practitioners reduce disparities in chronic diseases. It provides a collection of health equity considerations for policy, systems, and environmental improvement strategies focused on tobacco-free living, healthy food and beverages, and active living.

Thank you for reading this post and we invite you to send us comments or additional resources to [email protected]. We read each email and appreciate your contributions.

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Equity and Trauma-Informed Care Resources

COVID-19 & Diabetes: Examining the impact of health disparities in a time of crisis(link is external) – This live event, posted on the ADA website, was recorded Thursday, April 23. It provides an excellent exploration of health equality vs. health equity with honest and insightful discussions by a panel of experts. As the nation grapples with the COVID 19 health crisis, communities already experiencing social, economic, and health disparities face even more severe challenges combatting this disease. Join us for an information-packed webinar exploring the nexus of COVID-19, diabetes, and health equity.

Daniel E. Dawes, JD, Author, The Political Determinants of Health, and Director, Satcher Health Leadership Institute at Morehouse School of Medicine. 

Adverse Childhood Experiences (ACE) Resources

Nadine Burke Harris, MD TED Talk on How Childhood Trauma affects health

Becoming ACE-Aware Training Program

ACE Screening Tool and Resilience Inventory

Posted on www.AcesAware.org A Health Problem and An Opportunity: Screening for Adverse Childhood Experiences

Dr. Dayna Long, Director for the Center for Child and Community Health at UCSF Benioff Children’s Hospital Oakland, discusses the pervasiveness of Adverse Childhood Experiences (ACEs) and why screening for ACEs is critical to providing trauma-informed care.

NPR Article – Take the ACE Score and Learn what it does and doesn’t mean

Trauma-Informed Care Fact Sheet

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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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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

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.