Rationale of the Week | JR arrives late and out of sorts
For last week’s practice question, we quizzed participants on helping someone flustered and late to an appointment. 73% 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 a 22-year-old living with type 1 diabetes who arrives late for their appointment and seems out of sorts. When looking at the ambulatory glucose profile, you notice that time in range is less than 40% and coefficient of variation is also over 40%. You remember from a previous visit that JR had experienced almost half a dozen adverse childhood experiences and had elevated diabetes distress.
Based on this information, what is the next best step?
Answer Choices:
- Use the empowerment approach to help JR take charge of their life.
- Request that JR is referred to a mental health specialist.
- Utilize motivational interviewing techniques to help JR through this rough spot.
- Create a judgement free zone and explore with JR how they are feeling.
Getting to the Best Answer
Answer 1 is incorrect. 4.31% chose this answer. “Use the empowerment approach to help JR take charge of their life.” Even though the empowerment approach can be used as a tool to help people take a more active role in their self-care, given JR’s level of distress, this would not be the best approach. We will need to first assess the situation and discuss next steps as part of collaborative care.
Answer 2 is incorrect. 9.66% of you chose this answer. “Request that JR is referred to a mental health specialist.” Even though JR is clearly struggling with diabetes distress and being “out of sorts’, this does not automatically mean he needs to be referred to a mental health specialist. We will need to first assess the situation and discuss next steps as part of collaborative care.
Answer 3 is incorrect. About 13.10% of respondents chose this. “Utilize motivational interviewing techniques to help JR through this rough spot.” Even though motivational interviewing can be used as a tool to help people take a more active role in their self-care, given JR’s level of distress, this would not be the best approach. We will need to first assess the situation and discuss next steps as part of collaborative care.
Finally, Answer 4 is correct. 72.93% chose this answer. “Create a judgement free zone and explore with JR how they are feeling.” YES, GREAT JOB. We need to provide a safe environment for JR to have the freedom to share what is happening in their life and support them in taking action to decrease their distress.
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 October 29, 2024 for our
The Impact of Adverse Childhood Experiences on Health
Level 4 | Advanced & Specialty Topic Courses
Adverse childhood experiences (ACE) are associated with an increased risk of diabetes, heart disease, cancer & a variety of other health consequences for adults. This session reviews how diabetes care & education specialists can provide screening, assessment, & trauma-informed care to individuals who experienced ACEs & are living with toxic stress. We will explore strategies to address ACES & improve outcomes for individuals & communities. Throughout, we will focus on supporting self-care with a focus on recognizing & promoting resilience.
Objectives:
- Discuss the benefits of assessing Adverse Childhood Experiences (ACE) in individuals with diabetes.
- State the relationship between ACE Scores & the risk of future health complications.
- Describe a person-centered approach to fostering resilience & self-care for individuals with toxic stress.
- Identify two strategies to provide trauma-informed care in your work setting.
Learning Outcome:
Participants will identify how trauma can impact diabetes and self-management along with strategies to support hope when working with people with diabetes.
Target Audience:
This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research.
CDR Performance Indicators:
- 9.2.1
- 9.2.3
- 9.4.3
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 15 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert.
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Rationale of the Week | What do the NEW 2025 ADA Standards Say?
- Renewing your CDCES – Important Updates to Keep in Mind
- Question of the Week | Best Meds to Treat MASH – 2025 Standards
- Rationale of the Week | Low carb diets and SGLT-2’s a good mix?
- Entering the Field of Diabetes Education – Building a Bridge Program
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our Level 4 | The Impact of Adverse Childhood Experiences on Health awards 1.0 CPEUs in accordance with the Commission on Dietetic Registration’s CPEU Prior Approval Program.
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Rationale of the Week | JR and Donut Fridays – What is the wise approach?
For last week’s practice question, we quizzed participants on helping people address special treat days. The majority 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:
You are reviewing JR’s ambulatory glucose profile and it is over 70% time in range. JR usually takes bolus insulin before each meal and basal insulin at night. However, you notice that once a week on Fridays, JR’s blood glucose levels are above target between 2-5pm. When you bring this Friday glucose elevation to JR’s attention, they tell you it’s because the boss always brings in donuts after lunch on Fridays to celebrate everyone’s hard work. JR asks you about strategies to address this time above target.
What is the wise approach?
Answer Choices:
- Have you considered eating a piece of fruit instead?
- Can you let your boss know that you appreciate the gesture, but your diabetes doesn’t allow for this treat.
- Would you consider giving a little extra bolus insulin and enjoying the donut?
- Would you be willing to bring in a special low carb treat for everyone to enjoy?
Getting to the Best Answer
Answer 1 is incorrect. 3.55% chose this answer. “Have you considered eating a piece of fruit instead?” Even though fruit might be a healthier choice, it may not be the “wise” choice for this situation. The ADA Standards encourage us to help individuals “maintain the pleasure of eating.” An occasional donut to celebrate hard work can certainly be included in JR’s meal plan.
Answer 2 is incorrect. 3.55% of you chose this answer. “Can you let your boss know that you appreciate the gesture, but your diabetes doesn’t allow for this treat.” JR can choose to make a “wise” decision and participate in the festivities. The ADA Standards encourage us to help individuals “maintain the pleasure of eating.” An occasional donut to celebrate hard work can certainly be included in JR’s meal plan.
Answer 3 is correct. About 81.07% of respondents chose this. “Would you consider giving a little extra bolus insulin and enjoying the donut?” JR can choose to make a “wise” decision and participate in the festivities and take a little extra insulin to prevent post treat hyperglycemia. The ADA Standards encourage us to help individuals “maintain the pleasure of eating.” An occasional donut to celebrate hard work can certainly be included in JR’s meal plan.
Finally, Answer 4 is incorrect. 11.83% chose this answer. “Would you be willing to bring in a special low carb treat for everyone to enjoy?” JR can choose to make a “wise” decision and participate in the festivities. The ADA Standards encourage us to help individuals “maintain the pleasure of eating.” An occasional donut to celebrate hard work can certainly be included in JR’s meal plan.
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?
Invite Coach Beverly Thomassian to Speak – In Person or Virtually!
An Innovative Approach to Diabetes Education
With over two decades as a thought leader in diabetes care and education, Beverly is an inspiring and informational presenter. She can delve deep into the science of diabetes while incorporating real-life applications coupled with a compassionate approach that resonates with healthcare professionals.
Beverly is a relentless advocate for non-judgmental and inclusive diabetes care and believes that we are at our best when we are curious, kind, and engaging.
As a nurse entrepreneur and professional speaker, Beverly champions person-centered and evidence-based diabetes care through her live courses, keynote speeches, and webinar presentations.
Coach Beverly makes it a priority to make time to teach at conferences and organizations across the country. In addition to providing the latest research-based information, she incorporates story telling, games, movement breaks and small group activities.
She believes people learn best when the content is meaningful and fun!
Participants leave feeling energized, inspired, and excited about providing best diabetes care.
See more info here >>
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Rationale of the Week | What do the NEW 2025 ADA Standards Say?
- Renewing your CDCES – Important Updates to Keep in Mind
- Question of the Week | Best Meds to Treat MASH – 2025 Standards
- Rationale of the Week | Low carb diets and SGLT-2’s a good mix?
- Entering the Field of Diabetes Education – Building a Bridge Program
The use of DES products does not guarantee the successful passage of the diabetes certification exams. CBDCE & ADCES does not endorse any preparatory or review materials for the certification exams, except for those published by CBDCE & ADCES.
**To satisfy the requirement for renewal of certification by continuing education for the Certification Board for Diabetes Care & Education (CBDCE), continuing education activities must be applicable to diabetes and approved by a provider on the CBDCE List of Recognized Providers (www.ncbde.org). CBDCE does not approve of continuing education. Diabetes Education Services is accredited/approved by the Commission of Dietetic Registration which is on the list of CBDCE Recognized Providers.
Rationale of the Week | Screening for Celiac Disease
For last week’s practice question, we quizzed participants on screening for celiac disease. Almost half 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: TC is a 15-year-old who was diagnosed with type 1 diabetes just over a year ago. Following their diagnosis, they quickly transitioned to sensor-augmented pump therapy and are not currently taking any other medications. Recent lab results show normal lipid and renal profiles, a hemoglobin A1c of 7.5%, and a fasting glucose level of 148 mg/dL. Despite following a nutrient-rich diet, TC reports experiencing fatigue, difficulty gaining weight, frequent nausea, and diarrhea.
What Standard of Care recommendation may help explain TC’s reported symptoms?
Answer Choices:
- TC’s Hemoglobin A1c is above target. Elevated glucose values could be contributing to fatigue and difficulty with weight gain.
- Ensure IgA tissue transglutaminase (tTG) antibodies, with documentation of normal total serum IgA levels have been checked.
- Recommend a gluten-free diet since individuals with type 1 diabetes can be at higher risk of celiac disease.
- Consider referral for a gastric emptying study given complaint of frequent nausea and diarrhea.
Getting to the Best Answer
Answer 1 is incorrect. 13.97% chose this answer. “TC’s Hemoglobin A1c is above target. Elevated glucose values could be contributing to fatigue and difficulty with weight gain.” 1. Answer 1 is incorrect, as it is not the best answer. Although the ADA Standards of Care state an A1C of <7% is appropriate for many children and adolescents, we must provide additional assessment for TC’s case. Keep reading below.
Answer 2 is correct. 49.71% of you chose this answer. “Ensure IgA tissue transglutaminase (tTG) antibodies, with documentation of normal total serum IgA levels have been checked.” 2. Answer 2 is correct. Screening for celiac disease is recommended in individuals with type 1 diabetes soon after diagnosis or when symptoms occur, such as those reported by TC. It is recommended that IgA tissue transglutaminase (tTG) antibodies be checked, with documentation of normal total serum IgA levels, or IgG tTG and deamidated gliadin antibodies if IgA is deficient.
Answer 3 is incorrect. About 16.53% of respondents chose this. “Recommend a gluten-free diet since individuals with type 1 diabetes can be at higher risk of celiac disease.” 3. Although a gluten-free diet is recommended if TC is diagnosed with celiac disease, it is essential to complete appropriate screening before implementation of a gluten-free diet.
Finally, Answer 4 is incorrect. 19.79% chose this answer. “Consider referral for a gastric emptying study given complaint of frequent nausea and diarrhea.” 4. Although we can see an increased risk of gastroparesis in diabetes, determined by a gastric emptying study, gastroparesis typically develops as a long-term complication of diabetes. Initial recommendations would be to rule out other causes and ensure recommended screening and treatment.
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!
FREE Webinar:
The Impact of Adverse Childhood Experiences on Health
Join us October 29th, 2024 at 11:30 am
Adverse childhood experiences (ACE) are associated with an increased risk of diabetes, heart disease, cancer & a variety of other health consequences for adults. This session reviews how diabetes care & education specialists can provide screening, assessment, & trauma-informed care to individuals who experienced ACEs & are living with toxic stress. We will explore strategies to address ACES & improve outcomes for individuals & communities. Throughout, we will focus on supporting self-care with a focus on recognizing & promoting resilience.
Topics include:
- Discuss the benefits of assessing Adverse Childhood Experiences (ACE) in individuals with diabetes.
- State the relationship between ACE Scores & the risk of future health complications.
- Describe a person-centered approach to fostering resilience & self-care for individuals with toxic stress.
- Identify two strategies to provide trauma-informed care in your work setting.
Intended Audience: These courses are knowledge-based activities designed for individual or groups of diabetes educators, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants and other health care providers interested in enhancing their knowledge of management of inpatient hyperglycemia.
Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator and a nationally recognized diabetes expert.
Two registration options:
- Enroll for FREE (No CEs): Click here to enroll.
- Earn 0.5 CEs – Fee: $19.00 – Click here to enroll in the course.
Enroll in our entire Level 4 | Advanced & Specialty Topic Courses
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Rationale of the Week | What do the NEW 2025 ADA Standards Say?
- Renewing your CDCES – Important Updates to Keep in Mind
- Question of the Week | Best Meds to Treat MASH – 2025 Standards
- Rationale of the Week | Low carb diets and SGLT-2’s a good mix?
- Entering the Field of Diabetes Education – Building a Bridge Program
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Rationale of the Week | KR is Overwhelmed with Insulin Regimen
For last week’s practice question, we quizzed participants on feeling overwhelmed with insulin regimen. 49% 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: KR is a 49-year-old with a learning disability and diabetes for over 20 years and is taking the following classes of diabetes medications at maximum doses; SGLT-2, Sulfonylurea, GLP-1 RA, biguanide and a TZD. Over the past month, KR’s blood glucose levels have increased to over 300 despite a 20-pound weight loss. The endocrinologist starts KR on basal insulin plus bolus insulin at each meal based on blood glucose and carbohydrates consumed. KR arrives for their education appointment in tears, saying “I feel completely overwhelmed and confused about all this insulin stuff.”
What is the best response?
Answer Choices:
- This must seem overwhelming, but I believe that you can do this.
- Let’s review carb counting again, so you feel more confident about calculating your dose.
- Many people starting on insulin feel overwhelmed, but with time it gets easier.
- Let’s start the basal insulin first, then we can tackle the meal bolus when you are ready.
Getting to the Best Answer
Answer 1 is incorrect. 21.01% chose this answer. “This must seem overwhelming, but I believe that you can do this.” Even though this response affirms KR’s ability to count carbs and adjust insulin coverage, it is not a realistic expectation. Given KR’s learning disability and his feelings of being overwhelmed, this complicated insulin management strategy is not the best approach for KR. We need to keep the insulin plan simple, until KR is ready to move forward.
Answer 2 is incorrect. 12.67% of you chose this answer. “Let’s review carb counting again, so you feel more confident about calculating your dose.” While this is a compassionate response, it does not take into account the complexity of the overall insulin management strategy and KR’s feelings of being overwhelmed. We need to keep the insulin plan simple, until KR is ready to move forward.
Answer 3 is incorrect. About 16.84% of respondents chose this. “Many people starting on insulin feel overwhelmed, but with time it gets easier.” This is a compassionate response that doesn’t address the main issue. The insulin plan is not realistic for this individual with a learning disability. We need to keep the insulin plan simple, until KR is ready to move forward.
Finally, Answer 4 is correct. 49.48% chose this answer. “Let’s start the basal insulin first, then we can tackle the meal bolus when you are ready.” YES, this is the best answer and most of you chose this. GREAT JOB. We need to keep the insulin plan simple, until KR is ready to move forward. Start with basal insulin first, until KR seems ready to add on bolus insulin at meals.
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?
There is still time to join us Live in Beautiful San Diego for our
Annual DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content and give away prizes. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at [email protected] with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Rationale of the Week | What do the NEW 2025 ADA Standards Say?
- Renewing your CDCES – Important Updates to Keep in Mind
- Question of the Week | Best Meds to Treat MASH – 2025 Standards
- Rationale of the Week | Low carb diets and SGLT-2’s a good mix?
- Entering the Field of Diabetes Education – Building a Bridge Program
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Rationale of the Week | Why is JR’s blood glucose elevated?
For last week’s practice question, we quizzed participants on why JR’s blood glucose is elevated. The majority 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: During a hospital stay, JR, who has no prior history of diabetes experiences elevated blood glucose levels.
Which of the following factors is the most likely cause of this hyperglycemia during hospitalization?
Answer Choices:
- Increased physical activity during recovery.
- Use of corticosteroids for inflammation.
- Intake of special snacks brought in by their family.
- Decreased fluid intake during the hospital stay.
Getting to the Best Answer
Answer 1 is incorrect. 1.13% chose this answer. “Increased physical activity during recovery.” Physical activity would most likely contribute to lowering glucose levels.
Answer 2 is correct. 92.66% of you chose this answer. “Use of corticosteroids for inflammation.” GREAT JOB. The vast majority of you chose this best answer. Steroids are notorious for increasing insulin resistance and contributing to hyperglycemia.
Answer 3 is incorrect. About 1.69% of respondents chose this. “Intake of special snacks brought in by their family.” While snacks may cause an increase in blood glucose, steroids pack a much more potent glucose raising punch.
Finally, Answer 4 is incorrect. 4.52% chose this answer. “Decreased fluid intake during the hospital stay.” While dehydration is often co-associated with hyperglycemia, it is not likely to cause extreme hyperglycemia. The better answer is steroid therapy as the cause of elevated blood sugars.
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 in Beautiful San Diego for our
Annual DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content and give away prizes. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at [email protected] with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Rationale of the Week | What do the NEW 2025 ADA Standards Say?
- Renewing your CDCES – Important Updates to Keep in Mind
- Question of the Week | Best Meds to Treat MASH – 2025 Standards
- Rationale of the Week | Low carb diets and SGLT-2’s a good mix?
- Entering the Field of Diabetes Education – Building a Bridge Program
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Rationale of the Week | Hypoglycemia and Hospitalization: Is there a Connection?
For last week’s practice question, we quizzed participants on the connection with hypoglycemia and hospitalizations. Almost all of the 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 79 years old and takes insulin 3 times daily. Lately, they have been experiencing increased episodes of hypoglycemia.
Which of the following statements is true regarding hypoglycemia and the risk of hospitalization?
Answer Choices:
- Hypoglycemia is a minor concern and rarely leads to hospitalization.
- Only severe hypoglycemia results in hospitalization.
- Hypoglycemia, whether mild or severe, significantly increases the risk of hospitalization.
- Hospitalization from hypoglycemia is mainly a concern for people with type 1 diabetes.
Getting to the Best Answer
Answer 1 is incorrect. 1.4% chose this answer. “Hypoglycemia is a minor concern and rarely leads to hospitalization.” Hypoglycemia can lead to falls, confusion and loss of consciousness, all of which can precipitate hospitalization.
Answer 2 is incorrect. 1.4% of you chose this answer. “Only severe hypoglycemia results in hospitalization.” Even mild hypoglycemia can lead to falls and confusion, and if not treated, can worsen and result in loss of consciousness and hospitalization.
Answer 3 is correct. About 93.95% of respondents chose this. “Hypoglycemia, whether mild or severe, significantly increases the risk of hospitalization.” GREAT JOB! This is the best answer. Creating a collaborative plan to PREVENT hypoglycemia is especially important for people taking secretagogues or using insulin therapy.
Finally, Answer 4 is incorrect. 3.26% chose this answer. “Hospitalization from hypoglycemia is mainly a concern for people with type 1 diabetes.” Older people with type 2 diabetes and diminished renal function, who use insulin or secretagogues to lower glucose levels, are at risk of severe hypoglycemia and require close glucose monitoring.
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 in Beautiful San Diego for our
Annual DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content and give away prizes. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at [email protected] with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Rationale of the Week | What do the NEW 2025 ADA Standards Say?
- Renewing your CDCES – Important Updates to Keep in Mind
- Question of the Week | Best Meds to Treat MASH – 2025 Standards
- Rationale of the Week | Low carb diets and SGLT-2’s a good mix?
- Entering the Field of Diabetes Education – Building a Bridge Program
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Rationale of the Week | Older Adults & Goals for Care
For last week’s practice question, we quizzed participants on older adults and goals for 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: TS is 82 years old, living with type 1 diabetes for the past 56 years. They present to the clinic with their family for diabetes care and education. TS’s last A1c was 7.6%, with a Time in the Range of 64% and Time below the Range of 1%. TS lives alone and self-manages their medications, and the family reports concern of potential missed insulin doses and dietary intake patterns are less consistent over the past few months.
Considering diabetes management in older adults, what recommendations would you give TS and his family?
Answer Choices:
- TS’s A1C is not at target of less than 7%, recommend behavior modifications and work to improve medication adherence.
- A1C targets need to be liberalized to less than 8% for all older adults to reduce hypoglycemia risk.
- Assess TS’s comorbidities, cognitive function, and life expectancy before providing additional recommendations
- Recommend increased family involvement in TS’s daily diabetes medication management due to missed insulin doses and change in diet intake.
Getting to the Best Answer
Answer 1 is incorrect. 3.76% chose this answer. “TS’s A1c is not at target of less than 7%, recommend behavior modifications and work to improve medication adherence.” Answer 1 is incorrect. The American Diabetes Association 2024 Standards of Care recommends personalizing glycemic targets for adults over 65 depending on comorbidities, cognitive and functional status, and living situations. An A1c of less than 7% may not be appropriate.
Answer 2 is incorrect. 19.95% of you chose this answer. “A1c targets should be liberalized to less than 8% for all older adults to reduce hypoglycemia risk.” Answer 2 is incorrect. While it is true we may liberalize A1c targets for older adults to prevent hypoglycemia, it is not the best answer. Older adults over 65 who are otherwise healthy, have stable coexisting chronic conditions, and have intact functional and cognitive status may benefit from lower glycemic goals (less than 7 to less than 7.5%).
Answer 3 is correct. About 61.74% of respondents chose this. “Assess TS’s comorbidities, cognitive function, and life expectancy before providing additional recommendations.” Answer 3 is the correct action. In older adults with diabetes, assessing comorbidities, cognitive function, and life expectancy is important to allow for the personalization of diabetes management recommendations and care goals.
Finally, Answer 4 is incorrect. 14.55% chose this answer. “Recommend increased family involvement in TS’s daily diabetes medication management due to missed insulin doses and change in diet intake.” Answer 4 is incorrect. We need more information to conclude that TS needs additional family support today. Completing a comprehensive evaluation, including cognitive function screening, is essential before providing recommendations.
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 in Sunny San Diego for our
Annual DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content and give away prizes. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at [email protected] with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Rationale of the Week | What do the NEW 2025 ADA Standards Say?
- Renewing your CDCES – Important Updates to Keep in Mind
- Question of the Week | Best Meds to Treat MASH – 2025 Standards
- Rationale of the Week | Low carb diets and SGLT-2’s a good mix?
- Entering the Field of Diabetes Education – Building a Bridge Program
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Rationale of the Week | Blood Glucose Data Missing – Best Response?
For last week’s practice question, we quizzed participants on best response for missing blood glucose data. 42% 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 returns to clinic after trying to keep a three day 7-point data log. Looking at log, the diabetes specialists notice several blood sugar readings are missing.
What is the best response?
Answer Choices:
-
Good job, but we will need to repeat this experiment since we are missing quite a few results.
-
Looks like you captured most of your blood sugar patterns.
-
I am sorry, but to make insulin adjustments, we are going to need more data.
-
I appreciate you trying. What do you think is stopping you from completing the log?
Getting to the Best Answer
Answer 1 is incorrect. 15.27% chose this answer. “Good job, but we will need to repeat this experiment since we are missing quite a few results.” A 7-point log means that we are asking a person with diabetes to document their before and after meal glucose levels 3 times a day in addition to a middle of the night blood glucose. If we ask them to do this for 3 days, that means they are documenting 21 blood sugars over a 3 day period. If they are only missing several readings, we would consider that a success. We can certainly use the data they have collected to collaborate on problem solving and strategizing to support their future goals.
Answer 2 is correct. 42.02% of you chose this answer. “Looks like you captured most of your blood sugar patterns.” Yes, GREAT JOB! If they are only missing several readings, we would consider that a success. We can certainly use the data they have collected to collaborate on problem solving and strategizing to support their future goals.
Answer 3 is incorrect. About 10.12% of respondents chose this. “I am sorry, but to make insulin adjustments, we are going to need more data.” A 7-point log means that we are asking a person with diabetes to document their before and after meal glucose levels 3 times a day in addition to a middle of the night blood glucose. If we ask them to do this for 3 days, that means they are documenting 21 blood sugars over a 3 day period. If they are only missing several readings, we would consider that a success. We can certainly use the data they have collected to collaborate on problem solving and strategizing to support their future goals.
Finally, Answer 4 is incorrect. 32.59% chose this answer. “I appreciate you trying. What do you think is stopping you from completing the log?” If they are only missing several readings, we would consider that a success. We can certainly use the data they have collected to collaborate on problem solving and strategizing to support their future goals.
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 in Beautiful San Diego for our
Annual DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at [email protected] with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Rationale of the Week | What do the NEW 2025 ADA Standards Say?
- Renewing your CDCES – Important Updates to Keep in Mind
- Question of the Week | Best Meds to Treat MASH – 2025 Standards
- Rationale of the Week | Low carb diets and SGLT-2’s a good mix?
- Entering the Field of Diabetes Education – Building a Bridge Program
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
![](/wp-content/uploads/2023/01/insta-png-v5.png")
