Rationale of the Week | Is JR at Risk for NASH?
For last week’s practice question, we quizzed participants on being at risk for NASH. 63% 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: JR is 46 years old with type 2 diabetes and a BMI of 33. In addition, JR has hypertension and hyperlipidemia, with elevated liver enzymes (ALT and AST).
According to the latest ADA Standards, which of the following would best help determine if JR is at risk for liver fibrosis and cirrhosis?
Answer Choices:
- UACR
- FIB-4
- GAD or ICA
- Weight in (kg) divided by the square of height in meters (m2)
Getting to the Best Answer
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.
Answer 1 is incorrect. 14.51% chose this answer. “UACR.” This is a juicy answer, however the Urinary Albumin Creatinine Ratio (UACR) evaluates kidney function and doesn’t provide any hepatic insights. Instead we would recommend the Fibrosis-4 Index for Liver Fibrosis helps determine risk of hepatic cirrhosis and inflammation (see answer 2).
Answer 2 is correct. 62.53% of you chose this answer. “FIB-4.” GREAT JOB. The Fibrosis-4 Index for Liver Fibrosis helps determine risk of hepatic cirrhosis and inflammation. By entering the person’s age, AST, ALT and Platelet count using the FIB-4 calculator, a risk level is calculated (see slide below). The hope is that by screening for hepatic issues early, we can take action to protect the liver and improve outcomes.
Answer 3 is incorrect. About 11.69% of respondents chose this. “GAD or ICA.” Although this answer is familiar, it does not match the intent of the question. GAD and ICA are blood tests to determine if someone has autoimmune mediated type 1 diabetes. Instead we would recommend the Fibrosis-4 Index for Liver Fibrosis helps determine risk of hepatic cirrhosis and inflammation (see answer 2).
Finally, Answer 4 is incorrect. 11.27% chose this answer. “Weight in (kg) divided by the square of height in meters (m2).” This answer is also familiar since it is the formula to determine a person’s body mass index (BMI). Instead we would recommend the Fibrosis-4 Index for Liver Fibrosis helps determine risk of hepatic cirrhosis and inflammation (see answer 2).
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! Learn more by attending our Virtual Conference plus save $100 through April 18, 2023.
Register now for our Virtual DiabetesEd Training Conference
Your team is invited to our Virtual DiabetesEd™ Training Conference! Set your team apart and prepare for diabetes certification!
Join this state-of-the-art conference taught by content experts, Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, Beverly Thomassian RN, MPH, CDCES, BC-ADM, and Ashley LaBrier who are passionate about improving diabetes care.
Group discounts are available!*
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Rationale of the Week | Birthday Cake Dilemma
For last week’s practice question, we quizzed participants on having their cake and eating it too. A whopping 94% of respondents chose the best answer. We want to celebrate your success and give you all a shout out for a job well done.
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: AJ is a 9-year-old with type 1 diabetes, A1c of 7.2%, and uses an insulin pump and CGM. They ask you how to include a piece of birthday cake for an upcoming birthday celebration.
What is the best advice?
Answer Choices:
- Accept the cake but don’t actually eat it.
- Increase their daytime basal insulin to prevent hyperglycemia.
- Take additional bolus insulin to cover the extra carbs.
- Encourage AJ to have a piece of fruit instead.
Getting to the Best Answer
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST Person-Centered answer.
Answer 1 is incorrect. 1.53% chose this answer. “Accept the cake but don’t actually eat it.” Since this doesn’t honor AJ’s choice to accept and enjoy the cake, it is not the best answer. People with diabetes can absolutely enjoy special treats by adjusting their bolus insulin dose to account for the extra carbs to prevent post cake hyperglycemia.
Answer 2 is incorrect. 2.3% of you chose this answer. “Increase their daytime basal insulin to prevent hyperglycemia.” People with diabetes can absolutely enjoy special treats by adjusting their bolus insulin dose to account for the extra carbs to prevent post cake hyperglycemia.
Answer 3 is correct. About 94.12% of respondents chose this. “Take additional bolus insulin to cover the extra carbs.” YAY! This person centered approach is the BEST guilt free answer since it recognizes and respects AJ’s choice to enjoy a piece of birthday cake while still managing blood sugars with extra bolus insulin.
Finally, Answer 4 is incorrect. 2.05% chose this answer. “Encourage AJ to have a piece of fruit instead.” Since this doesn’t honor AJ’s choice to accept and enjoy the cake, it is not the best answer. People with diabetes can absolutely enjoy special treats by adjusting their bolus insulin dose to account for the extra carbs to prevent post cake hyperglycemia.
We hope you appreciate this week’s person-centered 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 Medical Nutrition Therapy?
You are invited to join our Virtual Conference with our Nutrition expert speaker, Ashley LaBrier, MS, RD, CDCES, who will be providing a half-day presentation on this important topic!
Ashley LaBrier, MS, RD, CDES, is an innovator in the field of diabetes, nutrition, and technology. Ashley is a consultant and the Diabetes Education Program Coordinator at the Salinas Valley Medical Clinic’s Diabetes & Endocrine Center.
Ms. LaBrier is passionate about providing person-centered education to empower those who live with diabetes. Having been diagnosed with type 1 diabetes herself nearly 20 years ago, she combines her professional knowledge with personal experience and understanding.
Virtual DiabetesEd Training Conference
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.
Group discounts are available!*
Download Course Flyer | Download Schedule
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Rationale of the Week | Why the Post Meal Glucose Spike?
For last week’s practice question, we quizzed participants on post-meal glucose spikes. 51% 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: TR can’t figure out why her BG always spikes after breakfast.
How many grams of carb is in the following breakfast? 2 corn tortillas, 2 fried eggs with salsa, ½ cup hashbrowns and an 8 ounce glass of milk.
Answer Choices:
- 75 gms
- 57 gms
- 60 gms
- 4 servings
Getting to the Best Answer
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.
Answer 1 is incorrect. 18.55% chose this answer, “75 gms”. To answer this question accurately, it is important to be familiar with the common servings sizes of carbs and to know which foods don’t count as carbs. This answer is incorrect because it is an over estimate of carbs in this meal.
Answer 2 is correct. 50.63% of you chose this answer, “57 gms”. Yes, this is the BEST Answer. GREAT JOB. Here are the carbs broken down. 2 corn tortillas = 30gms carb, 2 fried eggs with salsa= 0 gms carb, ½ cup hashbrowns – 15 gms and an 8 ounce glass of milk =12gms. 30 + 15+ 12 = 57 gms of carbohydrate in this meal. An important fact to keep in mind for exam success; a cup of milk is 12 gms of carb, not 15gms.
Answer 3 is incorrect. About 24% of respondents chose this, “60 gms” This was the juicy answer. An important fact to keep in mind for exam success; a cup of milk is 12 gms of carb, not 15gms. Here are the carbs broken down. 2 corn tortillas = 30gms carb, 2 fried eggs with salsa= 0 gms carb, ½ cup hashbrowns – 15 gms and an 8 ounce glass of milk =12gms. 30 + 15+ 12 = 57 gms of carbohydrate in this meal.
Finally, Answer 4 is incorrect. 6.81% chose this answer, “4 servings” This answer is tempting, but the question asks “how many gms of carbohydrate” not, how many servings of carb. A great idea is to always eliminate answers that don’t match the unit of measure used in the question.
If you want more info on carb counting, you are invited to join our Virtual Conference in April. Save $100 through April 7, 2023 (see info below). We hope you appreciate this week’s rationale!
Want to learn more about Medical Nutrition Therapy?
You are invited to join our Virtual Conference with our Nutrition expert speaker, Ashley LaBrier, MS, RD, CDCES, who will be providing a half-day presentation on this important topic!
Ashley LaBrier, MS, RD, CDES, is an innovator in the field of diabetes, nutrition, and technology. Ashley is a consultant and the Diabetes Education Program Coordinator at the Salinas Valley Medical Clinic’s Diabetes & Endocrine Center.
Ms. LaBrier is passionate about providing person-centered education to empower those who live with diabetes. Having been diagnosed with type 1 diabetes herself nearly 20 years ago, she combines her professional knowledge with personal experience and understanding.
Virtual DiabetesEd Training Conference
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.
Group discounts are available!*
Download Course Flyer | Download Schedule
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Rationale of the Week | According to label, how many kcals total Fat?
For last week’s practice question, we quizzed participants on their nutrition label reading ability. About 59% of respondents chose the best answer, revealing how challenging nutrition labels can be to dissect and understand, even for super-smart health care professionals. 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: You are teaching about counting fat.
If they ate 2 servings of this Macaroni and Cheese (see label), how many calories would come from total fat?
Answer Choices:
- 16 gms
- 144 kcals
- 460 kcals
- 20%
Getting to the Best Answer
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question or image (like this nutrition label). They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.
Answer 1 is incorrect. 13.75% chose this answer. “16 gms.” While it is true that there are 16 grams of fat in 2 servings of macaroni and cheese, this question doesn’t ask the test taker, “how many grams of fat”. The intent of the question is to determine how many kcals from total fat. Right away, we know this answer is wrong, because the unit is in gms not kcals.
Answer 2 is correct. 59.13% of you chose this answer. “144 kcals.” GREAT JOB. To get to this answer, you have to do a little math and know one important fact; there are 9 kcals in 1 gm of fat. On this label, one serving of macaroni and cheese has 8 gms, so 2 servings has 16 gms of total fat. 16 gms x 9 kcals = 144 kcals. In preparation for certification exams (and providing nutrition counseling), knowing how to read labels and being familiar with the kcals for protein, carbs and fats is very helpful.
Answer 3 is incorrect. About 12.81% of respondents chose this. “460 kcals.” This would be the correct answer if the question read, “how many total calories” is in 2 servings of this macaroni and cheese. However, the question is only asking for total fat calories in 2 servings. To get to best answer, you have to do a little math and know one important fact; there are 9 kcals in 1 gm of fat. On this label, one serving of macaroni and cheese has 8 gms, so 2 servings has 16 gms of total fat. 16 gms x 9 kcals = 144 kcals.
Finally, Answer 4 is incorrect. 14.31% chose this answer. “20%.” While it is true that there is 20% total fat in 2 servings of macaroni and cheese, this question doesn’t ask the test taker, “what percent of fat”. The intent of the question is to determine how many kcals from total fat. Right away, we know this answer is wrong, because the unit is in % not kcals.
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 Medical Nutrition Therapy?
You are invited to join our Virtual Conference with our Nutrition expert speaker, Ashley LaBrier, MS, RD, CDCES, who will be providing a half-day presentation on this important topic!
Ashley LaBrier, MS, RD, CDES, is an innovator in the field of diabetes, nutrition, and technology. Ashley is a consultant and the Diabetes Education Program Coordinator at the Salinas Valley Medical Clinic’s Diabetes & Endocrine Center.
Ms. LaBrier is passionate about providing person-centered education to empower those who live with diabetes. Having been diagnosed with type 1 diabetes herself nearly 20 years ago, she combines her professional knowledge with personal experience and understanding.
Virtual DiabetesEd Training Conference
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.
Group discounts are available!*
Download Course Flyer | Download Schedule
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Rationale of the Week | Is Fast Food the best solution for Food Insecurity?
For last week’s practice question, we quizzed participants on if fast food is the best solution for food insecurity. 90% 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: Due to the increased cost of groceries, JR tells you all they can afford to eat are fast foods.
As a diabetes care and education specialist, what is the best response?
Answer Choices:
- We generally recommend avoiding fast foods due to high fat and carbohydrate content.
- Let’s explore the possibility of preparing lower-cost, healthier foods at home.
- Ask JR to make a list of reasons that fast food may not be the best choice.
- Suggest eating more fresh fruits and vegetables to increase fiber intake.
Getting to the Best Answer
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.
Answer 1 is incorrect. 2.42% chose this answer. “We generally recommend avoiding fast foods due to high fat and carbohydrate content.” While it is true that many fast food options are often high in fat and carbohydrates, we want to honor people choices and situations. This response might be received as critical and could limit the opportunity to collaborate on healthier approaches.
Answer 2 is correct. 90.31% of you chose this answer. “Let’s explore the possibility of preparing lower-cost, healthier foods at home.” GREAT JOB, most chose this BEST answer for good reason. This person-centered approach invites JR to explore lower cost foods that they can prepare at home. It honors JR’s concern over their limited income and invites collaborative problem solving.
Answer 3 is incorrect. 4.48% of respondents chose this. “Ask JR to make a list of reasons that fast food may not be the best choice.” As with the first answer, this response might be received as critical and could limit the opportunity to collaborate on healthier approaches.
Finally, Answer 4 is incorrect. 2.42% chose this answer. “Suggest eating more fresh fruits and vegetables to increase fiber intake.” This answer doesn’t really address the intent of the question and might limit the opportunity to collaborate on problem solving.
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 Medical Nutrition Therapy?
You are invited to join our Virtual Conference with our Nutrition expert speaker, Ashley LaBrier, MS, RD, CDCES, who will be providing a half-day presentation on this important topic!
Ashley LaBrier, MS, RD, CDES, is an innovator in the field of diabetes, nutrition, and technology. Ashley is a consultant and the Diabetes Education Program Coordinator at the Salinas Valley Medical Clinic’s Diabetes & Endocrine Center.
Ms. LaBrier is passionate about providing person-centered education to empower those who live with diabetes. Having been diagnosed with type 1 diabetes herself nearly 20 years ago, she combines her professional knowledge with personal experience and understanding.
Virtual DiabetesEd Training Conference
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.
Group discounts are available!*
Download Course Flyer | Download Schedule
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Rationale of the Week | What is Person-Centered Care?
For last week’s practice question, we quizzed participants on person-centered care. 62% 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: TR is a healthcare professional who provides diabetes care and education support. They are interested in providing more person-centered care to the individuals they serve.
Which of the following statements verifies they are on the right track?
Answer Choices:
- Adherence to the diabetes self-care plan takes time.
- Motivating individuals to engage in their self-management is the first step.
- Adult learners do best when provided a step-by-step demonstration.
- Creating mutual agreement on the plan for next steps.
Getting to the Best Answer
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.
Answer 1 is incorrect. 8.04% chose this answer. “Adherence to the diabetes self-care plan takes time.” Under the umbrella of a person-centered care approach, the terms “adherence” and “compliance” are outdated concepts that are no longer used. For example, if we say that TR is adherent, it means that they are following the provider’s instructions instead of being an active participant in care. This person-centered approach engages the individual in the decision-making process and self-care plan.
Answer 2 is incorrect. 24.67% of you chose this answer. “Motivating individuals to engage in their self-management is the first step.” This is a juicy answer that sounds really good. However, it is not a realistic expectation to believe we can motivate people to make changes in their self-management. We can provide coaching and support, but ultimately, the person with diabetes needs to find their own motivation to make slow and steady behavior change. For this reason, this approach is not considered a person-centered approach.
Answer 3 is incorrect. 5.42% of respondents chose this. “Adult learners do best when provided a step-by the-step demonstration.” This answer is partially correct. Adult learners do apply their previous knowledge to the task at hand. However, more importantly than just observing, adult learners need to participate in the learning activity and have “hand’s on” practice to solidify their knowledge.
Finally, Answer 4 is correct. 61.87% chose this answer. “Creating mutual agreement on the plan for next steps.” YES, this is the BEST PERSON-CENTERED ANSWER. This approach invites the person with diabetes to fully participate in determining their needs and goals while making plans for the future in collaboration with the provider.
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!
Join us at our
Virtual DiabetesEd Training Conference
Your team is invited to our Virtual DiabetesEd™ Training Conference! Set your team apart and prepare for diabetes certification!
Join this state-of-the-art conference taught by content experts, Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, Beverly Thomassian RN, MPH, CDCES, BC-ADM, and Ashley LaBrier who are passionate about improving diabetes care.
Group discounts are available!*
All hours earned count toward your CDCES Accreditation Information
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Many of you have requested to set up payment plans for your orders and we have found a great solution for this! During checkout, on the payment page, you can now select “Shop Pay” to pay in 3 installments instead of just one payment.
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The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparator
Rationale of the Week | Prediabetes after GDM-What do the Standards Recommend?
For last week’s practice question, we quizzed participants on prediabetes after GDM. It was a challenging question and 60% 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:
LR experienced gestational diabetes with their third pregnancy and now, at age 41, was just diagnosed with prediabetes. LR’s BMI is 29.3 and she is trying to lose weight.
Based on the 2023 ADA Standards of Care, in addition to providing LR with lifestyle coaching, what other intervention is recommended?
Answer Choices:
- Start a GLP-1 RA Inhibitor to support weight loss.
- Initiate metformin therapy.
- Start pioglitazone (Actos) at a low dose
- Suggest adding a SGLT-2i to lower glucose and protect renal function.
Getting to the Best Answer
Answer 1 is incorrect. 29.67% chose this answer, “Start a GLP-1 RA Inhibitor to support weight loss.” Since LR has prediabetes, not diabetes, and her BMI is less than 30, GLP-1 RA therapy isn’t indicated. Plus, this recommendation isn’t included in the ADA standards (see below).
Answer 2 is correct. 60.63% of you chose this answer, “Initiate metformin therapy.” YES, this is the BEST answer. GREAT JOB! For people with a history of GDM who now express prediabetes, they have a very high risk of getting diabetes in the near future. In addition to referring to a Diabetes Prevention Program, the Standards recommend initiation of metformin therapy to delay the onset of diabetes.
Answer 3 is incorrect. 2.27% of respondents chose this answer, “Start pioglitazone (Actos) at a low dose” Although low dose pioglitazone is recommended for those with prediabetes or diabetes and a history of stroke, LR has no history of stroke. In addition, pioglitazone is associated with weight gain and is not recommended in the ADA Standards to treat prediabetes.
Finally, Answer 4 is incorrect. 7.44% chose this answer, “Suggest adding a SGLT-2i to lower glucose and protect renal function.” Since LR has prediabetes, not diabetes and no signs of kidney problems, SGLT-2i therapy isn’t indicated. Plus, this recommendation isn’t included in the ADA standards (see below).
Thank you so much for reading this “Rationale of the Week”. For more information on this topic, we also invite you to join our Online Courses and Virtual DiabetesEd Training Program.
2 Scholarships for
Virtual DiabetesEd Training Conference
Deadline Today, Thursday, March 2nd – Apply Today!
We are offering 2 Scholarship Options for our DiabetesEd Specialist Virtual Conference, April 26-28th, 2023.
- Making a Difference Exemplar – valued at $499 for a diabetes specialist who exemplifies advocacy and compassionate care in their community and is pursuing their CDCES. This top-tier scholarship provides funds to cover course registration for our Deluxe Virtual Conference, April 26-28, 2023.
- Making a Difference Scholar – valued at $399 for a diabetes specialist who exemplifies advocacy and compassionate care in their community and is pursuing their CDCES. This scholarship provides funds to cover course registration for our Basic Virtual Conference, April 26-28 2023
If you are passionate about diabetes education, actively involved in providing the best diabetes care, preparing for certification, and seeking financial assistance to attend our DiabetesEd Specialist Course, you are invited to apply for one of these scholarships.
We don’t want financial barriers to stop anyone from attending this conference. In appreciation of those who are role models and advocates for practicing the best diabetes care in their communities, we are offering one $499 Scholarship and one $399 dollar scholarship.
Scholarship Applications
Due, Today, March 2, 2023
Virtual DiabetesEd Training Conference
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.
Group discounts are available!*
Download Course Flyer | Download Schedule
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Rationale of the Week | Lipid Targets & New ADA Standards
For last week’s practice question, we quizzed participants on the new ADA Standards for lipid management. It was a complicated question and 43% 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:
JR is 67 with type 1 diabetes and was discharged a few months ago after receiving a coronary artery bypass. JR is on insulin pump therapy and a CGM, with a recent A1C of 6.7%. Their blood pressure is 129/78.
Other recent labs include:
- LDL cholesterol of 67 mg/dL
- HDL 54 mg/dL
- Triglycerides 172 mg/dL
- UACR 23 mg/g GFR 61
JR’s medications include: insulin, atorvastatin 80mg, atenolol 50mg, and aspirin therapy. JR has met with the dietitian and is trying to eat healthfully. They have lost 5 pounds over the past few months.
Based on the 2023 ADA Standards of Care and JR’s history, which of the following is considered best practice?
Answer Choices:
- Add an ACE or ARB
- Keep LDL cholesterol less than 70 mg/dL
- Increase fiber intake by 20%
- Add ezetimibe (Zetia) or a PCSK9
Getting to the Best Answer
Answer 1 is incorrect. 23.93% chose this answer, “Add an ACE or ARB.” This was a juicy answer. However, since the B/P is on target at less than 130/80 and JR does not have an elevated UACR, adding an ACE or ARB is not indicated at this time.
Answer 2 is incorrect. 21.08% of you chose this answer, “Keep LDL cholesterol less than 70 mg/dL.” Since JR has ASCVD, as evidenced by their need for a coronary artery bypass, the LDL target is less than 55 mg/dL. This new intensified LDL target is based on the 2023 updated guidelines. Read our blog on New Lipid Guidelines here.
Answer 3 is incorrect. 11.99% of respondents chose this answer, “Increase fiber intake by 20%.” While increasing fiber intake is always a good idea, in may not be enough to help JR get their LDL to a target level of less than 55 mg/dl.
Finally, Answer 4 is correct. 42.96% chose this answer, “Add ezetimibe (Zetia) or a PCSK9.” Yes, this is the best answer, GREAT JOB. Since JR has ASCVD, as evidenced by their need for a coronary artery bypass, the LDL target is less than 55 mg/dL. Since they are already on max dose of atorvastatin at 80mg, the ADA Guidelines recommend adding an additional agent, either ezetimibe (Zetia) or a PCSK9 to further lower the LDL to reach a target of less than 55 mg/dL. Download Lipid Medication Cheat Sheet Here
Thank you so much for reading this “Rationale of the Week”. For more information on this topic, we encourage you to Read our blog on New Lipid Guidelines and Download Lipid Medication Cheat Sheet Here. We also invite you to join our Online Courses and Virtual DiabetesEd Training Program.
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