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AHHA Study – Recruiting People Living with Type 2 Diabetes

RESEARCH STUDY

Innovative Diabetes Education Program: AHHA Study
A NEW research opportunity for people with Type 2 Diabetes

Are you a diabetes health care professional or person with diabetes who is ready to get on track with your diabetes?

We want to encourage you to let your community know about an exciting research opportunity.

We are inviting people diagnosed with type 2 diabetes less than 5 years ago, who live anywhere in the U.S., with a most recent A1C of 7.5% or higher to click this link below to see if they qualify for the study.

If so, the Behavioral Diabetes Institute is conducting a research study examining how innovative new approaches to diabetes education might help to improve glucose outcomes and quality of life outcomes. Participants will be randomly assigned to take part in one of two different live, online, group education programs. Each group program will be lively and informative, and will meet once weekly for 5 weeks in a row.

Also, half of the participants will receive a continuous glucose monitor and free testing supplies.

To find out more and see if you might qualify, click below to apply. Or for more information, email them at [email protected] or call us at 858-336-8693.

 Get Started – Pre-Qualify Here

 

Person-Centered Coaching; A Step-by-Step Approach

Person-Centered Coaching – A Step-by-Step Approach

People with diabetes experience a myriad of feelings as they utilize new technologies and try to make sense of all the data and new information. As diabetes healthcare providers, we can learn to address these feelings through person centered coaching and help individuals take steps to get to their best health. This approach not only acknowledges the individual’s feelings but also empowers them to take steps towards their optimal health.

This article equips healthcare professionals with a dozen practical coaching strategies. These strategies are designed to instill confidence in individuals with diabetes, fostering their belief in their ability to successfully self-manage their condition. 

Using a person-centered approach, we can identify the individual’s strengths and expertise and then leverage this information to open a door of possibilities. Our choice of communication techniques can spark behavior change in people living with diabetes.

Adopting a person-centered approach may require a significant adjustment for some healthcare providers. In traditional care, the provider assumes the role of the captain, steering the ship, providing the fuel, and plotting the course. However, in person-centered coaching, the provider becomes the rudder, guiding the individual while they steer their own course towards better health.

For this conversation, we imagine someone struggling with technology-related diabetes distress after switching from checking blood sugars using a meter to trying to make sense of the data being generated by their new CGM.

DO: Mindfully Listen to the individuals’ problems and fears.

The first strategy is carefully listening to the person’s fears and concerns. If someone struggles with nutrition, meds, or behavioral changes, listen to the struggle and try not to push, advise, or fix it. Listen and reflect on what you think is happening for the first few minutes.

For example, reflecting back could go something like this: 

“Taking insulin each meal is hard for you because you are worried about taking too much.” OR

“It’s hard not to constantly check your blood sugar on your CGM because you are worried that it is going above range.” OR

“It sounds like you blame yourself for having blood sugars that are above target.”

Listening and reflecting on the individual’s struggles is the first phase of energizing the visit.

 

DO: Focus on curiosity before exploring possible changes in behavior.

With a person-centered approach, spend more time in the “curiosity” phase before moving to the “action” phase.” 

We might ask the person who feels worried about elevated blood sugars, “I am curious to learn more about your feelings when blood sugars go above target.” 

As care providers, we may be slightly overanxious to get to the “action” phase, which involves action, planning, goal setting, and looking at specific foods and exercise prescriptions. It can be disorienting for providers to delay the “action” phase and spend most of the time exploring the “curiosity” phase, and there’s a perception that it takes longer. In fact, it’s probably more efficient with time. It’s a redistribution of the provider’s time in that more time is spent listening to the individual’s barriers and fears and responding to them.

Curiosity can provide comfort and open the door to insights.

 DO: Listen for individual insights and ideas.

After reflecting on the person’s struggles and feelings, the next phase is the “building change” talk. It combines having the person express how a behavior change would benefit them and realistic ways to move to the action phase.

As genuinely curious providers, we ask, “What are your ideas about how you can improve this situation?” Then, the provider listens carefully to what the person shares. 

Along with the struggles and barriers, the individual might say, 

“I will try only to check my blood sugar levels before meals and two hours after a meal instead of twenty times a day” or 

“I could try adjusting my insulin dose for a week to see how that affects my blood sugars.” 

We want to fine-tune our listening skills so that we can pick up the scent of the trail. People often allude to what they’re willing to do and drop crumbs when they feel safe and heard during the conversation. All we need to do is pick up on the hints and encourage them down the path.

DO: Ask Questions and Collaborate.

Once the individual has identified their motivation and begins brainstorming ways to change behavior, the door is open for respectful collaboration. You’ll want to explore how much change the individual is willing and able to make at that time. 

To keep it real and achievable, we start with a tiny step by saying, 

“So, you think you could limit checking your blood sugars to about eight times a day?” or 

“You think you could adjust your insulin dose for a week to see if that lowers post-meal blood sugars?” Let that sit; let the person describe their thoughts and feelings.

Then we might say, “How, if at all, do you see this plan fitting into your life?” We are careful to avoid any prescription or declaration and stick with asking questions. 

If they volunteer—”I will limit checking my blood sugars on my CGM to eight times a day.” Or 

“I will adjust my insulin dose to see if it lowers my post-meal blood sugars.” 

 We would absolutely reinforce and support these choices.

AVOID: Pressure, fix, or control.

A person-centered approach energizes individuals to take the lead in managing their condition, in step with their providers and supporters. We are careful to avoid forced solutions or controlling language. As providers, we feel we have these great ideas that will fix the person, if only…. However, the truth is, our job is to help the person with diabetes find their own answers and solutions.

 Let’s stop “Shoulding” on people.

It’s time to let go of terms like “You must, you should, you have to, it’s better, it’s important, do it for me” since they fall under the category of “controlling motivation”—which can be hurtful and lead to the individual becoming defensive or shutting down. We avoid controlling language because it elicits resistance and defiance. The literature is quite clear about people doing something because someone made them feel guilty, ashamed, or pressured them. The long-term prognosis for behavior change using this approach is underwhelming.

DON’T employ Scare Tactics.

As providers, we genuinely care about people’s health and may try to energize behavior change using fear. Such as, “If you don’t get your A1C down, you are heading for dialysis or amputation.” or “Don’t you want to see your kids grow up?” We don’t generally motivate people by scaring them since research shows it is ineffective, and they may never return for that follow-up appointment.

In the short term, people are usually willing to make changes when they’re terrified—when they first get diagnosed—but that willingness wanes in a relatively short period. The question is how to energize the person when the initial fear has worn off.

In conclusion, Celebrate and Recognize Each Person’s Efforts.

Making behavior changes, like losing weight or adjusting lifelong eating habits, can be extremely difficult. 

Find a way to recognize and affirm their efforts even if there is no or little change in clinical measures.

If someone’s A1C has not moved, but they decreased their CGM checks to eight times a day or adjusted their mealtime insulin, we can say, “Wow, I want to recognize the effort you put into this.” 

Respond kindly and compassionately to their disappointment, frustration, and fear. It won’t fix the immediate problem but will help the person feel that their effort was well spent. It will help them feel heard instead of us just “fixing it.” Over time, your empathy will build bridges and trust, leading to long-term collaboration and better health.

Want to share this with your colleagues or have a copy for yourself?

Download a PDF of this Person Centered Step-By-Step Approach

About the author – Coach Beverly has been fine-tuning her guilt-free approach to diabetes education for over 30 years and has witnessed its impact on improving well-being and building connections.  

Learn more about these effective communication approaches in our ReVive 5 Training Program.

Inspired by https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/motivational-interviewing-dos-dont

Unlock insights for managing diabetes distress with the experts!

Join us live on June 17 & 24, 2024 for our

ReVive 5 Diabetes Training Program: 

Click Here to Register for Session 1 for FREE | Airs June 17th (No CEs)
Click Here to Enroll in the Program | $149

The 2024 ADA Standards of Care now recommends annual screening for diabetes distress. If you are wondering how to screen for distress and tailor education based on the results, we encourage you to join this unique training program.

This two-session training provides the essential steps to address diabetes distress combined with an innovative approach to helping people make sense of their glucose data. 

The first session is team-taught by experts in the field of diabetes distress and effective communication approaches. Dr. Larry Fisher kicks off the program by describing the difference between depression and distress and interpreting Diabetes Distress screening results. Dr. Susan Guzman uses a case study approach and step-by-step communication strategies to address responses from the Diabetes Distress screening tool. This session includes an abundance of evidence-based approaches that you can apply in your clinical setting. 

Coach Beverly leads the second session.  During this three-hour program, Beverly describes insulin dosing strategies, meter and sensor data interpretation, and common issues encountered by people using diabetes technology.  Case studies include tools to help individuals discover what changes are needed to get glucose to target, coupled with the communication skills discussed in the first session. In conclusion, the team of instructors review a case study that pulls together all the ReVive 5 elements. 

“ReVive 5” breathes new life into our relationship with diabetes, bringing a fresh perspective to both the person with diabetes and the provider.

ReVive 5 Program PDF Flyer

Can’t join live? That’s okay. Your registration guarantees you access to the recorded version of the series, along with podcasts and resources for one full year.

Accredited Training Program:

  • 15+ CEs – Includes the 7-hour ReVive 5 Training Program, Certificate, and 5 FREE bonus courses to supplement content.
  • A comprehensive set of assessment tools, educational materials, log sheets, and resources.

Team of Experts:
ReVive 5 is taught by a team of 3 Interdisciplinary Experts:

  • Lawrence Fisher, Ph.D., ABPP, Professor Emeritus, UCSF
  • Susan Guzman, PhD
  • Beverly Thomassian, RN, MPH, CDCES, BC-ADM

Speakers Interviews – Learn more about the ReVive 5 Team

Click Here to Register for Session 1 for FREE | Airs June 17th (No CEs)
Click Here to Enroll in the Program | $149

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Recent Blog Bytes

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Troubleshooting CGM Accuracy

By Christine Craig, MS, RD, CDCES

As more and more people are using glucose sensors as a tool to improve their blood sugars, they may feel frustrated or confused about the mismatch between their sensor and glucose meter readings. Some many even ditch this new fangled sensor, thinking that their old friend, the meter, provides more reliable information.

AW called the clinic to report an issue with the accuracy of their continuous glucose monitor (CGM). They stated that their blood glucose (BG) and sensor glucose (SG) have been 60-100 points different for the past 24 hours. They are concerned about this difference and want help troubleshooting what could have gone wrong. 

In this article, Christine Craig, MS, RD, CDCES outlines strategies to explore this glucose mismatch and provides practical problem solving actions to clear up the confusion. In addition, we invite you to download a CGM Troubleshooting Cheat Sheet that provides specific information on different interfering substances and other factors that can affect the accuracy of continuous glucose monitor (CGM).

Assessing CGM Accuracy

Assessment of accuracy within CGM or flash glucose monitors in studies uses mean average relative difference or MARD. (For simplification, we will refer to both as CGM or sensor for the remainder of this article). CGM values, also called sensor glucose values, are compared with a standard reference, often the lab-measured Yellow Springs Instrument (YSI) analyzer, and are reported as a percent of the mean or median absolute error between CGM and reference values.

Almost 20 years ago, the MARD values for CGM were about 20%, and now most CGMs have MARD values near or under 10%.1

As CGM accuracy improves, we now see non-adjunctive indications for many CGMs on the market. This term means the FDA has approved the use of CGM for treatment decisions without BG confirmation. In studies, we can see MARD differences within specific populations, in different CGM site placements, or between different sensor glucose values. For example, a sensor glucose range between 70 and 180 may have a different MARD than a sensor glucose range of less than 54 mg/dl. 

How do we share about sensor accuracy and highlight when differences are most likely to occur? 

As an individual living with diabetes in the real world, MARD can be impacted by factors specific to the sensor or factors of daily living. Day of sensor wear, sensor-to-sensor variation, or insertion factors such as body site selection, skin integrity (thin or loose skin), scar tissue, or body movements can impact sensor glucose accuracy. 2

If the sensor is compressed due to positioning, lack of perfusion to the sensor site can cause the sensor glucose to be temporally lower than actual glucose values.3 In this case, during CGM data interpretation, you may see a fall and then a return of trend within the sensor glucose readings. Often, compression lows occur overnight due to sleeping directly on the sensor, but during the day, compression can occur with other situations such as placement around a beltline, other very tight clothing restrictions, or if positioned within the interior of the upper arm.

In studies, body site selection between arm, abdomen, and buttocks has shown differences in accuracy, and in the real world, for each individual, this actual difference can be more significant than for others. Using recommended site selection can improve sensor accuracy, but it is essential to consider each individual living with diabetes to determine the best placement for optimal sensor accuracy. 

We often hear that BG does not equal SG, but what does this mean? 

A blood glucose meter measures capillary blood glucose, and CGM sensors measure interstitial fluid, a thin layer of fluid surrounding the cells just below the skin. These values correlate well, but they measure two different types of fluids.

This difference in BG vs. SG at one point in time can be alarming at first and is a commonly reported concern related to sensor accuracy. Education about the difference in measure and understanding that this difference is most significant during rates of change (a rise or fall in glucose values) can help address this concern. Blood glucose values change first, followed by sensor glucose.

The lag time between BG and interstitial glucose (what the sensor measures) can be from 2 to 20 minutes.

We may notice this difference most during increased rates of change (such as >2 mg/dl per min) and during circumstances such as after a meal, after treating a low glucose event, during and immediately after exercise, or after taking diabetes medications that have a more rapid effect on glucose such as meal/correction insulin or sulphonylurea.1

Educating about the difference between BG and SG and how to interpret glucose trends, sensor glucose trend arrows, and monitoring change over time can improve understanding.  

Interfering Substances

The 2024 ADA Standards of Care recommends that for ALL people who wear CGM devices, education and assessment of potential interfering substances occur. Many of these interfering substances can be a common over-the-counter supplement or pain reliever. The effect for all reported interfering substances is a false elevation in sensor glucose versus actual blood glucose values. 4 It is cautioned that this could cause missing a severe glucose event.

Each manufacturer has different identified interfering substances.

  • For the Libre 2 and 3 systems, more than 500 mg/day of supplemental Vitamin C can interfere. More than 1000 mg/day can interfere with the Libre 2 Plus. 5
  • Dexcom G4, G5, G6 6, and G7 7 are all affected by hydroxyurea and acetaminophen,
  • However for Dexcom G6 and G7 devices acetaminophen dose is specified as greater than 4 grams per day or 1 gram every 6 hours.
  • Medtronic Guardian 3 and Guardian 4 devices are affected by hydroxyurea and any acetaminophen dose8
  • For more information, refer to our cheat sheet: CGM Interfering Substances.

Studies and reports of interfering substances are not comprehensive, so it is recommended that if suspicion occurs that a medication or supplement is contributing to erroneous CGM values, they should contact the manufacturer’s technical support team.9

Calibration

For sensors requiring calibration, poor quality of the blood glucose test can also create inaccuracies with the glucose sensor readings. Most manufacturers with CGM calibration requirements recommend ensuring a “clean calibration,” having individuals wash their hands, taking the second drop of blood when hand washing is unavailable, and calibrating when glucose values are more stable, such as before a meal, insulin, or exercise. Luckily, most devices no longer require calibration, but it is important to review technique when applicable. 

Getting Back to AW

AW reported no recent changes with medications, supplement intake, or fortified food sources, and no changes were noted at the sensor site. However, they did report that the CGM was on the last day of manufacturer recommended sensor wear. Sensor integrity variation based on day of sensor was determined to be the main consideration of cause. After changing to a new sensor, AW’s general range of BG to SB differences were observed. This event served as an important reminder to AW to check BG when SG values were not reading as expected and different than any symptoms.

Education When Starting Sensor Important

As educators, we can support individuals concerned with CGM accuracy by providing education about the differences between SG and BG values. Assessing individual factors such as medical conditions, movement and activity, site integrity and placement, issues of compression, and medication and supplement use (assessing for potential inferring substances). We can educate individuals to check BG anytime symptoms do not match SG readings and report any concern of a faulty sensor to the manufacturer. Reporting can often lead to the replacement of faulty sensor. 

Since the arrival of CGM, benefits including improved quality of life factors, A1c reduction, increased Time in Range, and prevention of hypoglycemia have been found.4  We know from working in diabetes care and through real-world studies the overall value of CGMs. Unlike BG, CGMs provide a complete picture showing trends for direction, personalized alerts, and supporting pattern recognition. 

Although not ideal for all, growth of users will continue to rise with approval of over-the-counter product options and understanding accuracy issues is essential to ensure safety and support user experience.

For more information, refer to our cheat sheet: CGM Interfering Substances.

References:

  1. Bailey, Timothy & Alva, Shridhara. (2021). Landscape of Continuous Glucose Monitoring (CGM) and Integrated CGM: Accuracy Considerations. Diabetes Technology & Therapeutics. 23. S-5. 10.1089/dia.2021.0236.
  2. Heinemann L, Schoemaker M, Schmelzeisen-Redecker G, Hinzmann R, Kassab A, Freckmann G, Reiterer F, Del Re L. Benefits and Limitations of MARD as a Performance Parameter for Continuous Glucose Monitoring in the Interstitial Space. J Diabetes Sci Technol. 2020 Jan;14(1):135-150.
  3. Mensh BD, Wisniewski NA, Neil BM, Burnett DR. Susceptibility of interstitial continuous glucose monitor performance to sleeping position. J Diabetes Sci Technol. 2013 Jul 1;7(4):863-70
  4. American Diabetes Association Professional Practice Committee. 7. Diabetes technology:Standards of Care in Diabetes—2024. Diabetes Care 2024;47(Suppl. 1):S126–S144
  5. Full Indications and Important Safety Information. Download On April 17th 2024 From: https://www.freestyle.abbott/us-en/safety-information.html
  6. Interfering Substances and Risks. Downloaded on April 17th 2024 from: https://www.dexcom.com/en-us/interference.
  7. Dexcom G7 Safety Information. Downloaded on April 17th 2024 from: https://dexcompdf.s3.us-west-2.amazonaws.com/en-us/G7-CGM-Users-Guide.pdf#page=12
  8. Medtronic Device Safety Information. Downloaded on April 17th, 2024 from: https://www.medtronicdiabetes.com/important-safety-information
  9. Heinemann L. Interferences With CGM Systems: Practical Relevance? J Diabetes Sci Technol. 2022 Mar;16(2):271-274.

Unlock insights for managing diabetes distress with the experts!

Join us live on June 17 & 24, 2024 for our

ReVive 5 Diabetes Training Program: 

Click Here to Register Now

The 2024 ADA Standards of Care now recommends annual screening for diabetes distress. If you are wondering how to screen for distress and tailor education based on the results, we encourage you to join this unique training program.

This two-session training provides the essential steps to address diabetes distress combined with an innovative approach to helping people make sense of their glucose data. 

The first session is team-taught by experts in the field of diabetes distress and effective communication approaches. Dr. Larry Fisher kicks off the program by describing the difference between depression and distress and interpreting Diabetes Distress screening results. Dr. Susan Guzman uses a case study approach and step-by-step communication strategies to address responses from the Diabetes Distress screening tool. This session includes an abundance of evidence-based approaches that you can apply in your clinical setting. 

Coach Beverly leads the second session.  During this three-hour program, Beverly describes insulin dosing strategies, meter and sensor data interpretation, and common issues encountered by people using diabetes technology.  Case studies include tools to help individuals discover what changes are needed to get glucose to target, coupled with the communication skills discussed in the first session. In conclusion, the team of instructors review a case study that pulls together all the ReVive 5 elements. 

“ReVive 5” breathes new life into our relationship with diabetes, bringing a fresh perspective to both the person with diabetes and the provider.

ReVive 5 Program PDF Flyer

Can’t join live? That’s okay. Your registration guarantees you access to the recorded version of the series, along with podcasts and resources for one full year.

Accredited Training Program:

  • 15+ CEs – Includes the 7-hour ReVive 5 Training Program, Certificate, and 5 FREE bonus courses to supplement content.
  • A comprehensive set of assessment tools, educational materials, log sheets, and resources.

Team of Experts:
ReVive 5 is taught by a team of 3 Interdisciplinary Experts:

  • Lawrence Fisher, Ph.D., ABPP, Professor Emeritus, UCSF
  • Susan Guzman, PhD
  • Beverly Thomassian, RN, MPH, CDCES, BC-ADM

Speakers Interviews – Learn more about the ReVive 5 Team

Click Here to Register Now

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Recent Blog Bytes

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

A Recipe from Mohammed Ali

Mohammed Ali was a fierce competitor and fought for what he believed in.

Yes, the towering figure had a poetic side, that leaned toward justice.

In 1972 Ali was being interviewed by journalist David Frost and was asked how he would like people to remember him when he was gone.  Here is his response.

Recipe for Life - Mohammed Ali

“I’d like for them to say he took a few cups of love.

He took one tablespoon of patience,

One teaspoon of generosity,

One pint of kindness;

He took one quart of laughter,

One pinch of concern.

And then, he mixed willingness with happiness,

He added lots of faith and he stirred it up well.

Then he spread it throughout a lifetime and he served it to every deserving person he met.”

Motivational recipe for a fulfilling life.

When I heard this, I thought it a perfect description of how we approach people with diabetes, starting with a foundation of love. The practice of diabetes care is just a little bit of science and loads of kindness and concern with lots of faith and belief in the ability of each individual.

We spread this over a lifetime of care and share it with generosity to each person we meet.

Join us in Preparing for the 2024 BC-ADM Exam!

Airs April 10th @ 11:30 am 

Free Webinar: Prep for 2024 BC-ADM Exam Tips
Click Here to Learn More

Topics of discussion include

  • Exam eligibility and test format
  • Strategies to succeed
  • Study tips and test-taking tactics

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

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Recent Blog Bytes

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Positively Type 1: A Holistic Perspective for Diabetes Educators

Holistic Diabetes Educator & Author of “Positively Type 1”  
An interview with Nick Kundrat, BS, CEP, CDCES, LMT

Nick Kundrat first caught our attention when he shared his incredibly detailed study sheets on our CDCES Exam Prep Facebook Group. He had just passed his CDCES exam and posted his lecture notes on the FB group to support his colleague’s success at the exam, too. This act of generosity made Nick a standout educator, and our team contacted him to help with our national CDR accreditation application. Through this connection, we learned that Nick not only provides diabetes care and education but also lives with type 1 diabetes. He recently published a book, “Positively Type 1” that emphasizes the transformative power of a positive mindset and a holistic approach. Whether you’re a seasoned educator or someone living with Type 1 diabetes, Nick’s message is clear: positivity, understanding, and resilience pave the way for a brighter future.

Let Nick’s words be a call to action. By fostering positivity and empathy, we contribute to a more hopeful journey for everyone touched by Type 1 diabetes.

We hope you enjoy this interview with Nick as he describes his path as a role model of holistic diabetes care and a beacon of hope for the 1.5 million people and their families living with type 1 diabetes. Thank you, Nick, for sharing the knowledge and insights you gained through personal experience and your commitment to lifelong learning. May “Positively Type 1” continue to inspire positive change in the diabetes community.

Interview with Nick Kundrat , BS, CEP, CDCES, LMT

In the realm of diabetes education, where deep struggles often cast shadows on hope, one holistic diabetes educator has embarked on a mission to illuminate a different path—a path that embraces positivity, resilience, and a profound understanding of living with Type 1 diabetes. Join us in this exclusive interview with Nick Kundrat – Holistic diabetes educator and author behind “Positively Type 1,” as we delve into a refreshingly simple and optimistic approach to diabetes care.

Nick Kundrat, a beacon of inspiration in the diabetes education community, didn’t arrive at this revolutionary approach by chance. It was forged through personal experiences, a deep empathy for those navigating the complexities of Type 1 diabetes, and a relentless belief in the transformative power of a positive mindset.

As we navigate the pages of “Positively Type 1,” we discover a manifesto for individuals with Type 1 diabetes seeking a brighter, more empowering point of view on their diabetes diagnosis. In this interview, Nick takes us behind the scenes, sharing the insights, anecdotes, and strategies that have the potential to redefine how we approach diabetes education.

Get ready to challenge preconceptions, embrace a holistic perspective, and embark on a journey that goes beyond the textbooks. “Positively Type 1” isn’t just a book; it’s a paradigm shift—a beacon guiding educators and individuals alike toward a positive, resilient, and fulfilling approach to Type 1 diabetes.

You mentioned being a “Holistic diabetes educator” – what does that mean?

Diabetes education technically includes a myriad of different topics related specifically to diabetes treatment, as well as nutrition, exercise and other lifestyle interventions. Yet in my experience, most diabetes education stops at the first one…. diabetes education. Now arguably, diabetes educators focusing on diabetes education seems like a good thing, right? Well…

While diabetes treatment is an important piece of the puzzle., it’s really only the tip of the iceberg when it comes to a person’s health. Your blood sugar balance is NOT just reliant on your insulin dosing and carb counting. Every other area of your life and health can affect your diabetes treatment in big ways. How you sleep, how you eat, how you think, how you rest, how you move, even how you relate to others are really the foundations of proper blood sugar control.

In my opinion, it is a disservice when health professionals focus solely on the diabetes. Besides… They are working with people. They aren’t working with diabetics, they’re working with people who just happen to also have diabetes. Unfortunately, many doctors and educators are just seeing numbers on a page rather than a whole person. 

The holistic approach to diabetes is exactly that. A people first approach to diabetes care. Addressing the foundations of health (sleep, stress, nutrition, hydration, exercise, emotions, detoxification) along with your traditional diabetes care is the only way to cultivate true wellness, rather than just staying stuck in the loop of disease treatment. 

In my wellness practice, I utilize a variety of different modalities to help my patients heal at a deep level. We always begin with the health foundations (as mentioned above) as well as optimizing diabetes care. With some clients who want to go even more in depth with their health, we utilize nutritional testing and manual therapy approaches to help rebalance the body at a deep level. I’m blessed to be able to share my experiences in both clinical and holistic health to help my patients feel good and cultivate true wellness.

How does your book tie into the Holistic Diabetes Education model? 

A holistic diabetes education means looking at the WHOLE PERSON. What many professionals believe that means is: Diabetes education + exercise + nutrition only. What it really means is taking into account EVERY PART OF YOU… This includes the parts you cannot see. Emotions, feelings, psychology, stress, behaviors, choices and spirituality are all important parts of you that cannot be “seen” but are nonetheless very real, and very important factors in your health journey. 

Your beliefs are a very important part of the “unseen” parts of your health puzzle. What you believe about the world, about your body, about health in general, and about your diabetes set the stage for how you will act in the world (and how well you will do actually treating your diabetes!

Beliefs determine our thoughts, which determine our feelings, which determine our actions. In other words, what you believe, determines how you act. So if you believe:

“Well my body is broken, I cannot get any better, and nothing ever works in my favor,” you will continue to run yourself in self limiting circles, keep making poor decisions and keep struggling with your health and diabetes treatment. 

But if you believe:

“My body is strong and resilient, I can always make positive change and get healthier, and my struggles are opportunities to grow and change,” you will be able to make choices that lead you in a positive direction with your health and your diabetes treatment.

If you can shift someone’s beliefs, you can shift their entire lives. This was the goal for Positively type 1 – to shift the negative beliefs (that most of us living with type 1 diabetes hold) in a more positive, optimistic direction. 

What inspired you to write “Positively Type 1”?

 

My book writing journey actually began at a very young age when I was diagnosed with Type 1 Diabetes myself. At age 4, after becoming terribly sick, my parents and I were told to head to the emergency room. We expected to be checked in, seen by the doctor, then be checked out with some antibiotics. But instead, a terrible nightmare ensued…. Being diagnosed with an incurable, life-long chronic illness: Type 1 Diabetes.

Growing up with a fantastic support system, the daily struggles of diabetes were outweighed by a very happy, healthy childhood filled with sports, school, activities, family and friendships. Yet still I spent lots of time with doctors and educators who helped me navigate my complex chronic condition.

Naturally, as an adult, I was led into the healthcare field, where I soon became the educator (instead of the educated). After spending countless hours around diabetes educators and endocrinologists as a patient, and countless hours on the other side of the coin, educating patients myself in hospitals & clinics, I arrived at a startling conclusion….

There is lots of negativity in the diabetes space. A LOT.

When I (and nearly everyone else I know with diabetes) was diagnosed with type 1, I was never given a pep talk and was never given much hope. Instead I was told:

“Your body is broken” 

Your pancreas doesn’t work”

“Your body turned against you” 

 “You wont get to be like other kids” 

While there is some truth in these statements, telling a 4 year old child these things can (and will) drastically shift their beliefs about their bodies and about themselves.

As an educator, I noticed most practitioners are approaching Type 1 diabetes through a similar lens. 

“Well, it’s just something you have to manage”

“You’ll be stuck with this forever”

Which again there is some truth to, but statements like these lack a vital ingredient in the recipe of health and healing… HOPE!

If I’ve learned one thing as a diabetes patient and educator… Sometimes all it takes to drastically change someone’s life is a little dose of hope. 

This was the inspiration behind writing Positively Type 1. 

Tell us a little about the book itself. What can readers expect to learn?

Put simply “Positively Type 1: How living with a chronic illness can be your most powerful motivator for an extraordinary life” is a lighthearted guide to seeing your type 1 diagnosis through a positive, optimistic lens. 

In each chapter, I explain a different skill or character trait you learn living with Type 1. Allow me to share a few examples: 

A person with type 1 diabetes makes on average over 180 more decisions per day (between insulin dosing and carb counting) compared to someone without diabetes. Through this, we become INCREDIBLE problem solvers.

With type 1, you learn to be extremely tuned in to every little shift and change in your blood sugar levels. This helps us build incredible levels of self awareness. 

Having to endure countless needle-sticks and finger-pricks helps you cultivate a mental and physical toughness unlike any other group of people I’ve ever met. 

And many more!

Plus, so that you aren’t just hearing from me, I sat down and interviewed amazing young type 1 warriors whom I’ve worked with as patients. So you get to hear from inspiring young voices who are doing a kick A** job with their diabetes mindset and treatment.

Overall, it’s an easy, lighthearted, humor filled read that will hopefully leave you smiling and filled with hope. 

Who is your book for?

Positively Type 1 is for anyone with type 1 diabetes, or those who love someone with type 1 diabetes. It’s written for all ages, but many of the “Type 1 Interviews” at the end of the chapters are with young adults, so it may particularly resonate with the preteen/teen age group.

In Conclusion…

As we conclude our exploration of “Positively Type 1” with Nick, it’s evident that the book is more than words on paper—it’s a source of inspiration for both educators and individuals with Type 1 diabetes.

The insights shared today emphasize the transformative power of a positive mindset and a holistic approach. Whether you’re a seasoned educator or someone living with Type 1 diabetes, the message is clear: positivity, understanding, and resilience pave the way for a brighter future.

Thank you, Nick, for guiding us on this empowering path. May “Positively Type 1” continue to inspire positive change in the diabetes community.

Learn More:

To learn more about Nick’s holistic wellness practice, please visit his website: 

Blueprint Wellness 

To purchase a copy of Nick’s book from amazon, please visit: 

Positively Type 1 

Nick Kundrat Educational Background and Bio

  • Bachelors in Exercise Science and Sports Medicine (BS) 
  • Clinical Exercise Physiologist (CEP)
  • Certified Diabetes Care and Education Specialist (CDCES)
  • Licensed Massage Therapist (LMT)

My name Nick and I’m a passionate educator, coach and the founder of Blueprint Wellness. My story began with years of struggle with multiple chronic illnesses. At my worst, I had over 12 chronic diagnoses including; POTS, Type 1 Diabetes, Hashimotos, EDS, parasite/fungal infections, lymes disease, mast cell activation syndrome, mold toxicity and depression/anxiety. After years of being severely debilitated with tons of “mystery symptoms,” and working with some of the best holistic doctors and practitioners who weren’t able to help me, I was truly sick of being sick.

Funny enough, being severely sick was the best gift I could’ve ever received. If I hadn’t been knocked out with illness, I never would’ve been forced to change my habits, and make an important shift in the way I thought about health.

Everything changed when I began focusing on cultivating wellness, rather than treating my diseases. I decided to completely disregard any diagnoses or labels, and embark on a mission of learning what a healthy human eats like, moves like, looks like, acts like, thinks like and functions like…. and cultivating habits and practices that would get me there.

And now after going on that journey myself, I have devoted my life to becoming the holistic practitioner I needed during my toughest health trials & tribulations.

I’m now blessed to be able to guide others on their journey to health, utilizing a unique blend of holistic and clinical approaches to facilitate real, deep healing for those who are also sick of being sick. I’m not simply after helping you “relieve your symptoms” My goal is to help you cultivate real health, evolve out of disease and grow into the person you were made to be.

 

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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Plant Based Diets – What Approach is Best?

The health benefits of plant-based diets are not a new topic, but as they continue to be a top headline in the news and on social media, #plantbased, we have more and more clients expressing interest in this dietary pattern.

When JR asks, “I just read about a plant-based diet; do think I have to avoid all meat?” What are we to answer?

Plant-based diet is a general term to include eating patterns that emphasize whole grains, legumes, vegetables, fruits, nuts and seeds, and discourage animal products. The popularity of this diet has grown as more evidence associates it with lower rates of hypertension, hyperlipidemia, cardiovascular mortality, obesity, cancer, and the prevention of type 2 diabetes.1 Research has also associated a higher intake of meat and processed meat with an increased risk of these similar chronic diseases.1 Definitions of plant-based can vary widely from avoiding all animal products to reducing intake of animal-based foods; Mediterranean, DASH diet, and Planetary diet approaches may fit within this definition. 

Different Types of Plant Based Diets Include:

  • vegan (avoiding all animal products), 
  • lacto-vegetarian (including only dairy),
  •  lacto-ovo-vegetarian (including dairy and eggs), 
  • pesco-vegetarian (including fish and often dairy and eggs), 
  • or flexitarian (occasional consumption of meat, dairy, and/or fish). 

As we review articles and noteworthy news, we might ask ourselves what plant-based definition has been used.

A vegan Diet, in persons with type 2 diabetes, is effective in reducing HgbA1c and body weight.1 The 2019 Nutrition Therapy for Adults with Diabetes or Pre-Diabetes Consensus report2  stated that a vegetarian or vegan diet can reduce A1c by 0.3-0.4% in people with type 2 diabetes, and plant-based eating patterns reduce weight, waist circumference, and LDL. A 2017 systemic review and meta-analysis3 of 14 studies found in 8 observational studies that vegetarian diet patterns (excluding meat and meat products) reduced the prevalence and incidence of type 2 diabetes compared to Omnivore diets. In five studies, no significant associations between a vegetarian diet and diabetes risk were observed, however, lack of definition of the degree of vegetarian, duration and actual intake, or specificity in diet quality could have affected the results.

A plant-based diet may not always be healthful, as it could include refined grains, starches, sugars, and processed plant-based products. Refined carbohydrates and highly processed foods are independently associated with a higher risk of type 2 diabetes. The ADA Standards of Care emphasize diet quality in every reviewed eating pattern. A 2019 meta-analysis4 of 9 total observational studies (307, 099 total participants) across North America, Europe, and Asia found that greater adherence to a plant-based diet was inversely associated with risk with diabetes, and this risk was further reduced when considering diet quality. In this study, it is essential to note that, when studies were combined, even the highest category of adherence to plant-based dietary patterns still included about 1.6-4 servings of animal-based foods per day; this may be from fish, dairy, meat, or poultry.4

Comparison Study: A 2024 cross-sectional study5 completed in Germany compared vegans, flexitarians (up to 50 grams of meat or processed meat products per day), and omnivores (>170 grams/day of meat and processed meat consumption). The vegan diet was associated with the most significant benefits to cardiovascular health; however, metabolic syndrome score and arterial stiffness were more favorable in flexitarians than in other groups. The vegan and flexitarian diets were associated with lower blood lipids, reduced insulin resistance, and a higher diet quality index than the Omnivore diet. Dietary intakes of soft drinks, dairy products, sweets, meat, and processed meat were all associated with higher total and LDL cholesterol levels and Metabolic syndrome scores. However, regarding how the study categorizes food groups, we are unsure if the type of meat or dairy would have changed these outcomes. Simple categories of plant-based or omnivore may not fully explain the synergy of health impacts from diet intake.

What are Americans eating now? 

Transitional dietary approaches that emphasize foods primarily from plants while also including animal foods may be a more realistic approach for many people. Despite the increasing interest in plant-based diets and a 54% growth in 2023 of plant-based product sales in the US market, only about 4% of Americans follow a vegetarian diet. Data from a recent March 2023 publication7 compared average consumption from 17 food categories to the Dietary Guidelines for Americans recommendations. Many categories fell short, with only refined grains, added sugars, proteins, and nuts, seeds, and soy meeting or exceeding the guidelines. There is a need for an overall shift in diet to improve the intake of foods touted as beneficial within plant-based diets. 

Barriers to implementing a plant-based diet include lack of knowledge, cultural acceptability, and cost.7

Like JR, many people may need to learn what it means to follow a plant-based diet. Understanding the individual’s interest, discussing the range of definitions and outcomes, and emphasizing transitional dietary changes could empower change.

  • All-or-nothing thinking can hinder change; reducing total meat consumption while focusing on other aspects of diet quality (reduced refined grains or sugar) can also provide health benefits.
  • JR motivations, interests and other clinical conditions will direct our recommendations. He reports that he has never tried “vegan foods.” Reviewing with JR the food choices he is making that fit within the plant-based diet, discussing meal modifications, and providing new recipes may support confidence while exploring new flavors and dietary changes. (Check out the resource list for recipe ideas).
  • Cost is another barrier that we must take into consideration. The 2023 article in Nutrients5 reported that consumption of “healthier” versus “less healthy” diets had a higher price difference per person than typical dietary patterns. Low-cost empty-calorie foods explained much of this cost difference and not necessarily animal-based proteins. Finding affordable food items can improve diet implementation.
  • One suggested alternative is incorporating recipes that include frozen fruits and vegetables, bulk grains, and dried or canned beans which can have a lower cost per calorie than meat-based foods.

The benefits of plant-based diets are well known, and future research is needed to examine different plant-based diet variations, combinations of foods, and degrees that are most beneficial and achievable. The 2024 American Diabetes Association Standards of Care emphasizes that there is no one-size-fits-all approach to dietary recommendations, and we need to individualize our recommendations based on cultural background, personal preferences, co-occurring conditions, and socioeconomics. They recommend “food-based dietary patterns should emphasize key nutrition principles: inclusion of non-starchy vegetables, whole fruits, legumes, whole grains, nuts/seeds and low-fat dairy products and minimizing consumption of meat, sugar-sweetened beverages, sweets, refined grains, and ultra-processed foods.”8

Strategies to Increase Plant Food Intake

We can support persons with diabetes and JR by asking questions and being curious.

  • “Tell me what interests you in a plant-based diet?”
  • “What is your current diet intake, and what modifications are realistic for you now?”
  • “Are you interested in modifying the types of foods you are consuming and learning about incorporating more plant-based food choices?”.

Based on JR’s response, we can confidently support a dietary pattern that is vegan, vegetarian, or a more flexible nutritional pattern that focuses on nutrient density and food quality.

Blog contributed by nutrition expert Christine Craig, MS, RDN, CDCES

References:

1. Sabrina Schlesinger; Diet and Diabetes Prevention: Is a Plant-Based Diet the Solution?. Diabetes Care 2 January 2023; 46 (1): 6–8.

2. Alison B. Evert, Michelle Dennison, Christopher D. Gardner, W. Timothy Garvey, Ka Hei Karen Lau, Janice MacLeod, Joanna Mitri, Raquel F. Pereira, Kelly Rawlings, Shamera Robinson, Laura Saslow, Sacha Uelmen, Patricia B. Urbanski, William S. Yancy; Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care 1 May 2019; 42 (5): 731–754

3. Lee Y, Park K. Adherence to a Vegetarian Diet and Diabetes Risk: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients. 2017 Jun 14;9(6):603.

4. Qian F, Liu G, Hu FB, Bhupathiraju SN, Sun Q. Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Intern Med. 2019;179(10):1335–1344.

5. Bruns, A., Greupner, T., Nebl, J., & Hahn, A. (2024). Plant-based diets and cardiovascular risk factors: a comparison of flexitarians, vegans and omnivores in a cross-sectional study. BMC Nutrition

6. U.S. consumers’ eating patterns differ from Federal recommendations downloaded on 2/14/2023 fromhttps://www.ers.usda.gov/data-products/chart-gallery/gallery/chart-detail/?chartId=106562.

7. Viroli G, Kalmpourtzidou A, Cena H. Exploring Benefits and Barriers of Plant-Based Diets: Health, Environmental Impact, Food Accessibility and Acceptability. Nutrients. 2023 Nov 8;15(22):4723.

8. American Diabetes Association Professional Practice Committee; 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024. Diabetes Care 1 January 2024; 47 (Supplement_1): S77–S110. https://doi.org/10.2337/dc24-S005

Checkout these websites with more information:

    •  Diabetes and Diet:  Food can be powerful in preventing and reversing diabetes. However, dietary approaches have changed as we have learned more about the disease. Published by the Physicians Committee for Responsible Medicine.

    • Vegetarian Starter Kit an easy to read and colorful handout for patients interested in learning more about a vegetarian diet. Published by the Physicians Committee for Responsible Medicine.

Videos

    • Forks Over Knives » feature film which examines the profound claim that most, if not all, of the degenerative diseases that afflict us can be controlled, or even reversed, by rejecting animal-based and processed foods (available on Netflix).

Reading

    • The China Study » The Most Comprehensive Study of Nutrition Ever Conducted And the Startling Implications for Diet, Weight Loss, And Long-term Health by T. Colin Campbell

    • The Cancer Survivor’s Guide  » a comprehensive text on the scientific link between diet and cancer, the benefits of a plant-based diet, including nutrition information, and more than 130 easy and delicious recipes.  (free) 

    • Plant-Based Nutrition: The Idiot’s Guide

Website Resources

    • Vegetarian Starter Kit (English and Spanish) » whys and how’s of a healthier diet, the New Four Food Groups guidelines, practical tips for beginning a vegetarian diet, and delicious low-fat, no-cholesterol recipes. This has been updated per above.

    • Plant Based Plate Method » Physicians for Responsible Medicine version of the USDA “Plate Method” which includes low fat, plant-based foods.

Take Education Courses

    • Nutrition Therapy and Exercise

Menus and Recipes

Menu Planning – 

    • Recipes: Week 3 >>

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Happy Registered Dietitian Nutritionist Day!

These treasured food and nutrition experts translate the science of nutrition into practical solutions for healthier living.

Some of my favorite people are RD/RDNs. I’ve been blessed to teach with many inspiring, kind, knowledgeable, and dynamic dietitians over a span of more than 20 years. RDN’s are trailblazers and advocates for improving the health of our communities through nutrition and are passionate about sharing their breadth of knowledge with their diabetes community and colleagues alike.

People with diabetes who meet with a Registered Dietitian Nutritionist (RD/RDN) can expect an A1C drop of 0.3% to 2.0%.

We are honored to highlight the significant impact RDNs have on individuals, communities, and society as a whole by promoting healthy eating habits, preventing disease, and improving our overall quality of life by encouraging us to eat a rainbow of foods filled with fiber and phytonutrients.

To celebrate Registered Dietitian Day, we are highlighting a leader in the field and the newest member of our DiabetesEd Team, Christine Craig.


Christine Craig, MS, RD, CDCES – Nutrition Content Expert and Contributor

We are excited to welcome our newest faculty member! Christine is a Registered Dietitian, Certified Diabetes Care and Education Specialist and a consultant dietitian. It is important to her that each person living with diabetes feels supported and empowered not only with information but an individualized approach for lifelong health. Winner of the 2023 Impact on Diabetes Award, she is a leader in the field of nutrition, technology, and diabetes care. She has served as a preceptor, lecturer, researcher, and is an active association board member. She has worked across health systems; within Diabetes Care Centers, Endocrinology clinics, Primary Care, Telemedicine Rural Health, and Virtual-First Primary Care. Currently she is owner of Nutrition for Daily Living, where it is her mission to increase access to compassionate and evidenced-based nutrition and diabetes care.

As an adventurer, travel, hiking and snow skiing are her favorite past-times. For Christine, having a moment to take in the landscape and beauty around us can re-energize and fuel a busy life.

Christine Craig, MS, RD, CDCES

Featured Articles by Christine 

Register for our Virtual Conference to enjoy a half-day presentation on Medical Nutrition Therapy!

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.

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.

Group discounts are available!*

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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

March 2024 eNews | Plant Based Eating, Untangling Weight Stigma, Mohammed Ali Shares a Recipe for Life

Happy March

We love celebrating National Nutrition Month and the registered dietitian nutritionists who help us maintain the pleasure of eating while empowering us to make informed decisions about daily food choices.

We are honored to highlight the significant impact RDNs have on individuals, communities, and society as a whole by promoting healthy eating habits, preventing disease, and improving our overall quality of life by encouraging us to eat a rainbow of foods filled with fiber and phytonutrients.

In this newsletter, we explore different types of plant-based diets and recognize that accumulating evidence supports the benefits of this approach, including the prevention of type 2 diabetes. We include lots of additional resources to explore and share.

Next, Coach Beverly shares a personal story about confronting weight stigma during a provider visit. She asks readers to raise awareness in their settings and advocate for weight-inclusive and respectful care for each individual.

We share Mohammed Ali’s “Recipe for Life” as we consider including this recipe and all of its’ ingredients in our daily lives.

Our guest contributor, Nick Kundrant, provides insights into the transformative power of a positive mindset based on his book, “Positively Type 1”. His message of empathy, resilience, and a holistic approach to health care is inspiring, Thanks, Nick!

Finally, we are excited to announce our “Connect with Coach Beverly” live Facebook event on March 13th! Test your knowledge with our nutrition-inspired Questions and Rationales of the Week!

Sending notes of joy and health,

Coach Beverly and Bryanna

Click here to read our full March 2024 newsletter.

Featured Articles

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Virtual DiabetesEd Training Conference – Join us Live on April 17th – 19th 2024 at 11:30 AM PST

Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, and “aha” moments for our Virtual DiabetesEd Training Conference April 17th – 19th, 2024.

Attendees will leave this conference with new tools and a refreshed understanding of the latest advances in person-centered diabetes care.  Our team highlights the ADA Standards of Care, medications, behavior change, technology, medical nutrition therapy, and more!

Our instructors co-teach the content to keep things fresh and lively. 

Friend Discount: 3 or more only $449 per person. Email us at [email protected] with the name and email of each registrant to get the discount!

Program Details

  • Dates: April 17-19th, 2024
  • Registration Fee: $399-$569 (see more about reg. options below)
  • Friend Discount: For 3 or more people, each person saves $50 off their registration. Email us at [email protected] with the name and email of each registrant to get the discount!
  • CEs: 30+ CEs | 18 units for Virtual Conference plus 10+ Bonus CEs. CEs can be applied toward CDCES’s initial application or renewal.
  • Speakers: View Conference Faculty
  • Conference Schedule >
  • Conference Flyer >

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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

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Diabetes Education Services offers education and training to diabetes educators in the areas of both Type 1 and Type 2 Diabetes for the novice to the established professional. Whether you are training to be a Certified Diabetes Care and Education Specialist (CDCES), practicing at an advanced level and interested in board certification, or a health care professional and/or Certified Diabetes Care and Education Specialist (CDCES) who needs continuing education hours to renew your license or CDCES, we have diabetes education information, resources and training; learning and teaching tools; and diabetes online courses available for continuing education (CE). Read our disclaimer for full disclosure.

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