Rationale of the Week | Navigating Diabetes Care on the Road?
For last week’s practice question, we quizzed participants on Navigating Diabetes Care on the Road. 84% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
SJ is a 62-year-old long-haul truck driver with type 2 diabetes for the past 18 years. They take basal insulin nightly and metformin twice daily. Despite consistency of medications and a recent focus on lifestyle changes, Time in Range remains at 5% with a GMI of 9.2%. Last A1c was 9.7%. No history of hypoglycemia nor signs of retinopathy or neuropathy are documented. Incretin therapy or SGLT-2 inhibitor has been recommended but SJ shares that the insurance share of cost makes those medications unaffordable. SJ has an erratic schedule and drives across multiple states for work. They report fatigue during long drives but denies difficulty with driving nor any episodes of low blood glucose. SJ is motivated to improve diabetes management but is concerned about their livelihood if license were to be impacted.
As the diabetes care and education specialist, which of the following is the most appropriate next step in SJ’s care plan?
- Advise SJ to stop driving until A1C is under 7%.
- Report SJ to the state licensing agency due to hyperglycemia and commercial driving risk.
- Collaborate with SJ to develop an individualized plan focused on driving safety and affordable medication strategies.
- SJ would benefit from prandial insulin therapy, recommend switching to a premixed insulin regimen to improve time in range.
Getting to the Best Answer
Answer 1 is incorrect. 2% chose this answer, “Advise SJ to stop driving until A1C is under 7%.” Stopping driving based on an elevated A1C or Time in Range not at target is not recommended unless there is a clear safety risk. Hyperglycemia alone, without symptoms or complications, does not justify driving restrictions. Further assessment is needed before recommending driving cessation.¹
Answer 2 is incorrect. 1% of you chose this answer, “Report SJ to the state licensing agency due to hyperglycemia and commercial driving risk.” There is no legal or clinical basis to report SJ at this time. Reporting should occur if it is believed SJ poses a risk to public safety, such as recurrent severe hypoglycemia or functional impairments1 affecting driving ability.
Answer 3 is correct. About 84% of respondents chose this, “Collaborate with SJ to develop an individualized plan focused on driving safety and affordable medication strategies.” Individualized care should be emphasized, particularly in cases where cost limits access to newer therapies. We can explore medication cost saving resources, cost-effective oral agents, titration of basal insulin if not already optimized, or addition of prandial insulin support glycemia. SJ has been driving for many years, ensure driving safety strategies and ensure SJ knows the Federal Motor Carrier Safety Administration rules, which allow individuals with insulin-treated diabetes to drive commercially, as long as safety is maintained.²
Finally, Answer 4 is incorrect. 13% chose this answer, “SJ would benefit from prandial insulin therapy, recommend switching to a premixed insulin regimen to improve time in range.” Premixed insulin may not be the best option for someone like SJ with an unpredictable schedule. It increases the risk of hypoglycemia and limits flexibility. While it may help improve A1C, other options should be considered first, including more flexible insulin regimens or cost-conscious oral therapies.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Live in San Diego
DiabetesEd Training Seminar
Join us live October 22nd – 23rd, 2025!
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
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.
Rationale of the Week | Insulin Pump Inquiry for Rising A1C on MDI?
For last week’s practice question, we quizzed participants on Insulin Pump Inquiry for Rising A1C on MDI. 97% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
C.K. is a 55-year-old elementary school teacher diagnosed with type 1 diabetes ten years ago and is managing glycemic control with multiple daily injections (MDI) and a CGM. You are seeing C.K. for diabetes education due to an increasing hemoglobin A1c from 7.0% to 9.9%. During the appointment, C.K. reports missing mealtime doses due to being “too busy to get all that stuff out” at both work and home. C.K. notes that a friend from church has an insulin pump and asks if an insulin pump would help improve their A1c.
As the diabetes care and education specialist, what factors do you need to assess before determining if C.K. is ready for insulin pump therapy?
Answer Choices:
- C.K. is not ready for an insulin pump because of the frequently missed mealtime doses of rapid-acting insulin.
- C.K. is a candidate for an insulin pump because this person dislikes their current MDI therapy regimen, making no further evaluation or assessment necessary.
- C.K. may be a appropriate candidate, but it is essential to assess knowledge of diabetes self-management, willingness to learn pump skills, and ability to troubleshoot the insulin pump.
- C.K. is not a candidate for an insulin pump because the A1C is above target.
Getting to the Best Answer
Answer 1 is incorrect. 1% chose this answer, “C.K. is not ready for an insulin pump because of the frequently missed mealtime doses of rapid-acting insulin.” Missing insulin doses will not keep C.K. from starting an insulin pump. The use of an insulin pump can make it easier to bolus for meals, particularly with mobile bolusing features. By using an insulin pump, C.K. can bolus without stopping to get out all the supplies needed to give an injection, which may improve his success with bolus doses.
Answer 2 is incorrect. 1% of you chose this answer, “C.K. is a candidate for an insulin pump because this person dislikes their current MDI therapy regimen, making no further evaluation or assessment necessary.” The fact that C.K. dislikes the current MDI regimen is a conversation starting point to explore insulin pump therapy. When determining appropriateness for insulin pump therapy, the diabetes healthcare professional needs to evaluate for other factors, such as the physical and cognitive ability to operate and troubleshoot an insulin pump. More evaluation, including social determinants of health and CK’s goals and needs, are necessary to determine if pump therapy is right for C.K.
Answer 3 is correct. About 97% of respondents chose this, “C.K. may be a appropriate candidate, but it is essential to assess knowledge of diabetes self-management, willingness to learn pump skills, and ability to troubleshoot the insulin pump.” This client is frustrated with their regimen and their A1C is elevated. This could be a valid reason to start the discussion of insulin pump therapy for those using insulin therapy to manage diabetes. The diabetes healthcare professional needs to first evaluate and assess the clinical factors, lifestyle, and goals, of the individual to set them up for maximum success while reducing frustration in their diabetes self-management.
Finally, Answer 4 is incorrect. 1% chose this answer, “C.K. is not a candidate for an insulin pump because the A1C is above target.” An elevated A1C level is not a reason to dismiss insulin pump therapy. CK might actually benefit from using an insulin pump based on his goals and consideration of his social determinants of health.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Live in San Diego
DiabetesEd Training Seminar
Join us live October 22nd – 23rd, 2025!
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
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.
Rationale of the Week | Lower Extremity Recommendation for JT?
For last week’s practice question, we quizzed participants on Lower Extremity Recommendation for JT? . 77% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
Question:
JT is a 58-year-old with type 2 diabetes presents for a routine exam. Has a 20-year history of diabetes, hypertension, and peripheral neuropathy. Reports no foot pain, but partner notes they have been walking with a slight limp. On exam, you note dry skin, thickened toenails, a callus on the plantar aspect of the first metatarsal head, and diminished monofilament sensation at multiple sites on both feet. Pedal pulses are diminished bilaterally, and ABI (Ankle-Brachial Index) is 0.6 on the right and 0.7 on the left.
Which of the following is the most appropriate next step in managing this JT’s foot care?
Answer Choices:
- Refer to a podiatrist for debridement of the callus and initiate custom orthotics.
- Reassure JT that this is only a minor issue since they are not experiencing pain and schedule follow-up in 6 months.
- Prescribe a topical antifungal for the toenails and instruct JT to inspect feet weekly and apply moisturizing cream.
- Recommend vascular imaging and refer to a vascular specialist due to abnormal ABI and diminished pulses.
Getting to the Best Answer
Answer 1 is incorrect. 16% chose this answer, “Refer to a podiatrist for debridement of the callus and initiate custom orthotics.” While podiatry referral is important, vascular compromise must be evaluated first. Debridement in a patient with peripheral arterial disease (PAD) could lead to poor healing or ulceration.
Answer 2 is incorrect. 1% of you chose this answer, “Reassure JT that this is only a minor issue since they are not experiencing pain and schedule follow-up in 6 months.” Absence of pain does not exclude serious pathology, especially in individuals with neuropathy.
Answer 3 is incorrect. About 3% of respondents chose this, “Prescribe a topical antifungal for the toenails and instruct JT to inspect feet weekly and apply moisturizing cream.” This addresses a minor issue (onychomycosis), but ignores signs of ischemia and neuropathy.
Finally, Answer 4 is correct. 77% chose this answer, “Recommend vascular imaging and refer to a vascular specialist due to abnormal ABI and diminished pulses.” ABI values <0.9 indicate PAD; values <0.5 are considered severe. Given the ABI of 0.6 and 0.7, along with diminished pulses and gait change, vascular referral is necessary to assess perfusion and prevent future ulceration or amputation.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Want to learn more about this question?
Join us live on August 12th @ 11:30am PST for Level 4 | 3 Steps to DeFeet Amputation
Coach Beverly will walk participants through the 3-Step Process to Save Feet; Assess, Screen, & Report. She will provide simple and clear instructions on how to assess and inspect feet, along with risk assessment & action steps. We will share free teaching tools, strategies, & documentation forms adapted from the Lower Extremity Prevention Program (LEAP) that you can immediately implement in your practice setting. This course is free to attend without earning CEs, or you can choose the paid option if you wish to receive CE credits.
All hours earned count toward your CDCES Accreditation Information
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!
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.
Rationale of the Week | Best example of Person-Centered Question?
For last week’s practice question, we quizzed participants on Best example of Person-Centered Question. 93% of respondents chose the best answer – GREAT JOB! We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
Question: RJ is entering the field of diabetes care and education and has heard about the new language movement but isn’t sure how to apply it to their clinical practice. Which of the following is the best example of using person-centered language when speaking to someone with diabetes?
Answer Choices:
- Would you describe yourself as non-compliant, but working toward achieving better control?
- Thanks for making it to your appointment. What would you like to work on today?
- By carefully following the plan I have outlined, I am sure you will feel more confident with your diabetes self-management.
- To prevent complications, don’t you think you should watch your numbers more closely?
Getting to the Best Answer
Answer 1 is incorrect. 2% chose this answer, “Would you describe yourself as non-compliant but working toward achieving better control?” This response uses outdated judgmental terms like “non-compliant” and “control”.
Answer 2 is correct. 93% of you chose this answer, “Thanks for making it to your appointment. What would you like to work on today?” This uses respectful, person-first language and invites collaboration by focusing on the individual’s goals.
Answer 3 is incorrect. About 1% of respondents chose this, “By carefully following the plan I have outlined, I am sure you will feel more confident with your diabetes self-management.” This non-collaborative approach doesn’t include the individual in creating a plan.
Finally, Answer 4 is incorrect. 1% chose this answer, “To prevent complications, don’t you think you should watch your numbers more closely?” This uses a negative tone and the outdated “should” word. It can lead to shame or resistance.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Live in San Diego
DiabetesEd Training Seminar
Join us live October 22nd – 23rd, 2025!
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
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.
Rationale of the Week | What best describes the action of GLP-1 Receptor Agonists?
For last week’s practice question, we quizzed participants on What best describes the action of GLP-1 Receptor Agonists? 54% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
Question: Which of the following is accurate statement regarding Glucagon Like Peptides (GLP-1)?
Answer Choices:
- Main action is inhibition of DPP-IV enzyme
- Increases post prandial glucagon secretion
- Promotes gastric motility
- Decreases hepatic glycogenolysis
Getting to the Best Answer
Answer 1 is incorrect. 22% chose this answer, “Main action is inhibition of DPP-IV enzyme.” The GLP-1’s do not inhibit the action of the DPP-IV enzyme (that is the DPP-IV inhibitor class). GLP-1 agonists work by activating the GLP-1 receptor found on cells in the pancreas and brain. They slow gastric emptying, inhibit the release of glucagon, and stimulate insulin production, promote satiety and reduce hyperglycemia in people with type 2 diabetes.
Answer 2 is incorrect. 15% of you chose this answer, “Increases post prandial glucagon secretion.” GLP-1 agonists work by activating the GLP-1 receptor found on cells in the pancreas and brain. They inhibit the release of glucagon, slow gastric emptying and stimulate insulin production, promote satiety and reduce hyperglycemia in people with type 2 diabetes.
Answer 3 is incorrect. About 7% of respondents chose this, “Promotes gastric motility.” GLP-1 agonists work by activating the GLP-1 receptor found on cells in the pancreas and brain. They slow gastric emptying, inhibit the release of glucagon, and stimulate insulin production, promote satiety and reduce hyperglycemia in people with type 2 diabetes.
Finally, Answer 4 is correct. 54% chose this answer, “Decreases hepatic glycogenolysis.” YES – GREAT JOB! GLP-1 agonists work by activating the GLP-1 receptor found on cells in the pancreas and brain. They inhibit the release of glucagon which decreases hepatic glycogenolysis. They also slow gastric emptying, stimulate insulin production, promote satiety and reduce hyperglycemia in people with type 2 diabetes.
For more information, download our Medication PocketCard for more information.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Live in San Diego
DiabetesEd Training Seminar
Join us live October 22nd – 23rd, 2025!
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
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.
Rationale of the Week | What Helps Manage Gastroparesis in Type 1 Diabetes?
For last week’s practice question, we quizzed participants on What Helps Manage Gastroparesis in Type 1 Diabetes? 80% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
Question: VC has been living with type 1 diabetes for 43 years and was recently diagnosed with gastroparesis. Symptoms have included early satiety, nausea, bloating and intestinal pain. VC has an A1c of 6.7% but is experiencing frequent hypoglycemia. What general nutrition modifications would VC benefit from?
Answer Choices:
- Consume 3 meals per day, at the same time each day.
- Consume soft foods and include protein with meals to prevent hypoglycemia.
- Include small frequent meals, choose soft foods and reduce foods high in fat and fiber.
- Include high fiber foods and increase fluid intake to prevent constipation.
Getting to the Best Answer
Answer 1 is incorrect. 3% chose this answer, “Consume 3 meals per day, at the same time each day.” This approach can be helpful to manage glucose for some individuals with diabetes, however in gastroparesis timing, meal size, type of foods, and food textures are key.
Answer 2 is incorrect. 8% of you chose this answer, “Consume soft foods and include protein with meals to prevent hypoglycemia.” While soft foods and adequate protein is important, this doesn’t address the need to reduce fat and fiber and shift to smaller, more frequent meals.
Answer 3 is correct. About 80% of respondents chose this, “Include small frequent meals, choose soft foods and reduce foods high in fat and fiber.” Small frequent meals can improve rate of motility through the stomach to small intestine, low fat and low fiber whole foods also tend to move more quickly from the stomach (liquid sources may be tolerated better), and soft foods such as well-cooked vegetables to tender proteins may help reduce nausea, bloating and can ease the digestive process. Individual assessment of rate of digestion and insulin administration timing should also be considered to reduce the risk of post-prandial hypoglycemia.
Finally, Answer 4 is incorrect. 7% chose this answer, “Include high fiber foods and increase fluid intake to prevent constipation.” A high fiber diet can often worsen symptoms in gastroparesis by slowing gastric emptying further. Fluids are important, but fiber from whole foods is typically reduced.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
DiabetesEd Training Seminar - Save $75 through July 23rd. Code SDLIVE
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Join us live October 22nd – 23rd, 2025!
30+ CEs with Expanded Accreditation!
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
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.
Rationale of the Week | Managing Overnight Hypoglycemia: Best Plan?
For last week’s practice question, we quizzed participants on Managing Overnight Hypoglycemia: Best Plan? 86% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
Question: Your client wants to discuss a concern about overnight hypoglycemia alerts on the CGM. These hypoglycemia alerts have been happening intermittently and only in the overnight hours. The client reports no changes in diet, activity, or insulin doses over the past 2 weeks. These events are asymptomatic, and the client reports that these episodes resolve rapidly before they can get to the kitchen to treat the hypoglycemic event. What is the best plan of action for this client?
Answer Choices:
- Advise the client to eat a high-carbohydrate snack before bed to avoid hypoglycemia.
- Advise the client to verify the asymptomatic hypoglycemia with a fingerstick blood glucose reading and treat if hypoglycemia is verified.
- Advise the client only to treat hypoglycemia if they are symptomatic.
- Advise the client to decrease their basal insulin dose.
Getting to the Best Answer
Answer 1 is incorrect. 4% chose this answer, “Advise the client to eat a high-carbohydrate snack before bed to avoid hypoglycemia.” Although tempting, eating a high-carbohydrate snack before bed doesn’t address the need to verify an asymptomatic and unexpected low blood glucose.
Answer 2 is correct. 86% of you chose this answer, “Advise the client to verify the asymptomatic hypoglycemia with a fingerstick blood glucose reading and treat if hypoglycemia is verified.” GREAT JOB! Continuous glucose monitors are susceptible to compression lows. These lows occur when pressure is applied to the sensor/transmitter, which can occur during sleep. This can result in hypoglycemia alerts. Diabetes care and education specialists can help recognize this pattern and coach clients using CGM technology to verify any asymptomatic or unexpected hypoglycemia with a fingerstick blood glucose reading before making a treatment decision.
Answer 3 is incorrect. About 2% of respondents chose this, “Advise the client only to treat hypoglycemia if they are symptomatic.” All clients need to be encouraged to verify any unexpected glucose readings, particularly if they have asymptomatic hypoglycemia, with a fingerstick blood glucose reading before treating.”
Finally, Answer 4 is incorrect. About 5% of you chose this answer, “Advise the client to decrease their basal insulin dose.” The blood glucose readings need to be verified before adjusting the basal insulin dose.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
ReVive 5 Diabetes Training Program: A Person-Centered Approach to Diabetes Distress & Glucose Management
Join us live on July 15th and July 22nd, 2025 at 9:00 am PST
6+ CEs with Expanded Accreditation!
Join experts Larry Fisher, Ph.D., ABPP, Susan Guzman, Ph.D., and Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM, for this transformative two-part training on the ReVive 5 framework—an evidence-based approach that integrates emotional well-being and glucose data into person-centered diabetes care.
Grounded in the results of the EMBARK Trial, this program emphasizes the urgent need to assess and address diabetes distress, now recognized in the ADA Standards of Care as a critical component of care. You’ll gain practical tools and strategies used in the trial to support emotional well-being, meet clinical standards, and empower individuals on their diabetes journey.
Program Objectives:
Upon completion of this activity, participants will be able to:
- Identify the key differences between diabetes distress and depression and explain their impact on self-care behaviors.
- Apply evidence-based communication strategies to respond to diabetes distress screening results.
- Demonstrate how to analyze glucose patterns using meter and sensor data.
- Utilize the ReVive 5-step approach to integrate emotional and glucose management into diabetes care.
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
CEO of DiabetesEd Services
Faculty Bios & Disclosures
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Lawrence Fisher, Ph.D., ABPP, Professor Emeritus, UCSF
- Consultant, advisor, and speaker for Eli Lilly
Speaker Interview:
Bio:
Dr. Fisher has been a professor in the Department of Family & Community Medicine at the University of California, San Francisco for over 25 years, and he is the Director of The Behavioral Diabetes Research Group at UCSF.
He has a Diplomate in Clinical Psychology from the American Board of Professional Psychology and is a former Associate Editor of Diabetes Care. He has conducted multiple cross-sectional and longitudinal NIH- and ADA-supported clinical research with adults with diabetes and their families.
His recent work focuses on diabetes distress and depression, disease management, and how adults and families struggle over time to manage chronic health conditions. He has won two major UCSF School of Medicine teaching awards, was nominated for the UCSF Postdoctoral Scholars Association Outstanding Mentorship Award, and has received a certificate from the American Psychological Association in “Recognition for Substantial Contributions to the Field of Family Psychology and Health.”
In 2012 he received the Richard Rubin Award from the American Diabetes Association. He maintains an active clinical practice at UCSF, has published over 190 peer-reviewed articles on diabetes and related topics, and frequently speaks to both professional and lay groups at local, national, and international meetings and workshops.
Susan Guzman, PhD
- Consultant, advisor, and speaker for Abbot Labratories and Embecta
Dr. Guzman is a clinical psychologist specializing in diabetes. In 2003, Dr. Guzman co-founded the Behavioral Diabetes Institute (BDI), the first non-profit organization devoted to the emotional and behavioral aspects of living with diabetes.
At BDI, she serves as the Director of Clinical Education, developing and leading programs for people with diabetes and healthcare professionals. She has helped develop and facilitate diabetes distress group interventions for two NIH-funded research studies for adults with type 1 diabetes.
Dr. Guzman is passionate about helping to change the conversations in diabetes away from shame, blame, and judgment to those based on facts, empathy, and engagement. She has been part of a joint ADA/ADCES effort to address problematic language and messages in diabetes.
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADMBeverly Thomassian has no financial disclosures
Speaker Interview:
Bio:
Expanded Accreditation
Activity Start and End Date: 7/15/2025 to 7/22/2027
Estimated time to complete the activity: 6 hours and 15 minutes
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 6.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 6.25 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 6.25 contact hour(s) (.625] CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – UAN JA4008073-9999-25-198-H01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 6.25 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 6.25 Interprofessional Continuing Education (IPCE) credit for learning and change.
Disclosure of Unlabeled Use:
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer:
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Instructions for Credit
Participation in this self-study activity should be completed in approximately 6 hours and 15 minutes. To successfully complete this activity and receive CE credit, learners must follow these steps during the period from 7/15/2025 to 7/22/2027.
- Review the objectives and disclosures
- Study the educational content in Online University
- After review of content, a module within the course in the Online University will list a link to Partners for Advancing Clinical Education’s website
- Visit Partners for Advancing Clinical Education website listed in course in the Online University
- Complete the activity evaluation through Partners for Advancing Clinical Education website
For additional information about the accreditation of this activity, please visit https://partnersed.com.
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.
Rationale of the Week | Diabetes Burnout Despite Control?
For last week’s practice question, we quizzed participants on Diabetes Burnout Despite Control. 94% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question.
Question: Jada, a 29-year-old with type 1 diabetes, tells you she’s feeling burned out and emotionally drained, despite maintaining a time in range above 70% for the past several months. She says, “I’m doing everything right, but I’m exhausted and don’t feel like myself lately.” You review her CGM data and see no major red flags. She denies any recent illnesses or major changes in insulin needs. What is the most appropriate next step?
Answer Choices:
- Celebrate her strong glucose metrics and encourage her to stick with the same plan, reassuring her that she’s doing well.
- Recommend scheduling an appointment with her endocrinologist to reevaluate her insulin doses and technology settings.
- Acknowledge her experience and assess for emotional burnout, stressors, or imbalances in her lifestyle that could be contributing to her fatigue.
- Increase the frequency of data sharing and remote monitoring to help identify subtle trends and reduce her self-management burden.
Getting to the Best Answer
Answer 1 is incorrect. 1% chose this answer, “Celebrate her strong glucose metrics and encourage her to stick with the same plan, reassuring her that she’s doing well.” While it’s important to acknowledge the hard work it takes to stay in range, this answer misses the bigger picture. Jada is telling us she’s struggling emotionally — this is not the time to brush past her experience. High time in range does not always equal high quality of life. When someone shares they’re feeling burned out, it’s our cue to pause and dig deeper, not simply pat them on the back and move on.
Answer 2 is incorrect. 2% of you chose this answer, “Recommend scheduling an appointment with her endocrinologist to reevaluate her insulin doses and technology settings.” Jada isn’t expressing concerns about her insulin needs — she’s talking about emotional exhaustion. Jumping to insulin or tech adjustments may send the message that we’re not really listening. Yes, there’s always room to optimize settings, but that’s not the priority here. This response may unintentionally medicalize a problem that’s likely rooted in something else.
Answer 3 is correct. About 94% of respondents chose this, “Acknowledge her experience and assess for emotional burnout, stressors, or imbalances in her lifestyle that could be contributing to her fatigue.” YES — this is the best answer. Jada is doing a great job with her glucose, but she’s telling us she’s tired. Diabetes burnout is real, even when the data looks “perfect.” This is our opportunity to normalize her feelings, offer support, and explore what might be out of balance — whether it’s stress, sleep, relationships, or unrealistic expectations around self-management. Holistic care means seeing the person, not just the numbers.
Finally, Answer 4 is incorrect. 1% chose this answer, “Increase the frequency of data sharing and remote monitoring to help identify subtle trends and reduce her self-management burden.” While that might sound helpful, more data is not necessarily the answer here. In fact, increasing monitoring could add to Jada’s mental load — and she’s already telling us she’s exhausted. If anything, now might be a time to consider reducing the burden, simplifying routines, or talking about boundaries with diabetes tech.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Want to learn more about this question?
Join us live on July 24th for our
Level 5: Beyond Blood Glucose: Empowering Health Through a Holistic Lens
Join us live on July 24th, 2025, at 11:30 am PST to watch our brand new webinar, Beyond Blood Glucose: Empowering Health Through a Holistic Lens by Nick Kundrat, BS, CEP, CDCES, LMT
Despite the rise of cutting-edge diabetes technologies and therapeutics, many people with diabetes still struggle with fatigue, blood glucose swings, and burnout. Why? Because we’re often so focused on managing diabetes itself that we often forget to take care of the human being who lives with it.
Join Nick Kundrat, BS, CEP, CDCES, LMT and Integrative Health Practitioner, for an engaging webinar where he simplifies the often-misunderstood world of holistic health. You’ll learn practical, accessible strategies to begin thinking more holistically and discover simple, effective tools that enhance conventional care and empower people with diabetes to thrive—physically, emotionally, and spiritually.
Drawing from over two decades of lived experience with type 1 diabetes and years of supporting clients in both clinical and holistic settings, Nick offers a unique perspective on diabetes care focused on the whole person. Through reconnecting with the foundational elements of health, which are often overlooked in conventional diabetes care, Nick aims to equip you with actionable strategies to help people with diabetes restore their energy, support their bodies, and thrive beyond diabetes.
All hours earned count toward your CDCES Accreditation Information
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!
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.
![](/wp-content/uploads/2023/01/insta-png-v5.png")
