Subscribe
eNewsletter
Ready to get certified?
Free CDCES Coach App
Download
Free Med Pocket Cards
eNewsletter
Free CDCES Coach App
Free Med Pocket Cards
Eli Lilly and Company issues a voluntary nationwide recall of one lot of GLUCAGON® Emergency Kit due to Loss of Potency. Warning – A person with severe hypoglycemia who injects this faulty formulation will experience worsening hypoglycemia.
Eli Lilly and Company is voluntarily recalling lot D239382D, Expiration April 2022, of Glucagon Emergency Kit for Low Blood Sugar (Glucagon for Injection, 1 mg per vial; Diluent for Glucagon, 1 mL syringe).
The Eli Lilly injectable glucagon kit (pictured here), usually contains a syringe with diluent and a vial with powdered glucagon. The user needs to put the diluent into the vial with the powdered glucagon and reconstitute it before injecting it.
However, a product complaint from a user found that the vial of Glucagon was in liquid form instead of powder form. Associated with this useful product complaint, the patient who was given this glucagon vial content, experienced worsening hypoglycemia and also reported subsequent seizures.
The use of the liquid form of this product may fail to treat severe low blood sugar due to loss of potency.
It is well known that severe hypoglycemia in people with diabetes, if not promptly treated and reversed, can potentially cause adverse health consequences ranging from transient, minor complaints to neurological damage, seizures, and even death. Eli Lilly’s investigation indicates that the liquid in this Glucagon vial could be related to a problem with the manufacturing process.
The Eli Lilly Glucagon product is packaged in a kit containing 1mg of freeze-dried (lyophilized) product in a 3 mL vial and a pre-filled diluent syringe. The affected Glucagon Emergency Kit lot is D239382D and the expiration date is April 2022 (label expiry date: 04 2022). The lot number can be found on the label of the kit as well as the vial (refer to the complete FDA warning below). The lot was distributed nationwide to wholesalers and retailers.
Consumers in possession of Glucagon Emergency Kit lot D239382D should contact The Lilly Answers Center at 1-800-LILLYRX (1-800-545-5979) for return and replacement instructions for the product (hours of operation are Monday- Friday, 9AM – 7PM EST) and should contact their health care provider for guidance. Consumers should contact their physician or healthcare provider if they have experienced any problems that may be related to taking or using this product.
Lilly is notifying its distributors and customers by written communication and is arranging for the return and replacement of all recalled products. Wholesalers and Distributors with an existing inventory of Glucagon Emergency Kit lot D239382D should cease distribution and quarantine the product immediately.
Read complete FDA Announcement Here
There are now 4 different glucagon formulations to choose from.
This free card details the different formulations available, from the injectables to the nasal powder formulation.
The backside includes teaching and hypoglycemia prevention strategies, along with the different official levels of hypoglycemia (for your certification study preparation).
Join us live on November 11th from 8:00 am to 4:00 pm for our Virtual Conference: Diabetes in the 21st Century | 6.5 CEs
This conference offers comprehensive presentations on care of a person with diabetes examining a variety of evidence-based topics to aid in the care of a person with diabetes.
Click here to download the program flyer.
Location: Virtual
Fees: No charge for Meritus Health Employees. $50.00 for Non-Meritus Health Participants Meritus Health Employees: Please register via Healthstream, using keyword search “21st Century” or by clicking here.
Cancellation Policy: If you must cancel, please notify Ruth Leizear by phone at 301-790-8619 or toll free at 888-803-1518.
Check-in: Check-in starts at 8:00 a.m., please log in 15 minutes prior to the first presentation
Accreditation:
Click here to download the program flyer.
Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator and a nationally recognized diabetes expert.
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!
[yikes-mailchimp form=”1″]
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.
We are so excited to announce our DiabetesEd Specialist Scholarship Recipients!
We received dozens of applications for our annual Making a Difference Scholarship and the Flower Scholarship gifted from an anonymous donor! It was a great personal joy for our team to read these scholarship applications. Each applicant is serving communities with a great need and going “above and beyond” to promote and provide accessible diabetes care and education. It is always a very difficult decision for all of the judges, and we read each application in careful detail considering the financial need, impact, volunteerism, and readiness to take the CDCES exam.
We greatly appreciate the good work of all the applicants and thank them for their service!
This year we are offered 3 Scholarship Options for our Virtual DiabetesEd Specialist Conference, October 6-8, 2021.
Congratulations Chantel Wade, his year’s Flower Scholarship Recipient!
Chantel Wade is the recipient of our “Flower Scholarship.” Chantel is an ambulatory RN and the lead in the Patient Education Department at her local health center. There she serves a diverse population of individuals from different socioeconomic backgrounds, seeing many people who are on Medicare, Medi-Cal or are uninsured. She uses a hands-on, interactive approach with those she works with; she is committed to meeting people where they are by creating custom care plans that meet their individual needs. Outside of work, she is active in her local Fellowship Church and other organizations where she volunteers her time and expertise to offer pre-diabetes and diabetes education.
Congratulations Keira McCrary, “Making a Difference Exemplar Scholarship” Recipient!
Keira McCrary is the recipient of our “Making a Difference Exemplar Scholarship” because of her dedication to her community. Keira works as a Registered Dietician who provides direct care services to Native American tribal communities in her area. In her work, she supports people living with diabetes through all stages of life with programs such as home meal delivery for elder tribal members and the Native Youth Preventing Diabetes Organization. Through Native Youth Preventing Diabetes Organization Keira assists in the education of tribal youth in the areas of diabetes prevention, nutritional education, physical activity, behavioral health, and more. She also creates user-friendly tools for those she works with such as informational “how-to” diabetes-friendly recipe videos and a weekly newsletter.
Congratulations Logan Mumphrey, “Making a Difference Scholarship” Recipient!
Logan Mumphrey is our second recipient of our “Making a Difference Scholarship” for many reasons! Logan is currently working towards his MSN/FNP and has worked as the primary nurse and clinical coordinator for transgender health services helping to build the program from the ground up. This program provides gender-affirming care that goes beyond hormone therapy including care navigation, surgery coordination, assistance with identity document changes, peer support, and much more. Logan is passionate about diabetes care and education and hopes that by becoming a CDCES, it will allow him to provide more support for those he works with so they can manage their diabetes with a gender-affirming lens.
This year we are offered 3 Scholarship Options which include:
The goal of these scholarships are three-fold:
As a child, LR lived with neglect and mistreatment by their parents. Escaping home as a teenager, LR couch surfed at friends but finally ending up living in their car. At the age of 23, LR showed up at our local community clinic with dysregulation, depression, and anxiety coupled with a new diagnosis of type 2 diabetes and elevated triglycerides. LR had limited access to healthy food and carried a BMI of over 35.
After a few months of getting comfortable with the clinic staff, our counselor asked LR to complete the Adverse Childhood Experiences (ACE) screening assessment. After LR finished checking off their adverse childhood experiences, they looked up with tears and said, “I scored a 9 out of 10”.
Adverse Childhood Experiences (ACEs) are common. At least two-thirds of people living in the U.S. have experienced one ACE and over 15% have experienced 4 or more.
Furthermore, a dose-response relationship exists: as the number of adverse experiences increases so does the risk of problems from childhood through adulthood.
These childhood traumas can lead to toxic stress which, over time, can change the biology of our bodiy.
People with elevated ACE scores are more likely to experience a variety of mental health issues, which is not surprising given their painful, confusing, and unsafe childhoods. Based on sound research by the CDC and Kaiser, they are also more likely to suffer from physical diseases, like heart attack and stroke, diabetes, and cancer. They are more likely to break bones and experience unintended pregnancies.
The Impact of Adverse Childhood Experiences on Health: A Personal Story of Resilience and Hope with Coach Beverly
ADCES National Virtual Meeting – Ready for Viewing
California Coordinating ADCES Chapter – September 30, 2021 at 4:45pm PST
Diabetes Ed Services Webinars – airs October 27th at 11:30 am PST
Research shows that ACEs can lead to a cycle of toxic stress and cellular inflammation. This heightened adrenal-mediated “flight or fight” response over time, can lead to neuroendocrine dysregulation, altered immune response, affect DNA packaging and activate epigenetic tags that can alter genetic makeup.
The CDC Morbidity and Mortality Weekly 2019 report tell us that preventing ACEs could reduce:
The first Surgeon General of California, Nadine Burke Harris, MD, MPH, has made it her mission to increase awareness, identify and address ACEs with parents, children, and adults so that we can break the cycle.
Health care professionals at risk for ACEs
People who enter healing professions may be experiencing toxic stress from childhood or current trauma. They may be dealing with burnout, fear, or feelings of deep pain with their past coupled with all the intensity of providing care during the COVID pandemic. This chronic and toxic stress can lead to dysregulation while impairing our ability to cope and care for others. You are not alone.
My own personal journey of experiencing childhood trauma and holding myself together until I ended up in the hospital, has compelled me to share my story with you. And offer a message of hope.
Coach Beverly
As I work on healing and integrating the different aspects of myself, I now feel more attuned to others who have weathered and survived childhood trauma. This awareness has significantly changed the way I hear what people with diabetes are saying and interpret what they are doing. For example, knowing that LR had a very high ACE score, I was able to adjust my expectations and focus on behavior changes that support self-care and self-regulation. When LR doesn’t take their diabetes medications for a few weeks, I provide gentle strength-based coaching to help LR get back on track. I make sure LR knows that they are safe sharing the truth of their story, no matter what.
In your hospital setting, do you have a person who keeps getting readmitted to the hospital in a diabetes crisis? In your outpatient setting, do you experience frequent no-shows or situations where people aren’t able to make changes in self-care? Maybe, they are struggling with the emotional impact of toxic stress.
Adults who have experienced trauma as children may exhibit the following behaviors:
As Diabetes Care and Education Specialists, if we recognize these behaviors as a response to dysregulation due to toxic stress, we can provide a therapeutic response to start the healing process.
Helpful provider responses when you suspect that participants are not engaging in care due to childhood trauma and toxic stress:
Diabetes Care and Education Specialists recognize that the mind and body are a deeply connected, dynamic, and powerful force when they are working together in harmony. When trauma and toxic stress are not recognized or treated, there can be devastating health consequences. We can make a difference in preventing, recognizing, and helping people heal from adverse childhood experiences.
Want to learn more about the ACEs and Healing?
The Impact of Adverse Childhood Experiences on Health:
A Personal Story of Resilience and Hope with Coach Beverly
ADCES National Virtual Meeting – Ready for Viewing
California Coordinating ADCES Chapter – September 30, 2021 at 4:45pm PST
Diabetes Ed Services Webinars – airs October 27th at 11:30 am PST
ACE Screening Tool and Resilience Inventory
Becoming ACE-Aware Training Program
Nadine Burke Harris, MD TED Talk on How Childhood Trauma affects health
NPR Article – Take the ACE Score and Learn what it does and doesn’t mean
Trauma-Informed Care Fact Sheet
Why should I care about my number?
CDC Vital Signs – Impact of ACES
CDC Mortality and Morbidity Weekly Report on ACEs – 2019
What happened to you? Conversations on Trauma, Resilience, and Healing – authors Oprah Winfrey and Bruce D. Perry, M.D., Ph.D.
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!
[yikes-mailchimp form=”1″]
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.
We have some heartwarming news to share!
We have awarded 3 DiabetesEd Scholarships to trailblazers who are delivering above and beyond diabetes care to under-resourced individuals and communities across the U.S.
We couldn’t be more proud of these three scholars who have volunteered, innovated and worked hard to make sure their communities get the resources and care needed to thrive with prediabetes and diabetes. If you need some inspiration, please take a moment to read their stories below.
We also take a deep breath and investigate the impact of Adverse Childhood Experiences (ACEs) on the health of all people including those living with diabetes.
Beverly shares her personal experience with ACEs and offers approaches to reaching out to participants and providers living with toxic stress and trauma. We hope you can join us in learning more about this critical topic.
Coach Beverly also interviewed Dr. Ashby Walker to discover why more people with type 1 diabetes aren’t using insulin pumps and CGMs. It turns out that lack of access isn’t the biggest barrier. We take a closer look at the importance of recognizing the expertise of people living with type 1 and the provision of truly collaborative care.
Lastly, just like the Olympians who are boldly working to be their best, but sometimes find themselves with the “twisties”, we keep working toward being the best versions of ourselves as we deliver diabetes care and provide meaningful coaching to each individual.
Keep cool everyone,
Coach Beverly, Bryanna, Jackson, and Robert
Click here to read our full August 2021 newsletter.
Featured Blogs
Upcoming Events & Resources
I felt pretty discouraged reading through the New England Journal of Medicine (NEJM) summary of the state of diabetes treatment and control in the U.S. from 1999-2018. We have stalled in improving diabetes outcomes in spite of exciting new therapies and dazzling technologies.
Based on this “Diabetes Report Card” for the U.S it seems pretty clear that changes in our care delivery system are urgently needed. First, let me share the data, then we consider how Diabetes Care Specialists (you and me) can drive the improvement arrow in the right direction.
The data summarized below is extracted from the National Health and Nutrition Examination Survey (NHANES) which assesses national trends in diabetes care and outcomes for the past decade.
Summary of the major findings of the Diabetes ABC’s. A1C, Blood Pressure and Cholesterol.
Data is compared from the 2007 -2010 period to the 2015-2018 time period.
Reaching A1c Target of less than 7%?
Coach Bev’s Report Card Comment: Blood glucose levels trended up. GRADE C-
Reaching LDL target of less than 130 mg/dL?
Coach Bev’s Report Card Comment: Lipid levels improved slightly. GRADE B-
Reaching blood pressure goal of less than 140/90 mm Hg?
Coach Bev’s Report Card Comment: Blood pressure control achievement dropped slightly. GRADE C-
The percent of participants who achieved all 3 targets of A1C, BP, and lipids?
Coach Bev’s Report Card Comment: ABC’s of diabetes control dropped slightly. GRADE C-
Data and Graph from Trends in Diabetes Treatment and Control in U.S. Adults, 1999–2018 | NEJM
The year 1999 got off to a good start with improved diabetes control but stalled and declined as the decade moved forward. There are several possible reasons as cited by the authors.
Sluggish initiation of first-line therapies. In 2015–2018, only 56.3% of adults with diabetes were using statins, 59.5% were using metformin, and 60.3% were using an ACE inhibitor or ARB.
These results are consistent with those of previous studies and point to clinical inertia as a potential culprit.
In addition, achieving glycemic and blood-pressure control often entails the use of multiple agents. However, the study found that only 60.6% of participants with an A1C level of 7% or higher and 52.8% of those with a blood pressure of 140/90 mm Hg or higher were treated with more than one glucose-lowering or blood-pressure-lowering medication, respectively.
Coach Beverly suggested action: Diabetes Care and Education Specialists can continue to raise awareness of the ADA Standards of Care for Diabetes and advocate for initiating first-line and add-on therapies in their work settings. Plus, we can encourage a streamlined referral process to facilitate participant access to DSMES and to RD/RDN for initial and ongoing lifestyle and nutrition counseling.
Care Gaps for Young People, Ethnic Groups and Uninsured Populations
The study found that younger people, Mexican Americans, and persons without health insurance were more likely to be untreated when risk-factor targets were not achieved. These gaps are especially magnified in under-resourced areas.
In addition, given that the rates of diabetes-related complications are higher in people of color and uninsured populations and that type 2 diabetes discovered in young adulthood have a more aggressive clinical course than diabetes, immediate action is required to improve outcomes.
Coach Beverly suggested action: Diabetes Care and Education Specialists continue to take a leadership role in intentional and unrelenting outreach to provide DSMES and MNT to under-resourced communities using novel and evidenced-based approaches. Since prediabetes rates are also higher in many of these communities, establishing easily accessed Diabetes Prevention Programs and networking with community health workers and leaders can contribute to improved health outcomes.
Medications are too expensive for many people
Even though we have a slew of new and highly effective classes of diabetes medications, they are out of the financial reach for many. As patents expire and the medications are available as generics, access and affordability will increase. In the meantime, a realistic approach to providing affordable diabetes treatment is needed.
Coach Beverly suggested action:
Diabetes Care and Education Specialists can help craft a medication plan that is realistic and affordable. For people with no insurance or large co-pays, consider using available generic diabetes medications. These medications often cost $10 or less for a 3-month prescription. They include: metformin, sulfonylureas, and pioglitazone. In addition, Walmart offers Reli-On insulins including Regular, NPH, and 70/30 insulin for $25 a vial. There are also online resources like GoodRx.com that help people find discounts on their usual medications and the different pharmaceutical companies also offer discount programs based on need.
See Insulin Cost Savings Guide for an abundance of resources and useful links.
In conclusion, Diabetes Care and Specialists are perfectly positioned to influence health delivery systems and advocate for best clinical practices. We can be catalysts for establishing DPP and DSMES programs in under-resourced communities and advocate for access to affordable medications and technologies to help participants reach their targets for A1C, Blood Pressure, and Cholesterol while improving quality of life.
With a concentrated effort, maybe our next report card will be a little bit better!
With hope, Coach Beverly
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!
[yikes-mailchimp form=”1″]
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.
Happy July!
Did you know that only about 50% of people in the U.S. are reaching the A1C target of less than 7%?
And only 22% of Americans reached all 3 targets for A1C, blood pressure, and lipids.
Unfortunately, the percentage of people reaching these goals has declined or stalled over the past ten years. These disappointing results are based on an analysis of the most recent data from the National Health and Nutrition Examination Survey (NHANES) published in NEJM this June.
But I have hope for several reasons!
First, Diabetes Care and Education Specialists can continue to raise awareness of the ADA Standards of Care for Diabetes and advocate for initiating first-line and add-on therapies in their work settings. Plus, we can encourage streamlining of the referral process to facilitate participant access to DSMES and to RD/RDN for initial and ongoing lifestyle and nutrition counseling. Plus, we discuss lots more ideas to improve care in the article below.
Second, I am excited to highlight our interview with a health care visionary and leader, Dr. Avni Shah, who is moving forward with a radical approach to providing diabetes care to our most vulnerable populations designed to improve outcomes.
Third, to improve care, we need more CDCES’s and taking the exam just got a little bit easier. By the end of the year, we will be able to take the CDCES exam from our home or other remote locations.
In this newsletter, we also dive into a Pediatric Question of the Week and explore Preparation for Surgery with our Rationale of the Week. We are thrilled by the interest & response to our Live San Diego Course in October and look forward to gathering together again in person.
Keep cool everyone,
Coach Beverly, Bryanna, Jackson, and Robert
Click here to read our full July 2021 newsletter.
Featured Blogs
Upcoming Events & 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!
[yikes-mailchimp form=”1″]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.
Happy June!
Coach Beverly is feeling grateful
For this newsletter, I am practicing my gratitude out loud and sharing it with you all.
Here are 7 things I am grateful for:
In this newsletter, we address topics ranging from hemoglobinopathies to inclusion to new glucagon meds.
Bryanna and I had a lot of fun putting this newsletter together because it rings so true to the mission of our company; to be inclusive and welcoming, to celebrate each individual while leaving judgment behind. To lift each other up, especially during hard times. To offer hope, promote curiosity, and let you always know that we believe in you.
Happy June everyone,
Coach Beverly, Bryanna, and Jackson
Click here to read our full June 2021 newsletter.
Featured Blogs
Featured Items
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!
[yikes-mailchimp form=”1″]
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.
Happy National Nurses Day and Week!
When I was considering college as a teenager, my dad offered me some simple advice, “Why don’t you become a nurse?” I rolled my eyes and said, “Nah, I am going to be a social worker.” Four years later, I stood proudly with my white cap and nursing pin securely fastened as an RN graduate.
As I reflect on my years in this noble profession, I have witnessed the most unselfish acts of love and pure heroism by my nursing colleagues. 2020 -2021 have been rough times for the four million nurses in the United States.
Nurses have not wavered from their commitment to providing care to even the sickest among us.
Like the founder of nursing, Florence Nightingale, nurses are “Holding the Lamp” and shining it in dark places that are scary and unknown to provide comfort to those who need it most.
In this newsletter, we celebrate Nurses.
Has a nurse touched your life? Check out our blog on 5 ways you can show thanks. Did you know that in addition to founding nursing, Florence Nightingale was a statistics whiz? You can discover more about this trailblazer in the blog below.
This newsletter also offers a fresh perspective on using the plate method to encourage healthy eating while promoting the pleasure of eating.
Also, we all know that living with type 1 diabetes isn’t easy. We are hopeful that you can help us get the word out about a study geared toward not only supporting people with type 1 but providing them with excellent information and problem-solving coaching. Read more about the Embark Study below and thank you for sharing this unique opportunity with those living with type 1 diabetes.
Finally, we are excited to share an updated approach to managing diabetes in the hospital setting and encourage you to take a look at our question and rationale of the week.
Thank you nurses for the love and care you provide every day!
Coach Beverly, Bryanna, and Jackson
Click here to read our full May 2021 newsletter.
Featured Blogs
Featured Items
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!
[yikes-mailchimp form=”1″]
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.
