September 2022 eNews | Boosting Nutrition Health & Jumping for Joy

September Greetings

We are experiencing a food crisis. Ten percent of Americans in every state, across rural and urban households, experienced food insecurity at least some time during 2020. With food prices on the rise, how do we help people with prediabetes and diabetes make healthy food choices within their means? There is good news! A national nutrition task force has unveiled its findings and ambitious strategies to improve nutrition access and reduce diet-related diseases. These thought leaders and food experts have outlined an innovative plan to address the food crisis by increasing nutrition education and access, including funding cooking classes and more.

Good news in diabetes tech. The first ever tubeless integrated insulin delivery system was just FDA approved for toddlers 2 years old and up. Parents and providers alike are celebrating this latest advance in insulin delivery technology for kids and adults alike.

We all know that exercise is good for you, but does it elicit feelings of joy? A researcher has identified a series of one-minute movements that not only improve coordination, balance, and strength but also bring a smile to your face. Give it a try and invite your friends and family to join you in Jumping for Joy.

In preparation for our 25th year anniversary, we are adopting a higher tech Online University Learning Platform. This means easier navigation and more bells and whistles for our subscribers. We plan to make the switch in early Fall, so keep your eyes open for more info as we get closer to the date.

Finally, we are thrilled to announce two Flower Scholars for our October Virtual DiabetesEd Course. They are making a big difference in their communities, and we are overjoyed to celebrate both of them.

You and your colleagues are invited to join our three FREE Webinars this month. If you feel like a challenge, take a moment to check out our Question and Rationale of the Week.

Thank you in advance for your actions and advocacy on behalf of people living with diabetes.

Beverly, Bryanna, Robert, and Amanda

Click here to read our full September 2022 newsletter.

Featured Articles

• Task Force aims to Help Americans Eat Healthier
• New Tubeless Insulin Delivery for Toddlers
• Can Movement Increase Feelings of Joy?
• DiabetesEd University Launches New Platform
• Question of the Week
• Rationale of Week
• Flower Scholarship Recipients

Upcoming Webinars

• Virtual DiabetesEd Specialist Conference | Oct. 12-14th
• What We Say | Sept 13th
• BC-ADM Prep | Sept 20th
• CDCES Exam Prep | Sept 22
• ADCES Book Bundle
• Free Resources

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Upcoming FREE Webinar

What We Say Matters: Language that Respects the Individual and Imparts Hope| Airs September 13th

What we say matters.

As educators, advocates, spouses, friends, and providers, our use of language can deeply affect the self-view of people living with diabetes every day.

Intentional communication is a powerful tool that can uncover trauma, identify barriers, and move both the provider and person with diabetes toward a greater understanding of the issues involved.

The language used in the health care setting is immensely important in determining trust, mutual respect, and meaningful long-term relationships.

Many people with diabetes have experienced injustice, trauma, and marginalization, and are often struggling with feelings of shame and blame.

• Let’s lift people through our commitment to careful listening.
• Let’s choose a language that is person-centered and free from judgment.
• Let’s empower our interactions by identifying and addressing trauma and the impact of social determinants.

FREE Webinar – Lifting People Up

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Topics covered include:

• Learn phrases, words, and approaches that can be left behind.
• Describe diabetes language that is respectful, inclusive, person-centered, and imparts hope.
• Discuss how to evaluate for ACE and provide trauma-informed care
• Practice communicating about diabetes using phrases free from judgment with a focus on a strength-based approach.

This mini-webinar is free, and no CEs are provided, but there is lots of great info!

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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.

LS tells you that they frequently attend company mixers where they feel compelled to have at “least a few drinks”, to fit in and network. The tricky part of this scenario is that LS lives with type 1 diabetes. Since they don’t have a working pancreas, their circulating levels of insulin and glucagon are often mismatched to their body’s needs.

When discussing the situation, LS says they feel confident they can handle alcohol and prevent lows since they have lived with type 1 diabetes for over ten years. LS shares, “I feel comfortable recognizing when both arrows are pointing down and I am heading for a glucose crash”.

As educators, we are committed to taking person-centered approach while encouraging safe practices.

In regards to LS, we realize alcohol’s impact on the thought process and blood glucose levels. We know that alcohol can affect critical thinking and possibly impair recognition of an impending hypoglycemic event. Inebriation also has many symptoms in common with hypoglycemia. Plus, alcohol consumption slows glycogen breakdown in the liver, which increases the risk of hypoglycemia. Lastly, based on a study published in Endocrinology Advisor, higher levels of alcohol in the blood can delay and blunt the effectiveness of glucagon rescue medications.

In the worst-case scenario, if LS experiences severe low blood sugar and passes out, alcohol ingestion can blunt the effectiveness of the glucagon rescue medications.

Alcohol and Glucagon Pathophysiology Review

The body considers alcohol a toxin and as soon as it reaches the bloodstream, the liver prioritizes metabolizing the alcohol and breaking it down. During this clean-up process, the liver is distracted from responding to endogenous glucagon, the hormone that signals the liver to break down glycogen for energy and liberate glucose into the bloodstream. This clean-up can last for up to 8 hours, making delayed hypoglycemia a real possibility.

When a person with type 1 diabetes drink alcohol, they at increased risk of hypoglycemia because the liver isn’t breaking down stored glycogen to increase blood glucose levels.

Let’s get back to LS. What if LS is drinking gin and diet tonics and only munching on low-carb vegetables and cheeses during the mixer? LS is not ingesting many carbohydrates, so glycogen stores may be low and the liver is busy cleaning up the alcohol and blood sugars start dropping. By the 4th drink, LS isn’t thinking very clearly, says they “feel funny” and passes out.

A colleague of LS carries a glucagon emergency kit and provides LS with a dose and calls 911. After 15 minutes, LS still hasn’t regained consciousness, so a second dose is administered. The paramedics arrive and check the glucose, it is 53.

Simply put, glucagon rescue medications may not work if the person drinks too much alcohol.

After reviewing the package inserts of all available US manufactured Glucagon Rescue Meds, there are no warnings for alcohol intake decreasing the effectiveness of glucagon rescue meds. So, I dug a little deeper and found a decent study on the topic which describes the impact of alcohol ingestion on glucose-regulating hormones.

I also found a very helpful monograph published by Lilly Baqsimi in Canada. Baqsimi is a powdered glucagon rescue medication that is delivered nasally. The Baqsimi monograph clearly states several warnings, “Alcohol can suppress hepatic gluconeogenesis and chronic alcoholism can deplete liver glycogen stores. Therefore BAQSIMI may be less effective in presence of acute or chronic alcohol ingestion. Alcohol-induced hypoglycemia is associated with a failure of blood glucose levels to rise normally after glucagon administration. BAQSIMI may not work if the person drinks too much alcohol.“.

Keeping it Real and Safe

In conclusion, having a conversation with people with type 1 about the suppressive nature of alcohol on glycogen release for many hours after consuming alcohol is very important. Another important teaching point is that glucagon rescue meds may not be as effective and timely in raising glucose to safe levels.

As a general rule of thumb, encouraging people with type 1 to eat 15gms of carbs with each drink and have a glass of water in between, may help make sure they have enough circulating carbs and slow the pace of alcohol consumption to help the liver with processing. They may also consider decreasing their insulin dose in association with alcohol intake to prevent this serious side effect.

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Want to learn more about Diabetes Care?  Join us for our

Virtual DiabetesEd Specialist Conference
30+ CEs

Airs October 12-14th, 2022

Join us LIVE for this Virtual Course 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

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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

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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.

July 2022 eNews | 3 Steps to”DeFeet” Amputations in People with Diabetes

Happy July

It’s officially summer. What better season to celebrate feet and lower extremities!

My passion for lower extremity advocacy began with my work at Stanford Hospital over 25 years ago. A kind-hearted man was admitted to the vascular unit with an infected foot ulcer and osteomyelitis. Despite days of antibiotic therapy and wound care, a partial foot amputation was required. He was devastated by this loss and so was I.

Here is the real tragedy. I am sure this amputation could have been prevented with some simple foot care education.

For this newsletter issue, we have put together a toolkit full of foot care resources that we are excited to share with you, including a FREE Webinar on 3 Steps to Save Feet.

Amputation rates are on the rise. We hope by sharing these tools and information, we reverse this trend and save limbs.

The great thing about foot care education is that all health care professionals can engage in sharing the prevention strategies outlined in our free handouts. Just think of all the unnecessary suffering we can prevent by looking at feet, providing education, and taking action on any unusual foot findings.

I think our foot care motto from Stanford Hospital says it best, “Lift the Sheets and Look at the Feets”. Let’s just start with this first step.

We are also overjoyed to announce that we are providing two Flower Scholarships that cover the cost of our Fall Virtual DiabetesEd Course. Applications are now being accepted.

Thank you in advance for your actions and advocacy on behalf of people living with diabetes.

Beverly, Bryanna, Robert, and Amanda

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Featured Articles

• FREE Feet Toolkit
• Diabetes Wellness Visits Reduce Amputations
• 3 Steps to Save Feet FREE Webinar| July 19th
• Virtual Conference Scholarships
• Question of the Week
• Rationale of Week

Upcoming FREE Webinars

• Virtual DiabetesEd Specialist Conference|Oct. 12-14th
• CDCES Exam Prep | July 12th
• BC-ADM Exam Prep | July 14
• 3 Steps to Save Feet FREE Webinar| July 19th

Free Resources

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Want to learn more about this question?
Join us for our new FREE Webinar
3 Steps to Save Feet; Assess, Screen, and Report

Airs live July 19th at 11:30 am PST (45 to 60 minutes)

All health care professionals are invited to join us to learn strategies to protect lower extremities during this FREE Webinar.

Coach Beverly will walk participants through the 3 Step Process to Save Feet; Assess, Screen and Report.   She will provide simple and clear instructions on how to assess and inspect feet, along with risk assessment and action steps. We will share free teaching tools, strategies, and documentation forms adapted from the Lower Extremity Prevention Program (LEAP) that you can immediately implement in your practice setting.

CEs: 1.0 CEs for $19 or No CEs for FREE

Topics include:

• Effective foot assessment made easy
• How to use a monofilament to assess sensation
• Using screening form to report findings

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

FREE Handouts and Resources

3 Steps to Save Feet – Assess, Screen, Report Handout.  This handout walks health care professionals through the steps involved in a 10-minute foot assessment and monofilament screening. Also includes a Screening Form to document and report findings.

Foot Care Teaching Sheet: This handout covers the important elements of foot care for people living with diabetes with simple and straightforward language.

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

Author, Nurse, Educator, Clinician and Innovator, Beverly has specialized in diabetes management for over twenty years. As president and founder of Diabetes Educational Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes.

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NEW! Order Monofilament (5.07) for Diabetes Foot Screening 20-Pack

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Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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

Last week, I attended my 17-year-old son’s band and theater high school award ceremony. In addition to the cultural diversity of these gifted teenagers, there were a number of award recipients from the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. Each individual was celebrated and cheered on by their peers and recognized for their unique talents. As I left the auditorium, my heart was filled with joy knowing that there is room for everyone to share their gifts. This event was so much more enlightened compared to my high school experience over 30 years ago.

I am thrilled that the public high school in our community is taking steps to increase inclusivity for the LGBTQ+ community, but we have a long way to go in making other public spaces and health care settings welcoming for all.

According to an article recently published in ADCES in Practice, “Know Thyself, A Cultural Humility Framework for Diabetes Education for LGBTQ+ Individuals”, authored by Katie Savin and Theresa Garnero, the LGBTQ+ population continues to experience worse health outcomes than their heterosexual and cis counterparts. This discrimination is amplified in communities of color.

Health and Diabetes Disparities

In their article, Garnero and Savin highlight that members of the LGBTQ+ community are less likely to have health insurance and experience higher rates of food insecurity. LGBTQ+ adults are also vulnerable to poor physical and mental health. Membership in a stigmatized community puts LGBTQ+ adults of all ages at greater risk for engaging in behaviors such as smoking, substance misuse and binge eating. Experts suggest that the Minority Stress Model, which includes the LGBTQ+ community, increases sexual and gender minorities risk for mental illness, anxiety, depression and risky health behaviors.

Actions diabetes professionals can take to provide more inclusive care

Create health care settings that send a message of welcomeness to the LGBTQ+ community. There are many small and big ways to send a message of inclusion.

• Making sure the health intake forms include more than just Male and Female when asking people to check their gender.
• Bathroom door signs that welcome all genders.
• Placing pride symbols in the waiting and exam rooms, especially during Pride month.
• Practicing cultural humility when providing care
• Get comfortable with the language of LGBTQ+

Cultural humility asks health care providers to develop critical self-awareness of personal implicit or explicit values that and behaviors that may contribute to health care disparities.  Cultural humility acknowledges the role of power and privilege within the patient-provider dynamic and within the health care system itself.  Cultural values and behaviors emanating from the provider actually have the power to shape the encounter and may minimize the values of the person seeking care. By taking a closer look at our own biases during interactions, we can start becoming more intentional and align with the individual’s needs and values when providing care.

Get comfortable with the language of LGBTQ+

Inclusive language creates a bridge and the foundation of trust between health care provider and participant.  Challenge yourself to adopt inclusive language practices by taking time to learn the terminology. Make sure intake forms include same-gender parenting, same-gender partnerships and non-binary gender options.

To get more comfortable with the language culture of LGBTQ+ community members, consider challenging your healthcare setting to integrate LGBTQ+ cultural events and practices in the work setting.

As individuals, we can visit a local LGBTQ+ Center, attend a pride march, drag show or other event that provides acculturation to the community’s customs. Plus, you’re likely to have fun in the process.

Increasing exposure to the LGBTQ+ community helps decrease discomfort and improves the quality of your interactions when providing care. In addition, since members of the LGBTQ+ are at higher risk for mental health distress, make sure to assess for anxiety, depression and drug misuse.

We enrich our practice when we welcome people from diverse communities and backgrounds. Let’s make sure to let our LGBTQ+ community know they are safe with us.

List of Resources

ADCES Inclusive Care for LGBTQ+ People with Diabetes Handout – this handout provides definitions, terms to avoid, and a cultural competency checklist to help you move towards improving inclusivity within your practice.

All Gender Restroom Sign PDF

Diabetes Prevention and Management for LGBTQ+ People Handout – this handout includes research of diabetes within the LGBTQ+ community, along with clinical considerations, programs, and resources for diabetes educators to use within their practice.

Policies on Lesbian, Gay, Bisexual, Transgender & Queer (LGBTQ+) issues – this resource by the American Medical Association lists all the current healthcare policies in place for the LGBTQ+ community.

Helio’s LGBTQ+ Health Updates Resource Center – this is a “collection of news articles and features that provide the latest information on the unique health needs of individuals in the LGBTQ+ community.”

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Studying for the CDCES Exam?

Enroll in CDCES Online Prep Bundle + 5th Ed ADCES Review Guide Book | 47 CEs

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What is a Certified Diabetes Care and Education Specialist?

Read More: What is a CDCES?

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Why become a CDCES?
Three Reasons from Coach Beverly

Read More: 3 Reasons to Become a CDCES

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Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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

As we enter fire and storm season, it’s always a good idea to think ahead and be prepared for disaster. For people living with diabetes, a “diabetes kit” is an important part of emergency preparedness. We are excited to share a few getting ready checklists and resources that we think are really helpful.

For any emergency scenario, it’s important to have an emergency preparedness plan that includes a meeting point, an exit route, a “get-away” bag, and communication strategies. Identify and inform the people who will be included in the emergency plan ahead of time and make sure everyone clearly knows what to do and what action to take.

An easy way to get started is to download the Checklist and Plan created by the Diabetes Disaster Response Coalition. We have also created a Disaster Checklist Word document that you can download and customize for yourselves. These checklists can help you start the conversation and commit the details to paper.

Disaster can happen in a moments notice. It’s important to plan ahead and be ready, especially for people living with diabetes.

Here are a few helpful resources for ourselves and our community:

Resources for People with Diabetes

General information from the Diabetes Disaster Response Coalition (DDRC) on preparedness for people living with diabetes.

Have an Emergency Diabetes Plan and Kit Ready: DDRC’s Diabetes Plan and Kit checklist includes helpful steps to take in preparation for disaster. The checklist details needed supplies and information that should be written down and kept in a waterproof container for emergency situations where is can be found by a health care provider to make informed emergency treatment decisions.

Stay Updated: Visit JDRF Disaster Relief Resources and Diabetes Disaster Response Coalition includes information on how to access medical support, shelters, and open pharmacies during times of disaster.

Individuals with diabetes who need help: Call 1-800-DIABETES (800-342-2383). The American Diabetes Association Center For Information is open, MON.-FRI. 9 a.m. TO 7 p.m. ET. Representatives are regularly updated with information on how to access medical support, shelters, pharmacies, and more.

American Red Cross Shelters: Contact the American Red Cross directly at 1-800-RED-CROSS.

Resource For Health Care Providers:

• Insulin Supply Hotline: During a disaster, call the emergency diabetes supply hotline 314-INSULIN (314-467-8546) if you know of diabetes supply shortages in your community (i.e. shelter, community center). The hotline is for health care providers only.
• Diabetes Disaster Response Coalition (DRRC). If a disaster hits, people with diabetes may need emergency supplies and help fast. Please visit the DRRC website if you are a diabetes health care provider and are requesting information about diabetes supplies during disasters.

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In addition to the items listed below, make sure to pack hand sanitizer, wipes, and masks due to the current pandemic. Also, bring your own pillow and bedding in case you need to spend time in a shelter.

Download, Share, and Personalize this Emergency Checklist

Emergency Evacuation-Items to Gather for People with Diabetes
We thought this list was a helpful way to prioritize what items to grab given different time frame limitations. We found it online and customized it for people with diabetes. It is available in Word or PDF. Thank you for sharing with your colleagues and community.

• Emergency List that you can Customize in a Word Doc
• Emergency List as a PDF to print out

• Emergency List that you can Customize in a Word Doc
• Emergency List as a PDF to print out

1-800-DIABETES (800-342-2383) is an excellent referral resource for people with diabetes to call toll-free for updates on accessing medical support during an emergency.

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10 Ways to Help the Planet

Change isn’t easy. We aren’t going for perfect, we are starting with intention and slowly moving to action, giving ourselves lots of grace along the way. I am excited to share my successes and wrong turns with you on this journey and we would love to hear from you too!

1. Grow plants native to your area.
2. Compost kitchen scraps and cut down on waste
3. Eat more sustainable veggies, fruits, grains and less meat, processed foods.
4. Drive less and walk more, especially in nature
5. Think of 3 ways to use less water
6. Use cold water to wash, hang clothes to dry.
7. Turn appliances, lights and computers off when not in use.
8. Purchase used items and re-use everything you can. Swap and trade instead of buying new.
9. Try to use less plastics
10. Trade out filament light bulbs for new LED bulbs.

Read more on our blog, Earth Day Secrets to Improving Planet Health

Stay tuned and we share details and resources on each of these 10 Steps over the next few months. And, please send us your stories too at info@diabetesed.net. We want to hear from you!

How to Protect the Planet Resources Page

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Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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

Like many of you, I have a personal relationship with climate change.

On a blustery day in November 2018, the Camp Fire burned down the hospital and the entire town where I provided diabetes care for over 20 years. In a matter of a short six hours, over 30,000 people who lived in Paradise lost their community and sense of place.

I lost working with my incredible diabetes team and my extended diabetes family. Others lost everything. The Camp Fire has devastated us all in very personal ways. It is considered the deadliest and most destructive wildfire in California history.

Since the town of Paradise was a popular retirement destination, many of those who survived the fiery drive down the hill were frail and elderly. More than 3,000 of them had diabetes and many fled their homes without their meters, insulin, or other critical medications.

With the help of the Red Cross and hundreds of volunteers, we were able to connect most people with needed medications and supplies, but many went without. People with diabetes lost connections to their providers, pharmacies and support systems.

We lost 85 of our beautiful community members due to the fire and thousands of our neighbors dispersed to other states and towns to start their lives over. Over half of our providers moved away and a hospital that provided care to a rural community was suddenly gone. This extreme loss and upheaval reveals the painful truth that we need proactively take action to reduce the frequency and severity of climate disasters and be prepared for future events.

How is climate change impacting diabetes risk?

According to a 2020 article published in the Journal of Community Hospital Internal Medicine Perspectives, climate change, and in particular, increasing global temperatures, is expected to impact the health of people living with diabetes and lead to worse outcomes.

After completing a literature review, the authors concluded that diabetes and climate change are interconnected. Let’s explore how.

Hotter Temperatures Worsen Diabetes Outcomes

People with diabetes are at greater risk of experiencing dehydration and cardiovascular events during periods of extreme heat. With the increasing frequency of extreme heat episodes, there is an associated increased risk of heat-related death and cardiovascular events for people living with diabetes. Several studies reveal that people with diabetes have a higher risk of death on hot days, and are more likely to need emergency care and those with a history of heart disease are most vulnerable.

Shortage of Medical Supplies and Medications

Recent climate disasters, like the Camp Fire, Hurricane Katrina in 2005, and Hurricane Harvey in 2017, resulted in people not being able to access, afford or safely store their medications, including insulin. In addition, we are experiencing supply chain disruptions in D50 (25 grams of glucose in a 50 ml prefilled syringe (50% glucose)) to treat hypoglycemia and certain intravenous fluids are in short supply.

Food Supply Shortages

Extreme weather can result in agricultural production disruptions. In our community, many fields that were once green with trees and crops, now are brown and barren. There is not enough water to keep crops alive and growing. This also means job loss and less money flowing into communities. When the healthy food supply is limited, people living with diabetes may turn to lower-cost, processed foods which are environmentally unfriendly and low in nutrients.

Diabetes and climate change are clearly interconnected. Extreme weather events and rising temperatures will significantly impact people living with diabetes, especially those with cardiovascular disease. The disruption in the supply of life-saving medications (e.g. insulin) due to extreme weather combined with decreased access to healthy foods are difficult issues that require problem-solving by individuals, communities, and government leaders.

We are expecting more intense weather-related events in the future and the question is what can WE do?

As Diabetes Specialists, I believe we can make a difference by leaning into our unique blend of behavior change skills, advocacy, and scientific knowledge

We can take a two-fold approach:

1. Take action to help slow and reverse climate change – Read our blog on actions we can start taking today.
2. Help people with diabetes to be prepared for natural disasters. Read our blog on How to Get Ready

A note of hope. Three years after the Camp Fire, people are rebuilding in Paradise. There is a better understanding of the need for preventive forest management and exit routes. However, the longstanding California drought continues to contribute to future fire risk. Water conservation is more important now than ever. We can take action to reverse the heating planet. Read our blog on actions we can start taking today.

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10 Ways to Help the Planet

Change isn’t easy. We aren’t going for perfect, we are starting with intention and slowly moving to action, giving ourselves lots of grace along the way. I am excited to share my successes and wrong turns with you on this journey and we would love to hear from you too!

1. Grow plants native to your area.
2. Compost kitchen scraps and cut down on waste
3. Eat more sustainable veggies, fruits, grains and less meat, processed foods.
4. Drive less and walk more, especially in nature
5. Think of 3 ways to use less water
6. Use cold water to wash, hang clothes to dry.
7. Turn appliances, lights and computers off when not in use.
8. Purchase used items and re-use everything you can. Swap and trade instead of buying new.
9. Try to use less plastics
10. Trade out filament light bulbs for new LED bulbs.

Read more on our blog, Earth Day Secrets to Improving Planet Health

Stay tuned and we share details and resources on each of these 10 Steps over the next few months. And, please send us your stories too at info@diabetesed.net. We want to hear from you!

How to Protect the Planet Resources Page

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Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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

Happy May

We loved celebrating Earth Day with all of you. Your response to our “PocketCard for a Planet Pledge campaign” knocked our socks off. Over 900 people committed to taking action for the Earth. Plus, hundreds of you added our own ideas. We decided to continue the planetary PocketCard party for one more week because we love our community!

This month’s newsletter explores the link between climate change and diabetes from a personal and community level. We provide ideas for prevention, preparation, and actions to take in case of a climate-related disaster. People with diabetes are especially vulnerable during extreme climate events and helping ready them for disasters can save lives.

In addition, we highlight a recent study that demonstrates reducing four risk factors improves outcomes, which is great news to share.

Living with diabetes can be overwhelming. Messages of hope for people with diabetes can provide motivation to continue with self-care during those hard times.

Lastly, I would like to dedicate this newsletter to a very special person. Ruth always showed up to our diabetes support group with the energy of two people and the mental clarity of someone half her age. Around this time of year, she would distribute Emergency Preparedness materials and would carefully review the exit routes out of Paradise in case of fire. She would go around the room and ask each person if they had their emergency bag ready. For each of the seventeen years that I ran that support group before the hospital and town burned down, Ruth gave the same impassioned spiel. I can only imagine how many lives she saved.

May we all embody the spirit of Ruth as we move forward on this journey. With wishes for health and wonderment,

Beverly, Bryanna, Jackson, and Amanda

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Featured Articles

• How a Changing Climate Impact Diabetes Risk.
• Earth Day Pledge Success
• Semaglutide Max Dose Increased to 2mg
• Reducing 4 Risk Factors to Increase Life Expectancy
• How to Prepare for Natural Disasters
• Question of the Week
• Rationale of Week

Upcoming Webinars

• DiabetesEd Virtual Conference | Recorded & Ready to Watch!
• Cardiovascular Disease & Diabetes | May 10th
• Older Adults | May 12th

Featured Items

• ADCES Book Bundle

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Studying for the CDCES Exam?

Enroll in CDCES Online Prep Bundle + 5th Ed ADCES Review Guide Book | 47 CEs

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What is a Certified Diabetes Care and Education Specialist?

Read More: What is a CDCES?

---

Why become a CDCES?
Three Reasons from Coach Beverly

Read More: 3 Reasons to Become a CDCES

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Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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

Research published in The Lancet Diabetes & Endocrinology this month confirmed the same findings as a growing number of studies.  COVID-19 increases a person’s risk of diabetes, even months after being infected.

In this latest robust study, researchers reviewed the medical records of over 180,000 US Veterans who survived the first 30 days of COVID-19 infection between March 2020 and September 2021 and compared them with 2 large control groups—a contemporary cohort of more than 4.1 million non-infected participants who used VA services during the same time period and a historical cohort of another 4.28 million non-infected participants who used VA services during 2017.

What researchers discovered is very concerning

Over 40% of study participants infected with COVID-19 were more likely to develop diabetes or be prescribed diabetes medication within a year compared to the control group.  Simply translated, 2 in 100 COVID-19 patients were more likely to develop diabetes than those who did not get infected.

People older than 65 years and those with cardiovascular disease, high blood pressure, high cholesterol, or prediabetes had a higher risk of diabetes than younger individuals or those without underlying conditions. Additionally, Black participants had higher risks of developing diabetes than White participants.

Most of the post-COVID diabetes cases (over 99%) developed type 2 diabetes. In addition, the severity of the COVID-19 infection impacted the risk. People with COVID-19 admitted to intensive had the highest risk of developing develop diabetes, compared to those not infected.

Some limitations of the study include that the findings may not translate to other populations, since the US Veterans study group consisted of mostly older white men, many of whom had risk factors for diabetes, including hypertension and extra weight.  The risk of getting diabetes post-COVID-19 seems to be much lower in younger people. Another limitation is that some people in the control group might have had an asymptomatic missed COVID-19 diagnosis.

Implications for Diabetes Specialists

These startling findings have significant implications for the 80 million people in the U.S. known to be infected with COVID-19, especially for people living with long-haul covid.

People who have experienced a COVID-19 infection need to know the symptoms of hyperglycemia and be encouraged to report suspicions of diabetes symptoms to their providers right away.  In addition, regular glucose testing of people who were infected with COVID-19 may now be recommended to detect those who may not be aware of the signs of diabetes.

Now, more than ever, we need to increase access to Diabetes Prevention Programs and Diabetes Self-Management Education, to make sure this expanding population of people with new diabetes gets the information they need to successfully manage glucose levels and maintain optimal quality of life.

For more information:
Washington Post Article and The Lancet Diabetes & Endocrinology

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