Question of the Week | How much bolus insulin at each meal?
KT weighs 60 Kgs and is newly diagnosed with diabetes and needs to start insulin therapy.
Based on the 50/50 rule for determining insulin dosing, which of the following is the most accurate bolus dose for each meal?
- 3 units
- 5 units
- 6-7 units
- More information is needed to determine bolus dose.
Want to learn more about this question?
Join us live on August 20 for our
Insulin Calculation Workshop | From Pumps & Beyond
Level 4 | Advanced Level & Specialty Topics
Determining basal & bolus rates for multiple daily injections or insulin pumps can seem overwhelming. This course provides participants with a step-by-step approach to determining basal rates, bolus ratios & how to problem-solve when blood glucose levels aren’t on target. During this course, Coach Beverly provides abundant case studies to give participants hands-on practice & build confidence when calculating insulin doses for a variety of situations.
Objectives:
- Describe using formulas to determine appropriate insulin dosing.
- Discuss strategies to determine & fine-tune basal insulin dose.
- Describe how to determine & fine-tune bolus rates including coverage for carbs & hyperglycemia.
- Using a case study approach, utilize calculations to determine the best insulin dosing strategy.
Learning Outcome:
Participants will have an increased knowledge of how to calculate bolus/basal insulin therapy based on person-specific factors and will be able to recommend insulin adjustments based on individual needs.
Target Audience:
This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research.
CDR Performance Indicators:
- 10.3.1
- 10.5.3
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 15 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert.
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!
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.
Question of the Week | Best Move to Get Glucose to Goal?
LS wears an insulin pump and uses lispro insulin. LS has an average basal rate of 0.6 units and hour, a 1:15 carb ratio and a 1:50 correction ratio. Based on the ambulatory glucose profile, LS is experiencing elevated glucose levels from 4am to 7am.
To get glucose to target, what is the best next step?
- Add basal insulin glargine to prevent Somogyi effect.
- Increase the basal rate to prevent glucose elevations.
- Make sure LS isn’t consuming carbohydrates after 10pm.
- Ask LS to double check their CGM insertion site.
Want to learn more about this question?
Join us live on August 20, 2024, for our
Insulin Calculation Workshop | From Pumps & Beyond
Level 4 | Advance Level & Specialty Topics
Determining basal & bolus rates for multiple daily injections or insulin pumps can seem overwhelming. This course provides participants with a step-by-step approach to determining basal rates, bolus ratios & how to problem-solve when blood glucose levels aren’t on target. During this course, Coach Beverly provides abundant case studies to give participants hands-on practice & build confidence when calculating insulin doses for a variety of situations.
Objectives:
- Describe using formulas to determine appropriate insulin dosing.
- Discuss strategies to determine & fine-tune basal insulin dose.
- Describe how to determine & fine-tune bolus rates including coverage for carbs & hyperglycemia.
- Using a case study approach, utilize calculations to determine the best insulin dosing strategy.
Learning Outcome:
Participants will have an increased knowledge of how to calculate bolus/basal insulin therapy based on person-specific factors and will be able to recommend insulin adjustments based on individual needs.
Target Audience:
This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research.
CDR Performance Indicators:
- 10.3.1
- 10.5.3
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 15 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert.
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our Level 4 | Insulin Calculation Workshop | From Pumps & Beyond awards 1.5 CPEUs in accordance with the Commission on Dietetic Registration’s CPEU Prior Approval Program.
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.
Question of the Week | Medical Nutrition Therapy Coverage
SJ is a 68-year-old recently referred for medical nutrition therapy (MNT). They are on a fixed income and are concerned about their out-of-pocket expense for their upcoming visit. SJ has Medicare (CMS) as their primary insurance.
What can we tell SJ about Medicare’s coverage for MNT services?
- Medicare provides full coverage and no cost share for all Medical Nutrition Therapy referrals.
- Medicare provides 3 hours of MNT services for the initial referral and calendar year and 2 hours after referral in subsequent years.
- Medicare provides coverage for diagnosis of diabetes, non-dialysis CKD stage 3- 5, and post-kidney transplants.
- Both B and C.
- All of the Above.
Want to learn more about this question?
Join us Live in Sunny San Diego for our
Annual DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at [email protected] with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
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!
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.
Question of the Week | Metformin and Cancer
JR is taking Metformin 1000mg BID but is worried about getting cancer and is thinking about stopping the metformin.
Which of the following is an accurate statement regarding diabetes, metformin and cancer?
- There is research suggesting that metformin may be associated with a decreased risk of certain cancers.
- Metformin is associated with B12 deficiency and anemia, so it is best to hold metformin for now.
- There is no additional benefit from metformin, since people with diabetes have a slightly lower risk of liver and uterine cancers.
- Metformin does not increase risk of cancer, but it can negatively impact renal function.
Want to learn more about this question?
Join us live on July 25 for our
Cancer & Diabetes
Level 4 | Advance Specialty Topics
Patients with cancer often experience hyperglycemia secondary to treatment, which can increase the risk of infection & compromise their nutritional status. In addition, recent research has identified the link between diabetes & cancer. Join us to learn more about this unexpected link & treatment strategies for steroid-induced hyperglycemia using a case study approach.
Objectives:
- Discuss the relationship between cancer, hyperglycemia, & insulin resistance.
- State 3 benefits of normalizing glucose levels during chemotherapy.
- Using a case study approach, discuss strategies to improve glucose levels & quality of life.
Learning Outcome:
Participants will have an increased understanding of the relationship between hyperglycemia and cancer based on person-specific factors and will be able to discuss treatment approaches.
Target Audience:
This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research.
CDR Performance Indicators:
- 10.4.2
- 10.5.1
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 15 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert.
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our Level 4 | Cancer & Diabetes awards 1.25 CPEUs in accordance with the Commission on Dietetic Registration’s CPEU Prior Approval Program.
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.
Question of the Week! | JR Wants to Avoid Ingrown Toenails
JR lives with type 2 diabetes and works 10-11 hours a day driving a tractor for a local farm. It is difficult for JR to make medical appointments since their employer has very strict attendance guidelines. JR has ingrown toenails in the big toes, that cause a great deal of pain. Since they didn’t have time to come in for care, JR cut off half of their toenails on both feet to prevent an ingrown nail. As you inspect JR’s feet, you see that their big toes are swollen and red. You ask the provider to evaluate JR’s feet because you are worried. After the provider evaluates JR’s feet, they turn to JR and say, “Diabetics should never cut their toenails like this. It causes infection”.
What is this an example of?
- Effective cultural humility coupled with compliance model.
- Avoidance of the adherence model and promotion of transtheoretical approach.
- Adult learning theory disruption coupled with interpersonal shaming.
- Unawareness of language and the impact of social determinants of health.
Want to learn more about this question?
Join us Live in Sunny San Diego for our
Annual DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at [email protected] with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
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!
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.
Question of the Week | Most important action in case of fire?
JR lives with type 1 diabetes and uses an insulin pump and sensor. They live in an area that is fire prone and JR asks you about how they should prepare for an emergency if evacuation is required.
What action is most important?
- Make sure they have their health history documented and stored in a watertight bag.
- Prepare an emergency kit that includes at least one week’s worth of diabetes supplies.
- Keep a fire extinguisher within easy reach and know the exit routes.
- Reach out to emergency responders ahead of time to let them know that JR has type 1 diabetes.
Want to learn more about this question?
Join us live on July 18th, for our
Type 2 Diabetes Intensive
Level 4 | Advanced Level & Specialty Topics
This course provides a detailed overview of the pathophysiology of type 2 diabetes, prevention strategies, & cardiovascular risk reduction. In addition, we highlight type 2 treatment approaches including nutrition, activity, oral & injectable medications plus screening & treatment guidelines for micro & macrovascular diseases. Through case studies & discussion, we highlight strategies to focus on a person-centered approach along with attention to psychosocial care for people living with diabetes.
Objectives:
- Discuss the current epidemiology of type 2 diabetes.
- Describe the classification, terminology & diagnostic criteria for diabetes.
- Identify the eight pathophysiologic defects associated with the ominous octet.
- Describe evidence and strategies to prevent type 2 diabetes.
- State strategies to implement a person-centered approach to those with diabetes.
- Discuss key aspects of type 2 diabetes management including education, therapeutic lifestyle changes, glucose, lipid, & hypertension management plus referrals.
- Understand the overarching principles of management of type 2 DM.
Learning Outcome:
Attendees will be able to articulate and integrate into practice the impact, goals, and management strategies for people living with type 2 diabetes.
Target Audience:
This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research.
CDR Performance Indicators:
- 10.4.2
- 10.5.1
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 15 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert.
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our Level 4 | Type 2 Diabetes Intensive awards 2.0 CPEUs in accordance with the Commission on Dietetic Registration’s CPEU Prior Approval Program.
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.
Question of the Week | Primary Goals for the DPP?
The Diabetes Prevention Program (DPP) primary lifestyle intervention goals include achieving and maintaining a minimum of 7% weight loss and 150 minutes of moderate-intensity physical activity per week.
What outcomes are expected from these intervention goals?
- DPP lifestyle intervention resulted in a 58% reduction of rate of diabetes over 3 years.
- Sustained interventions over 15 years reduced risk of progression to type 2 diabetes by 27%.
- Achieving 150 minutes of moderate-intensity activity per week without weight loss is adequate to reduce incidence of type 2 diabetes.
- All the above.
Want to learn more about this question?
Join us Live in Sunny San Diego for our
Annual DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at [email protected] with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
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!
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.
Question of the Week | Why did 16 year old stop taking meds?
A 16 year old tells you they stopped taking their diabetes medications. “It doesn’t seem to matter whether or not I take them”.
What is the best response?
- Acknowledge their honesty and ask them to discuss with their provider.
- Gently remind them that stopping their meds is dangerous.
- Ask them if they are experiencing trauma at home.
- Explore possible reasons for this action.
Want to learn more about this question?
Join us live on July 11th at 11:30 am PST for our
Language and Diabetes FREE Webinar
What we say matters.
As educators, advocates, spouses, friends, and providers, our use of language can deeply affect the self-view of people living with diabetes every day.
Intentional communication is a powerful tool that can uncover trauma, identify barriers, and move both the provider and person with diabetes toward a greater understanding of the issues involved.
The language used in the health care setting is immensely important in determining trust, mutual respect, and meaningful long-term relationships.
Topics covered include:
- Learn phrases, words, and approaches that can be left behind.
- Describe diabetes language that is respectful, inclusive, person-centered, and imparts hope.
- Discuss how to evaluate for ACE and provide trauma-informed care
- Practice communicating about diabetes using phrases free from judgment with a focus on a strength-based approach
This webinar is free and you can view it at any time, on any device. To earn CEs, you can purchase this course at our online university store.
Coach Beverly Thomassian, RN, MPH, BC-ADM, CDCES
Author, Nurse, Educator, Clinician, and Innovator, Beverly has specialized in diabetes management for over twenty years. As president and founder of Diabetes Educational Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes.
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!
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 diabetes certification exams. CBDCE & ADCES does not endorse any preparatory or review materials for the certification exams, except for those published by CBDCE & ADCES.
**To satisfy the requirement for renewal of certification by continuing education for the Certification Board for Diabetes Care & Education (CBDCE), continuing education activities must be applicable to diabetes and approved by a provider on the CBDCE List of Recognized Providers (www.ncbde.org). CBDCE does not approve continuing education. Diabetes Education Services is accredited/approved by the Commission of Dietetic Registration which is on the list of CBDCE Recognized Providers.
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