Ambitious Action Plan to Help Americans Eat Healthier | Free White House Conference

The Standard American Diet (SAD) is not known for optimizing health and improving longevity. Almost half of U.S. deaths from heart disease are linked to unhealthy food choices. People who have lower incomes have even worse health-related outcomes. “It is clear that the challenges of food insecurity, diet-related diseases, and health inequities intersect with and exacerbate each other, and that radical systemic changes across multiple sectors are needed to adequately address them.” (Task Force)

“We’re really in a nutrition crisis in this country.”

says Dariush Mozaffarian, a cardiologist and dean of the Friedman School of Nutrition Science and Policy at Tufts University.

Nutrition Task Force Recommendations

The good news is that there is growing momentum to address this problem. A newly convened Task Force on Hunger has put together a comprehensive plan to improve the nutrition of Americans.

The Task Force members have an unwavering belief in the “importance of taking decisive action to achieve transformative change to end food insecurity and hunger, improve nutrition, and reduce diet-related diseases.”

White House Conference Sept 28th | FREE registration

The Biden administration will hold the White House Conference on Hunger, Nutrition, and Health on September 28th with the agenda driven by the Task Force Recommendations.

Click here to get the link to view the conference online and let us know if you plan to host a Watch Party or Satellite Event.

Check out the conference agenda.

Afterward, they will announce a new national strategy to improve access to healthier foods based on these tenets.

Seven Big Ideas Recommended by Task Force on Hunger, Nutrition and Health

1. Treat Food as Medicine

There is growing momentum to integrate food and nutrition into regular health care through innovative strategies. Providing prescriptions for healthy groceries coupled with nutrition education is an idea that is being piloted around the country. In this model, health care systems or insurers pay for groceries to help people make significant changes to their eating habits.

2. Focus on the Quality of Calories, not just the Quantity

Historically, federal food assistance programs have helped to address hunger. Policies and programs have historically focused on improving access to sufficient quantities of food. Now there is momentum to modernize this approach and focus on the quality of food and make sure people have adequate access to enough nutritious food.

3. Expand Access to Dietary and Lifestyle Counseling

The task force recommends more preventive behavioral lifestyle coaching by providers as a part of usual care. They also recommend that Congress expand Medicare and Medicaid coverage for medical nutrition therapy for people with hypertension, prediabetes, celiac disease, HIV/AIDS, cancer and other diet-related conditions. There is also a call for expanded coverage of cooking classes and nutrition assistance, as well as coverage of the Diabetes Prevention Programs delivered by telehealth.

4. Support Food Entrepreneurs

By supporting individuals who start food businesses, they can help nourish communities and create jobs. The task force calls on the federal government to pass policies that boost new healthy food enterprises, including providing new loans and grants to food and nutrition-related companies centered on health, equity, and sustainability. The idea is to focus especially on businesses owned by people of color and other marginalized groups.

5. Increase the number of new farmers growing healthy foods using regenerative farming techniques

The U.S. has invested heavily in monoculture with a focus on producing corn and soybeans on most cropland. Now, there’s growing recognition of the need for more specialty crops – including fruits, vegetables, and nuts. To promote crop diversity, the task force proposed providing new farmers with paid internships and apprenticeships to learn about sustainable farming and funding to cover a living wage and housing. Read more here  Beginning Farmers and Ranchers Development Program

6. Make school meals free for all students

Many families who are eligible for free or reduced-priced meals may not receive them, sometimes due to the paperwork, bureaucracy or stigma of participating or enrolling. Amid the pandemic, school meals have been offered for free to all students. Now, the task force says this should be a permanent change.

7. Establish a Federal Agency and National Director of Food and Nutrition.

To initiate and formulate these bold and common sense changes, the task force recommends the creation of a new role in the federal government; a National Director of Food and Nutrition. This department could evaluate the success of programs, make adjustments and expand and fund programs that work.

Click here to access the Full report and dive into the details


Join Ashley LaBrier, RD, MS, CDCES & Nutrition Expert as she provides insights and strategies to promote healthy eating.

Join us on October 12-14th, 2022

Virtual Conference Banner with Speakers Oct 22.v2

Virtual DiabetesEd Training Conference
30+ CEs

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

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

Download Course Flyer | Download Schedule

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

Team of expert faculty includes:

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

Two Registration Options

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information


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

Can Fruits Boost Positive Mental Health?

Good news! People with diabetes can experience more joy and less depression by incorporating fruit into their diet. A study published in the British Journal of Nutrition found that swapping out cookies or chips for a few servings of fruit a day, boosted positive mental health.

How many times have you heard people or providers say they can’t eat fruit because it will wreak havoc on their diabetes? That statement is actually not accurate nor is it backed by science.

The truth is, people who consume a diet rich in fruits and vegetables, including fresh, canned, and frozen varieties, report a more positive psychological state. In addition, they are less likely to have symptoms of depression, stress, and anxiety compared to those who do not eat these nutrient-rich foods on a regular basis.

Why are fruits so good for our mental health?

Snacking on fruits throughout the day can promote the synthesis of serotonin, which improves moods. Plus, healthy gut bacteria thrive on the fiber and nutrients provided by these nutritional powerhouses. As a result, there is improved gut-brain communication and cognition and decreased inflammation.

Eat More Fruit and Fewer Snack Foods

These study results provide new insights into the associations between certain types of food and psychological health, and the mechanisms that may mediate the effect. This study identified that frequent fruit consumption has a direct positive relationship with mood. Whereas more frequent consumption of savory snacks, like packaged chips and other high-fat snack foods, was associated with increased symptoms of depression, stress, anxiety, and reduced psychological wellbeing.

People with diabetes are encouraged to celebrate fruit
Even though this study did not specifically evaluate people living with diabetes, they can still celebrate this news. Many people with diabetes think they have to avoid fruit since it contains sugar. However, by spreading their fruit consumption throughout the day, they can enjoy three servings a day, guilt-free. By watching portions, they can enjoy a rainbow of fruit knowing that they are boosting their mental health and well-being. In addition, we can encourage them to explore ways to include vegetables in their usual meals. These little changes can add up to big improvements in well-being and cognition.

For a quick list of fruit servings sizes in English and Spanish, you can download our Carbohydrate Cheat Sheets here, Carb Counting Quick Reference and Spanish Carb Counting Quick Reference.


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

Virtual DiabetesEd Specialist Conference
30+ CEs

Airs October 12-14th, 2022

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

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

Download Course Flyer | Download Schedule

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

Team of expert faculty includes:

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

Two Registration Options

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information


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

Warning – Food Dates Can Lead to Unnecessary Waste

Have you inspected a salad mix that you bought last week and wondered if you should toss it because it expired yesterday? If you said yes, you are not alone. About 40% of food waste happens in the kitchen, when consumers throw away foods that have passed the expiration date.

What do expiration dates mean?

However, food and legal experts are asking consumers to reconsider their thinking.

According to an NPR Article, “The U.S. Department of Agriculture, the Food and Drug Administration, the Harvard Food Law Clinic – all say that consumer uncertainty about the meaning of food dates is part of the food waste problem. And it’s not just about wasting food or wasting the water and resources that went into making it. Food is the main thing we send to U.S. landfills.” Food in landfills is converted to methane, a highly potent greenhouse gas.

Consider all the money we are throwing way every day by disposing of foods that might be perfectly fine for consumption. For people living with diabetes on a limited or fixed income, it can really add up. In addition, people may avoid purchasing fresh fruits and vegetables if they are worried about eating it by the date stamped on the package.

Research shows that one in three bags of groceries purchased will end up in the trash due to dates stamped on food items. What do these dates mean anyway?

The federal government doesn’t require dates on any food except baby formula. According to the United States Department of Agriculture (USDA), foods are still safe for consumption after these expiration dates pass, but make sure to look out for an off odor, flavor, or texture that mean the food has spoiled and should not be eaten.

The FDA says the dates on food aren’t serving a safety role. A food and law expert, Broad Leib says, “however, you do want to pay attention to dates on food in the prepared food section, including deli meat, raw fish, unpasteurized milk and cheese.”

But for most foods, like a box of mushrooms or a bottle of ketchup, Broad Leib suggests we take a pause to look at the food. Smell and taste it to determine if it seems okay to eat. We can tell if something went bad.

Except for infant formula, dates are not an indicator of the product’s safety and are not required by Federal law.

Where do the dates come from? Since the federal government doesn’t require the dates, the “sell by” or “enjoy by” dates are determined mostly by the manufacturers. Manufacturers put the date on the package to encourage consumers to eat the food product when it tastes best, not when the food will go “bad”. They want to protect their brand and encourage the consumer to purchase their product again.

Sometimes states will get involved in determining a shelf life of a product for various reasons, including supporting local companies. For this reason, there is a lot of discrepancy from state to state, since the date isn’t based on food spoilage data. An example is that in Montana, milk has to be sold within 12 days of pasteurization. In Idaho, the milk can stay on the shelf for 23 days.

Deciphering Food Label dates: 

  • “Best if Used By/Before” indicates best flavor or quality. It is not a safety date.
  • “Sell-By” date tells the store how long to display the product for sale for inventory management. It is not a safety date.
  • “Use-By” date is the last date recommended for the use of the product while at peak quality. It is not a safety date except for when used on infant formula*.

Food makers, grocery stores, federal agencies are ready to decrease the confusion and food waste. They suggest getting rid of all the “enjoy-by, packaged on” dates and have only two options – best if used by or use by.

Best if used by” would tell consumers this ketchup would be best by this date, but you could still eat it after.

Use by” would tell consumers, after this date, it’s probably not a good idea to eat the mustard.

The next time you are ready to toss your salad mix or Worchester sauce, look it over, take a whiff or a taste and you will know if it’s still good to eat.

For more information, see our Protecting the Planet Resource Page.


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Virtual DiabetesEd Training Conference
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Airs October 12-14th, 2022

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Your team is invited to our Virtual DiabetesEd™ Training Conference! Set your team apart and prepare for diabetes certification!

Join this state-of-the-art conference taught by content experts, Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, Beverly Thomassian RN, MPH, CDCES, BC-ADM, and Ashley LaBrier who are passionate about improving diabetes care.

?Group discounts are available!*

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

Team of expert faculty includes:

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

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

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

Does Intermittent Fasting Really Lead to Weight Loss?

In health care settings across the country, people with diabetes and providers have been asking if intermittent fasting is effective at helping with weight loss. Finally, a randomized outpatient study provides some answers so we can accurately respond to this frequently asked question.

According to a recent study published in The New England Journal of Medicine, “a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily calorie restriction.”

In this study, 139 participants were randomized into two groups. Both groups were placed on a limited calorie diet. Men in the study were limited to a 1500 to 1800 kcal per day diet while women were limited to a 1200 to 1500 kcal per day diet.

The main difference, was the eating time frame.

The intermittent fasting group ate their calorie-restricted diet between the limited hours of 8:00 am to 4:00 pm. Which is a fasting period of 16 hours and an eating window of 8 hours.

The control group also followed the calorie restrictions but could eat their assigned calories at whatever time.

Results After One Year
After a 12-month period of following these diets, each group was evaluated for changes in body weight, body fat, waist circumference, body-mass index (BMI), and metabolic risk factors. 85% of participants completed the trial.

The participants in the time-restricted group had a mean weight loss from baseline of -8.0 kg while the calorie restriction only group had a 6.3 kg mean weight loss from baseline. While the time-restricted group had a higher weight loss, it wasn’t enough to reach statistical significance.

Additionally, there were no statistically significant changes in waist circumference, body fat, body lean mass, BMI, blood pressure, and other metabolic risk factors between the two groups.

The conclusion is that time-restricted eating was not significantly beneficial in weight loss in comparison to following a calorie-restricted diet.

To read more, click here.


Join us for our upcoming

Virtual DiabetesEd Specialist Conference
30+ CEs | October 12-14, 2022

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

 Download Course Schedule |  Download Course Flyer

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.

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

Team of expert faculty includes:

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

Two Registration Options


Virtual DiabetesEd Specialist Conference Deluxe | 30+ CEs

Deluxe Option for $499: Virtual Program includes:

  • Q & A Session with the instructor after each webinar.
  • LIVE Presentations by our team of experts.
  • State of the art review of current diabetes care and technology.
  • Resources for each session.
  • Access to free podcasts and video recordings within a week of each live session for one year.

Deluxe Version includes Syllabus, Standards and Swag*:

  • Diabetes Educator Course 2022 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
  • ADA 2022 Standards of Care Book -The ADA Standards of Medical Care in Diabetes is a key resource for healthcare professionals involved in diabetes care, education, and support.
  • DiabetesEd Services highlighters, Medication PocketCard, Tote Bag and Pen

Virtual DiabetesEd Specialist Conference Basic | 30+ CEs

Deluxe Option for $499: Virtual Program includes:

  • Q & A Session with the instructor after each webinar.
  • LIVE Presentations by our team of experts.
  • State of the art review of current diabetes care and technology.
  • Resources for each session.
  • Access to free podcasts and video recordings within a week of each live session for one year.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information


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

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

Reach for a Rainbow – FREE Diabetes Self-Care Goal Sheet

On average, most Americans eat only one serving of fruit and 1½ servings of vegetables daily, far less than what’s recommended.

Fruit and vegetables ARE magical. They are loaded with fiber, micronutrients, energy, and mostly smell and taste so good. They are mood boosters, feed our healthy gut bacteria, and can lead to meaningful connections. By encouraging people of all ages to consume more fruits and veggies, we improve the well-being of our communities.

Reach for a Rainbow. Eating a rainbow of fruits and vegetable is key because they each contain different beneficial nutrients and antioxidants. According to a recent study, fruits and vegetables, including leafy greens, citrus fruits, and berries, were associated with lower mortality.

If we can just encourage people to eat 2 pieces of fruit a day and one serving of veggies with each meal, we are making a significant impact in improving health outcomes.

FREE Self-Care Goal Sheet

We are excited to share this FREE Diabetes Self-Care Goal Sheet to support an increased intake of fruits and veggies, one bite at a time.

Setting realistic person-centered goals is a critical part of providing diabetes education care and support. We have created a goal sheet that you can use in your practice to capture the next steps towards improving self-care. 

If you would like to customize the document, it is available in Diabetes Self-Care Goal Sheet in English in Word and Diabetes Self-Care Goal Sheet in Spanish in Word so you can make modifications for your practice.  Or you can download the PDF version of the Diabetes Self-Care Goal Sheet in English and PDF version of the Diabetes Self-Care Goal Sheet in Spanish, print and go.

Start small and Build on Success

Eating five servings of fruits and vegetables may not be realistic at first. We can encourage individuals to start with one to two servings a day and gradually increase portions as the person gains more confidence in their ability.

The Dietary Guidelines for Americans recommend 2½ cups of vegetables and two cups of fruit daily, which totals about nine servings per day. One “serving” is a half-cup of any vegetables or fruits or a whole cup of salad greens.

“People who eat five servings of vegetables and fruit daily have 13 percent lower risk of all-cause death compared to people who eat two servings of fruit and vegetables per day,” says Dong Wang, a faculty member at Harvard Medical School and Brigham and Women’s Hospital in Boston, and one of the study’s researchers. They also had a 12% lower risk of death from cardiovascular disease, a 10% lower risk from cancer, and a 35% lower risk from respiratory disease, compared with people who ate just two daily servings.

However, starchy vegetables such as peas, corn, and potatoes were not associated with a reduced risk of death or chronic diseases. The study results didn’t find harm or an increased risk of mortality from these options, but they also didn’t decrease mortality. Consider them neutral.

More good news – It doesn’t seem to matter whether people consume fresh, frozen or canned fruits and vegetables. They all offer similar nutrient values. The main consideration is promoting affordable and appealing fruits and veggies based on the individuals’ taste and preferences.

Self-Care Cheat Sheets in Spanish


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

Enjoy 5 Servings of Magic a Day

As a nine-year-old, I couldn’t wait for my Grandparents to arrive for Christmas. Since they lived in Canada and we lived in California, we didn’t get to see them enough. Plus, they had eight kids and an old station wagon that could barely make the 1000 mile journey.

In December of 1972, as they tumbled out of the station wagon onto our front lawn, my Grandfather scooped me up in his arms, gave me the biggest hug, and presented me with a bag of beautiful mandarin oranges. His face was glowing with joy as we each peeled the thin skins of that winter citrus fruit and slowly ate each segment. Me and my grandfather had never tried mandarins before and we both fell in love with this magical fruit that day, sitting on my front porch, together. This moment is one of my fondest childhood memories.

Fruit and vegetables ARE magical. They are loaded with fiber, micronutrients, energy, and mostly smell and taste so good. They are mood boosters, feed our healthy gut bacteria, and can lead to meaningful connections. I am a certified vegetable and fruit aficionado, happily sharing my enthusiasm for these fiber and nutrient powerhouses with the people I serve at our rural community clinic. However, many people are not eating the recommended daily dose.

How do we help others rekindle their connection to fruit and vegetables?

Most Americans eat only one serving of fruit and 1½ servings of vegetables daily, far less than what’s recommended. And a quarter of the vegetables consumed are potatoes, and half of those are consumed as fries. I think we need to keep it simple and start with realistic goals that people can achieve. I am excited to share this research with you in the hopes of increasing fruit and veggie intake in America, one bite at a time.

How many servings of Fruit and Veggies a Day to improve health outcomes?

A 2021 study in the journal Circulation backs up the long-standing nutritional guideline that consuming five daily servings of a variety of fruits and vegetables increases lifespan. More specifically, the study encouraged participants to consume at least 2 servings of fruits and 3 servings of vegetables daily.

“People who eat five servings of vegetables and fruit daily have 13 percent lower risk of all-cause death compared to people who eat two servings of fruit and vegetables per day,” says Dong Wang, a faculty member at Harvard Medical School and Brigham and Women’s Hospital in Boston, and one of the study’s researchers. They also had a 12% lower risk of death from cardiovascular disease, a 10% lower risk from cancer, and a 35% lower risk from respiratory disease, compared with people who ate just two daily servings.

The Dietary Guidelines for Americans recommend 2½ cups of vegetables and two cups of fruit daily, which totals about nine servings per day. One “serving” is a half-cup of any vegetables or fruits or a whole cup of salad greens. This study found that after 5 servings a day, there was no additional decrease in mortality. In a way, this is good news.

If we can just encourage people to eat 2 pieces of fruit a day and one serving of veggies with each meal, we are making a significant impact in improving health outcomes.

Eating a rainbow of fruits and vegetable is key because they each contain different beneficial nutrients and antioxidants. According to the study, fruits and vegetables, including leafy greens, citrus fruits, and berries, were associated with lower mortality.

However, starchy vegetables such as peas, corn, and potatoes were not associated with a reduced risk of death or chronic diseases. The study results didn’t find harm or an increased risk of mortality from these options, but they also didn’t decrease mortality. Consider them neutral.

More good news – It doesn’t seem to matter whether people consume fresh, frozen or canned fruits and vegetables. They all offer similar nutrient values. The main consideration is promoting affordable and appealing fruits and veggies based on the individuals’ taste and preferences.

More resources from our Article Library

Read more in this Circulation Article.

Want to learn more about this topic?

You are invited to join our Virtual Conference on April 13 -15th. Our expert speaker, Ashley LaBrier, MS, RD, CDCES, will be providing a half-day presentation on this important topic!

Virtual DiabetesEd Specialist Conference
30+ CEs | April 13-15, 2022

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.

 Download Course Schedule |  Download Course Flyer

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

Team of expert faculty includes:

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

 Download Course Schedule |  Download Course Flyer


Two Registration Options


Virtual DiabetesEd Specialist Conference Deluxe | 30+ CEs

Deluxe Option for $499: Virtual Program includes:

  • Q & A Session with the instructor after each webinar.
  • LIVE Presentations by our team of experts.
  • State of the art review of current diabetes care and technology.
  • Resources for each session.
  • Access to free podcasts and video recordings within a week of each live session for one year.

Deluxe Version includes Syllabus, Standards and Swag*:

  • Diabetes Educator Course 2022 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
  • ADA 2022 Standards of Care Book -The ADA Standards of Medical Care in Diabetes is a key resource for healthcare professionals involved in diabetes care, education, and support.
  • DiabetesEd Services highlighters, Medication PocketCard, Tote Bag and Pen

Virtual DiabetesEd Specialist Conference Basic | 30+ CEs

Deluxe Option for $499: Virtual Program includes:

  • Q & A Session with the instructor after each webinar.
  • LIVE Presentations by our team of experts.
  • State of the art review of current diabetes care and technology.
  • Resources for each session.
  • Access to free podcasts and video recordings within a week of each live session for one year.
Enroll now in the Basic Virtual Conference | $399

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.


All hours earned count toward your CDCES Accreditation Information


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

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

Is Metformin associated with Low B12 levels?

Metformin is one of the most widely dispensed oral diabetes medications for good reason. It works great, lowering A1c 1-2% points, with an added benefit of dropping LDL cholesterol levels. It doesn’t cause hypoglycemia or weight gain and it is incredibly cheap. Many pharmacies offer a 3 month supply of this highly effective glucose-lowering medication for $10 or less, and that’s without insurance. This medication also seems to boost the diversity of the gut microbiota, in particularly increased levels of the very beneficial Akkermansia muciniphila.

However, it does have a few drawbacks. A small group of people on metformin will experience a B12 deficiency. This B12 deficiency may manifest as neuropathic pain or anemia.

Plus, a percentage of people will experience upset stomach, bloating, and diarrhea. People with these complaints will often respond better to the extended-release version (metformin XR), which isn’t any more expensive and it can be taken once a day. See our Mediation PocketCards for more info.

How prevalent is B12 Deficiency with metformin?

Milk, eggs, yogurt, fortified cereals are good sources of vitamin B12.

Currently, the ADA Standards have no clear recommendation for checking B12 for those on metformin, but it does note that long-term metformin use is associated with B12 deficiencies and that “measuring B12 levels should be considered for those with type 1 diabetes, peripheral neuropathy or unexplained anemia”.

To add to this, a study published this month in Human Nutrition and Metabolism, found the prevalence of B12 deficiency appears to be about 17% in people on metformin therapy. The highest rates of B12 deficiency were seen in those taking metformin for 2 years. Moreover, vitamin B12 deficiency is influenced by the occurrence and duration of diabetes.

They also measured the intake of vitamin B12 in the daily diet of the study participants. Those with lower vitamin B12 blood levels were also consuming less foods rich in vitamin B12 in their daily meal plan.

Recommendations for Regular B12 Monitoring and Replacement

The authors of this article suggest that routine monitoring for vitamin B12 serum levels is needed in people with T2DM, particularly when metformin is used for more than 2 years with a dose of over 1000 mg per day. They also recommend further studies are needed to assess the correlation between metformin duration and dose and patients with T2DM and other metabolic syndromes.

B12 replacement therapy

This article, nor the ADA Standards recommend dosing for B12 replacement therapy. However, based on several articles, including this 2005 Cochrane review, high-dose oral replacement (1 mg to 2 mg per day) for B12 deficiency, seems to be as effective as parenteral B12 administration for correcting anemia and neurologic symptoms.

Conclusion – Vitamin B12 deficiency is associated with worsening nerve pain and anemia. Testing B12 levels for those on long-term metformin therapy, especially for those taking more than 1000 mg of metformin a day seems like a reasonable approach. Increasing the intake of foods high in vitamin B12 and providing oral B12 replacement therapy of 1 mg to 2 mg a day, are both helpful interventions to boost B12 levels.

Resources from our Article Library

Plant Based Eating Resources and Recipes

Carbohydrate Counting Resource Page


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Meds Management for Type 2 Standards | 1.5 CEs

Recorded & Ready to Watch!

Coach Beverly will highlight the key elements of the latest Medication Guidelines by AACE and ADA. We will explore clinical factors to consider when determining the best strategy to improve glucose management in people with type 2 diabetes and other co-conditions. There will be a special focus on cardiovascular risk reduction and renal protection.

Objectives:

  1. Describe the role of Diabetes Care and Education Specialists in stopping clinical inertia
  2. Discuss using the latest ADA and AACE Guidelines to determine the best therapeutic approach.
  3. Using the ADA and AACE Guidelines, describe strategies to initiate and adjust injectable therapy.

Enroll in the entire
Level 2 | Standards of Care Intensive Series | 20 CEs | $199

2022 Updates Airs March 17 – May 26, 2022

This bundle is specifically designed for healthcare professionals who want to learn more about the ADA Standards of Diabetes Care for their clinical practice or for those who are studying for the BC-ADM or the CDCES certification exam.


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.


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

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

What is the Best Overall Diet?

A panel of 27 experts convened to rate and determine which of the top forty diets was best? It is like the Oscar’s for the best meal plan.

They scored each diet approach based on:

  • Ease of following
  • Ability to produce short and long-term weight loss
  • Nutritional completeness
  • Safety
  • Potential for preventing diabetes and CVD.

The U.S. News and World Report Health Team of 27 experts, rated over 40 different diets with a score of one to five, five being the highest score.

The winning meal plan focuses on whole grain, fruits, and vegetables with lean proteins. It also ranked first in the categories of best diets for healthy eating, easiest diets to follow, best diets for diabetes, and best plant-based diets; it tied with best heart-healthy diets for the No. 1 spot.

There was a clear choice for the winner “because it is really not a diet. It is more a lifestyle of eating”, said Fatima Cody Stanford, MD, MPH, MPA, MBA, FAAP, FACP, FAHA, FAMWA, FTOS, a Healio Primary Care Peer Perspective Board Member and one of the U.S. News & World Report panelists.

For the fifth year in a row, the Mediterranean Diet took home the Nutrition Oscar for best meal planning approach by the U.S. News & World Report. It was also ranked as the best meal plan for people living with diabetes followed in second place by the Flexitarian Diet.

The American Diabetes Association Standards also recognize the Mediterranean Diet, along with the Plate Method, Carbohydrate Counting, plant-based eating, and the DASH Diet as top contenders for healthy meal planning approaches based on current evidence. For people living with diabetes, the emphasis is on individualization. No one meal planning approach works for everyone. Plus, the cost of the plan is also a major factor in the decision-making process.

Most importantly, the ADA recommends a referral to a Registered Dietitian upon new diagnosis of diabetes and at least annually or if there is any change in health status. Studies show that meeting with an RD lowers A1c by 1-2%.

More resources from our Article Library

Want to learn more about Medical Nutrition Therapy?

You are invited to join our Virtual Conference on April 13 -15th. Our expert speaker, Ashley LaBrier, MS, RD, CDCES, will be providing a half-day presentation on this important topic!

Virtual DiabetesEd Specialist Conference
30+ CEs | April 13-15, 2022

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.

 Download Course Schedule |  Download Course Flyer

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

Team of expert faculty includes:

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

 Download Course Schedule |  Download Course Flyer


Two Registration Options


Virtual DiabetesEd Specialist Conference Deluxe | 30+ CEs

Deluxe Option for $499: Virtual Program includes:

  • Q & A Session with the instructor after each webinar.
  • LIVE Presentations by our team of experts.
  • State of the art review of current diabetes care and technology.
  • Resources for each session.
  • Access to free podcasts and video recordings within a week of each live session for one year.

Deluxe Version includes Syllabus, Standards and Swag*:

  • Diabetes Educator Course 2022 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
  • ADA 2022 Standards of Care Book -The ADA Standards of Medical Care in Diabetes is a key resource for healthcare professionals involved in diabetes care, education, and support.
  • DiabetesEd Services highlighters, Medication PocketCard, Tote Bag and Pen

Virtual DiabetesEd Specialist Conference Basic | 30+ CEs

Deluxe Option for $499: Virtual Program includes:

  • Q & A Session with the instructor after each webinar.
  • LIVE Presentations by our team of experts.
  • State of the art review of current diabetes care and technology.
  • Resources for each session.
  • Access to free podcasts and video recordings within a week of each live session for one year.
Enroll now in the Basic Virtual Conference | $399

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.


All hours earned count toward your CDCES Accreditation Information


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

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