Technology Toolkit Rescheduled| Pumps and Sensors + Insulin Pump Calculations

Live Stream Webinar Date Change

Due to technical difficulty during our July 21st course, we are re-recording session 1 and adding a new date for session 2. We apologize in advance for the inconvenience and we appreciate your patience.

Join us live on July 28th and 30th
3 CEs | $59.00

July 28 |Tech 101 – Pumps and Sensors Update and Overview | 11:30 am PDT

Join Coach Beverly for an overview of the complex world of insulin pumps and continuous glucose monitors. This webinar will discuss the features of available technologies, basic functions and how to integrate these into our practice. We will discuss the benefits, considerations and critical information to share with clients and providers.

July 30 | Tech 102 – Insulin Pump Calculations; From basal to square bolus | 11:30 am PDT

Determining basal and bolus rates for insulin pumps can seem overwhelming. This course provides participants with a step-by-step approach to determine basal rates, bolus ratios and how to problem solve when blood glucose levels aren’t on target. Included is a discussion on DKA recognition and an explanation of the safe use of technology in the hospital setting.

Perfect for those planning to take the CDCES / BC-ADM or for those who want to learn more about the technology used to manage diabetes.

As Diabetes Care and Education Specialists, we are expected to have expertise in diabetes technologies to improve person-centered care and optimize outcomes.

Yet, when it comes to insulin pumps, sensors, and calculations many of us feel overwhelmed and unsure about diabetes technology management. Coach Beverly created this 2-part Technology Toolkit to provide you with critical information on Insulin Pumps, Calculations, and Continuous Glucose Monitors. 

If you want cutting edge information on diabetes technology, problem-solving, and using a formula to determine appropriate insulin dosing, we highly recommend this toolkit.

Enroll Now | 3 CEs

Can’t join us live? Recorded video and podcast versions are ready for On-Demand Viewing. All updates webinars are uploaded within 4 hours of the live show ending.


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AccreditationDiabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

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

New Rapid Bolus Insulin Approved

This newly FDA approved rapid-acting insulin analog is aimed at reducing post-meal glucose spikes.

Lyumjev also known as insulin lispro-aabc, is approved for adults with Type 1 or Type 2 diabetes, can be taken before meals or even 20 minutes into the meal.

Insulin lispro-aabc (Lyumjev) by Lilly is comparable to Fiasp by Novo Nordisk since they are both very rapid-acting insulins that are detectable in the circulation within minutes of injection.

Insulin lispro-aabc (Lyumjev) appears in circulation approximately 1 minute after injection, peaks at 57 minutes and has an effective duration of about four to five hours. The safety and effectiveness of pediatrics with diabetes has not been established.

Description:

Insulin lispro-aabc (Lyumjev) is produced by recombinant DNA technology using a non-pathogenic strain of E coli. Insulin lispro-aabc differs from human insulin due to a switching of lysine and proline in the B28 and B29 position. Its chemical name is Lys(B28), Pro(B29) human insulin analog. See the package insert for more information.

Lys(B28), Pro(B29) human insulin lispro-aabc

Pricing:
Insulin lispro-aabc (Lyumjev) will be offered at the same price as lispro (Humalog). Lilly will also offer Lyumjev at $35 per month for people who are uninsured or have commercial insurance through its Insulin Value Program. The $35 cap applies regardless of the number of insulin doses required.

How supplied:
Insulin lispro-aabc (Lyumjev) comes in two strengths: U-100 (100 units per milliliter) and U-200 (200 units per milliliter) and a variety of delivery options, including the Junior KwikPen® which allows for 0.5 unit dosing increments.

Lyumjev Injection: 100 units/mL (U-100) available as:
• 10 mL multiple-dose vial
– 3 mL 300 unit KwikPen® (5 pens)
• 3 mL 300 unit Junior KwikPen® 0.5 unit dose increment (5 pens)
• 3 mL 300 unit Tempo Pen™ (5 pens)
• 3 mL 300 unit cartridges (5 cartridges)

Lyumjev Injection: 200 units/mL (U-200) available as:
• 3 mL KwikPen® (2 pens with 600 units each)

Storage:
Discard opened or unopened insulin lispro-aabc (Lyumjev) vials, pens, and cartridges stored at room temperature below 86°F (30°C) after 28 days.

Stay tuned for more new insulin approvals and updates to our Insulin PocketCards!


We are expanding our Online University. Check out our new bundle!

Level 3 | Boot Camp + Expert Team Bundle
Join us live starting September 16th!

When you join our DiabetesEd Certification Boot Camp, it’s like having your own online coaching staff.

?In each webinar, either Coach Beverly, Dr. Isaacs, or Ms. Armstrong, highlight the critical content of each topic area, so you can focus your study time most efficiently. They also launch multiple poll questions to help participants focus on key concepts and assess their knowledge while learning the best test-taking strategies. 

Mastery of this content is critical to ensure certification exam success and to improve clinical outcomes.

Click here to download Level 3 + Expert Bundle flyer Enroll Today!


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AccreditationDiabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

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

Rising HgbA1c Levels in Youth Despite Advanced Technologies | Tech Thursday

Young adults and youth with diabetes in the United States have rising HgbA1c’s despite advances in diabetes technologies.

At the recent virtual ADA Scientific Sessions, Faisal Malik MD, MSHS, shared findings from the SEARCH for Diabetes in Youth studies, which are funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the CDC.

According to Dr. Faisal Malik, by comparing results found in 2002-2007 (HbA1c mean, 8.6%) SEARCH studies to more recent data from 2014-2019 (HbA1c mean, 8.7%), we see that glycemic responses continue to rise for younger people.

“These results suggest that not all youth and young adults with diabetes are directly benefiting from the increased availability of diabetes technology, newer therapies, and the use of more aggressive glycemic targets for youth with diabetes over time,” said Dr. Faisal Malik.

Supporting Young Adults Living with Diabetes

For many, our teenage years and early adulthood are challenging, this pivotal time in our lives becomes even more challenging when we have the responsibility of managing diabetes. This population needs a lot of support.

We can offer more support through an increase of interventions including support groups, scheduled routine follow up visits, family and peer support groups, in addition to the newer therapies and advanced technology.

In addition, support networks like The College Diabetes Network for college-age youth transitioning to college is another resource for this age group.

This age group needs our support, empathy, and compassion, to successfully meet the challenges of managing type 1 and type 2 diabetes.

Written by Catherine Cullinane RN, CDCES, our resident Tech Thursday Content Writer

Read more here.


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!


AccreditationDiabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

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

Telemedicine in Rural Areas lead to A1c Improvements

COVID-19 has changed the landscape of how healthcare services are delivered in the U.S.

In our new “normal,” many healthcare professionals have begun to adopt telehealth/telemedicine services.

Is this new method leading to positive outcomes?

In a Veterans Health Administration program that combined Intensive telemonitoring, self-management and medication support, there were improved A1c levels within six months for those with diabetes residing in rural areas.

After 6 months of telehealth interventions, researchers of the Advanced Comprehensive Diabetes Care (ACDC), found a 1.36% reduction of HBA1c levels.

Specialists created custom-tailored intensive diabetes management interventions by using telehealth and electronic records systems.

Overall, the results from the ACDC programs across 7 VHA sites showed an overall improvement of “HbA1c, blood pressure, and diabetes self-care.”

People living in rural areas tend to have limited access to specialty care and diabetes management programs. By using telemedicine services we can create more opportunities for people living in rural areas to better manage their diabetes.

To read more, click here.


Meds Management for Type 2 |
Standards of Care Intensive 2020
Join us on June 25, 2020, at 11:30 am (PST) 
1.5 CE | $29.00 or No CEsFree

This advanced-level course is designed to help participants determine the best medication choice based on the patient’s unique characteristics. The content incorporates the management guidelines published by the American Association of Clinical Endocrinologists (AACE) and the American Diabetes Association (ADA) Algorithms. We will discuss the role of lifestyle changes and review the pros and cons of available diabetes medications using a patient-centered approach. In addition, we discuss medication algorithms in detail. Participants not familiar with the basics of diabetes medication may benefit from first enrolling in our “Meds for Type 2” and “Insulin 101 Course.”

Register for FREE live stream webinar (no CEs).


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!


AccreditationDiabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

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

Does Video Gaming Affect Food Choices? | Tech Thursday

College-aged men who play video games consumed less healthy foods than their non-gaming peers, according to data presented at Nutrition 2020 Live Online.

“Video game usage has been studied extensively in children and adolescence, less in adults, and to our knowledge not at all in college students. Because college students are presented with a unique experience compared to other adults and children, it is important to understand how video game users in this specific population behave,” stated Dustin G. Moore, a graduate student at the University of New Hampshire, told Healio Primary care.

Male college students who were moderate or heavy video game players ate more saturated fat than those who did not play video games. While those who were moderate gamers consumed more salt than those who did not play video games, according to the data presented at Nutrition 2020 Live Online.

Heavy video game playing was also associated with consuming more discretionary calories when compared with those who don’t play. Men who were moderate and heavy video game users consumed fewer fruits and vegetables.

There appeared to be no significant differences in alcohol consumption, sugar, total dietary fat, and waist circumferences.

“This is a concerning finding because previous research has shown that lifestyle habits in early adulthood tend to continue later in life,” Jesse S. Morrell, PhD, principal lecturer for the nutrition program at the University of New Hampshire, said in an interview. “If these poor lifestyle habits continue, this population will be at higher risk for [above target weight] and chronic disease.”

It would be interesting to track video game time vs outdoor physical activity time in this same group, and comparing eating habits.

As diabetes specialist invested in the health of future generations, it is important to encourage physical activity and healthy eating in all age groups, but especially in the college-age group.

College is often the first time teens are living away from home, and making independent choices on food and meals.

To read more, click here.

Written by Catherine Cullinane RN, CDCES, our resident Tech Thursday Content Writer


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!


AccreditationDiabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

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

Vitamin D, Diabetes, & COVID-19 | Tech Thursday

Interesting findings that explore the relationship between Vitamin D levels and COVID-19 outcomes are being released.

In an article by WedMD, there have been several international studies that evaluate Vitamin D levels in people infected with COVID-19.

None of these studies indicate definitively if higher levels of Vitamin D reduce the risk of contracting or becoming severely ill with COVID-19. Though, they’ve noticed that the “sickest” people with COVID-19 had low levels of Vitamin D.

Several studies conducted across different countries indicate that a healthy level of Vitamin D might strengthen our immune system and reduce our vulnerability to disease.

Vitamin D is so important for our bones, muscles, and a nutrient our immune systems need for optimal health. An adequate blood level of Vitamin D is between 20 nanograms/milliliter to 50 mg/ml. A simple but slightly costly blood test can measure one’s level of this vitamin.

People living with diabetes (type 1 & type 2) often have lower levels of Vitamin D. Vitamin D deficiency can manifest as fatigue, depression, muscle and bone pain, and decreased overall health.

Boosting Vitamin D Levels

Lifestyle changes can be used to treat low Vitamin D levels; eating healthy foods like eggs, mushrooms, fresh fish, and getting outside in sunlight, can increase our Vitamin D levels. As a supplement, Vitamin D3 or cholecalciferol is recommended at a dose of 400-1000 IU /day.

Vitamin D is made by the body when the skin is exposed to sunlight. Often people in the Northern Hemisphere with less sun exposure have lower levels of Vitamin D. Regular sun exposure can help increase Vitamin D levels, although supplementation seems to be more effective.

In addition, improving access to healthy foods needs to be a priority for all people, but especially vulnerable populations and those with diabetes.

For more information, read the WebMD article here. We also recommend you read Vitamin D and Type 1 Diabetes: What the Research Says & Higher vitamin D levels linked to lower risk for diabetes. Click here for NIH Vita D Info page.

Update

Healio has released more information on this topic that you can find on their recent article, “Researchers caution against ‘misinformation’ on vitamin D during COVID-19 pandemic.”

Written by Catherine Cullinane RN, CDCES, our resident Tech Thursday Content Writer


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!


AccreditationDiabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

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

Update for CMS Guidelines for CGM Coverage | Tech Thursday

Last week we posted a blog titled “CMS Updates For CGM Coverage,” which on the surface seemed like very exciting, impactful changes on CMS regulations for CGM coverage during the COVID-19 pandemic.

After sharing this post, members of our community let us know that although CMS guidelines have been relaxed in writing, this hasn’t translated into better access on the ground.

What do these changes actually mean?

To learn more we dove into the interim final rule with comment period (IFC) that was released by the Department of Health & Human Services – Centers for Medicare & Medicaid Services.

 In the March 31st COVID-19 IFC, we finalized on an interim basis that we will not enforce the clinical indications for coverage across respiratory, home anticoagulation management, and infusion pump NCDs (Nation Coverage Determinations) and LCDs (Local Coverage Determinations) (including articles) allowing for more flexibility for practitioners to care for their patients. This enforcement discretion will only apply during the PHE for the COVID-19 pandemic. 

The language in the IFC is vague and ambiguous regarding what it means to have less stringent and “more flexible” requirements of obtaining a CGM in the time of the COVID-19 for people with diabetes. Though we have found a few highlights from the document based on feedback by our community on what is unclear.

The Highlights

  1. These changes are only applicable to those who are COVID-19 positive and living with diabetes.
  2. The type of diabetes one has is no longer relevant in coverage determinations.
  3. These guidelines do not automatically expand to Medicaid coverage. For more details on Medicaid coverage, contact your local state.

In this IFC, we are finalizing on an interim basis that we will not enforce the clinical indications for therapeutic continuous glucose monitors in LCDs. For example, we will not enforce the current clinical indications restricting the type of diabetes that a beneficiary must have or relating to the demonstrated need for frequent blood glucose testing in order to permit COVID-19 infected patients with diabetes to receive a Medicare-covered therapeutic continuous glucose monitor.  

Overall, there is still much to learn about these changes as they apply to real-life situations. This is an unprecedented time for all of us and there is a lot of unknowing. We hope as things develop to keep you informed.

To read the full IFC click here. For more information about Medicaid Guidelines, click here.

If you have any more information on these changes, please click here to visit our survey to update us.

Update from Michael Christian breaking down the CMS changes.

Written by Catherine Cullinane RN, CDCES, our resident Tech Thursday Content Writer


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!


AccreditationDiabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

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

Has Access to CGM Coverage Improved with CMS updates? We want to hear from you!

Yesterday, we shared our blog about the CMS Updates For CGM Coverage. These updates made us feel hopeful that people with diabetes would have fewer barriers and improved access to CGM devices.

After sharing this post, members of our community let us know that although CMS guidelines have been relaxed in writing, this hasn’t translated into better access on the ground.

What is your experience with accessing CGMs for people with diabetes?

We are hoping to open up a dialogue around this topic and hear from our community members about how these guidelines apply to real-life situations.

If you have information to share, please fill out our brief survey by clicking here.

We will send a follow-up post next week with updates.


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!