For last week’s practice question, we quizzed participants on 2025 ADA Standards & hyperglycemic crises. 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: What do the NEW 2025 ADA Standards Say?
According to the Newly Published 2025 Standards of Care, which of the following statements reflect the latest guidelines to treat hyperglycemic crises?
Answer Choices:
Answer 1 is correct. 43.04% chose this answer. “Administer low dose basal insulin analog in addition to intravenous insulin infusion to improve glucose management.” YES, great job, this is the best answer. According to ADA Standard 16 on Hospital Care, “Studies have reported that the administration of a low dose of basal insulin analog in addition to intravenous insulin infusion may prevent rebound hyperglycemia without increased risk of hypoglycemia.”
Answer 2 is incorrect. 19.59% of you chose this answer. “If serum pH is below 7.4, administer IV bicarb, along with a glucose infusion to resolve severe acidosis.” Since this pH is in the normal range, this person is not in ketoacidosis. According to ADA Standard 16 on Hospital Care, “Several studies have shown that the use of bicarbonate in people with DKA made no difference in the resolution of acidosis or time to discharge, and its use is generally not recommended.”
Answer 3 is incorrect. About 20.10% of respondents chose this. “To differentiate between DKA and HHS, the most important lab indicators are the anion gap and glucose levels.” According to the 2024 Consensus Statement, to differentiate between the two conditions, the most decisive lab indicators are beta hydroxybutyrate or urine ketones to verify insulin deficiency along with pH levels to verify acidosis and osmolality to determine hydration status in HHS.
Finally, Answer 4 is incorrect. 17.27% chose this answer. “Lactated Ringers is now the preferred intravenous solution for fluid resuscitation.” According to the 2024 Consensus Statement, Normal saline or Ringer’s lactate are both accepted IV rehydration solutions.
You are invited to register for our Hyperglycemic Crises – New criteria and treatment guidelines for DKA, Euglycemic DKA and HHS | 1.25 CE – Recorded and Ready for Viewing.
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!
This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the annual updates to the American Diabetes Association’s (ADA) Standard of Medical Care in Diabetes & provides critical teaching points & content for healthcare professionals involved in diabetes care & education.
Objectives:
Learning Outcome: Participants will identify updates and articulate recommendations from the 2024 ADA Standards of Care that can be applied to their practice.
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.
Register above or simply visit our website.
For more information or any questions, please email [email protected].
All hours earned count toward your CDCES Accreditation Information
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.
In the 2025 ADA Standards, they have updated the term Non-Alcoholic Steatohepatitis (NASH) to Metabolic Associated Steatohepatitis (MASH). They also recommend pharmacologic agents along with lifestyle interventions to treat people with diabetes and MASH.
Which of the following are the recommended diabetes medications to treat MASH?
Join us live on December 17, 2024, at 11:30 am PST for our Level 2 | Meds Management Update for Type 2 Diabetes
Title: Level 2 | Meds Management Update for Type 2 Diabetes | 1.5 CEs
This course is included in: Level 2 – Standards of Care. Purchase this course individually for $29 or enroll in the entire bundle and save 45% (discount already applied). Don’t worry if you can’t make it live, your registration gives you access to the recorded version for a full year.
Diabetes Education Services Online University Courses are an excellent way to study for your exam anytime and anywhere that is convenient for you. You will have immediate access to your courses for 1 year after your purchase date. Each online course includes a: video presentation, podcast, practice test, and additional resources.
All hours earned count toward your CDCES Accreditation Information
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.
For last week’s practice question, we quizzed participants on SGLT-2’s & low carb diets. 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: ST is a 56-year-old presenting for MNT and diabetes education. Their last A1c was 7.4%, and they are currently taking 1000 mg of Metformin and 10 mg of empagliflozin daily for glucose management. They recently read that a very low-carbohydrate eating pattern can help individuals with type 2 diabetes reduce A1C and the need for additional medications and are motivated to implement diet changes.
What would be your primary considerations and guidance in response to ST?
Answer Choices:
Answer 1 is incorrect. 10.61% chose this answer. “ST is motivated for change, encourage their desire to implement a very low-carbohydrate diet as it is safe for all individuals with diabetes.” While very-low-carbohydrate diets has evidence for reducing A1c and need for additional medications, they may not be universally safe for all individuals. Keep reading to learn more.
Answer 2 is incorrect. 12.77% of you chose this answer. “ST should avoid a very low-carbohydrate diet.” A very-low-carbohydrate diet is not inherently contraindicated for individuals with diabetes, but careful planning and potential discontinuation of the SGLT2 inhibitor is recommended to reduce the risk of euglycemic ketoacidosis.
Answer 3 is correct. About 59.53% of respondents chose this. “A very low-carbohydrate diet may be appropriate if ST transitions off the SGLT2 inhibitor.” Use SGLT2 inhibitors with caution when implementing a low carbohydrate diet and strong consideration should be made to cease this medication if implementing a very low carbohydrate diet, less than 50 grams of carbohydrate per day. Very low carbohydrate diets may increase the risk of euglycemic ketoacidosis by lowering insulin levels. After additional clinical review, a very-low-carbohydrate diet can be considered for ST if they transition off the SGLT2 inhibitor. Educating ST about the difference between physiological ketosis and pathological ketoacidosis may also be considered.
Finally, Answer 4 is incorrect. 17.09% chose this answer. “ST should follow a fixed carbohydrate intake at each meal to align with their medication regimen.” While fixed carbohydrate intake can sometimes simplify diabetes management, it does not align with ST’s interest in very-low-carbohydrate eating patterns. The current medication regimen does not necessarily require a fixed carbohydrate plan. Simply educating on this approach without additional shared decision making may not provide an individualized dietary intervention.
Reference: American Diabetes Association Professional Practice Committee; 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024. Diabetes Care 1 January 2024; 47 (Supplement_1): S77–S110. https://doi.org/10.2337/dc24-S005
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!
All hours earned count toward your CDCES Accreditation Information
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.
We are geared up to help grow and mentor future diabetes specialists to meet the increasing and varied needs of our diabetes community, but we need your help.
Over the next 10 years we are “Building a Bridge” to welcome a thousand new diabetes educators into the field. If you know a healthcare professional seeking a new challenge and eager to pursue a meaningful and rewarding specialty, please invite them to consider becoming a Certified Diabetes Care and Education Specialist (CDCES).
To reach the goal of encouraging healthcare professionals to enter the field, we have created a new FREE webinar that outlines the benefits and steps involved in “Becoming a Diabetes Specialist.” We want to share this information with as many healthcare professionals as possible to encourage them to consider specializing in diabetes.
Our goal is to cast this net far and wide to address the rising prevalence of diabetes. Currently, 16% of people in the United States live with diabetes, and over 38% live with prediabetes according to the CDC. Diabetes is more prevalent in communities of color and impacts individuals with less income and resources. CDCES’s are influential in addressing health disparities and promoting equitable care through their work in health care settings across the country.
On a personal note, becoming a CDCES is one of the best professional decisions I have ever made. This certification has opened the door to many opportunities and dramatically increased my job satisfaction.
Currently, there are 19,500 healthcare professionals with the CDCES credential, including registered nurses (RNs), nurse practitioners (NPs), registered dietitian nutritionists (RDNs), pharmacists, physicians, and physician assistants (PAs)es. At Diabetes Education Services, we are trying to enhance diversity within the CDCES community through our scholarship programs, to encourage a broader range of applicants to pursue certification. We are planning to offer more scholarships in the future to reach our goal of welcoming a thousand new educators into this profession.
There is more to be done, and we appreciate your help speaking to colleagues and letting them know about the benefits of becoming a CDCES. If you are part of a healthcare organization and want Coach Beverly to present the steps involved in becoming a Diabetes Specialist, we are happy to provide a virtual presentation at no cost. Please reach out to discuss details at [email protected].
1. Improving Diabetes Outcomes and Quality of Life
2. Addressing Health Disparities:
3. Reducing Healthcare Costs:
4. Expansion of Care Models:
Visit the official CBDCE website or relevant professional bodies for more detailed guidance or recent updates.
Visit our CDCES Prep Page for more information and to register for FREE Webinars with lots of helpful information.
Building a Bridge Program: At Diabetes Education Services, our goal is to mentor the next generation of Certified Diabetes Care and Education Specialists (CDCES). We are committed to welcoming healthcare professionals with diverse experiences and backgrounds to enter the diabetes field. Our online programs and scholarship programs aim to provide emerging CDCES professionals with the knowledge, skills, and confidence to address the unique challenges encountered by people with diabetes from all walks of life, while also preparing them for certification.
Our FREE webinars will help you discover the steps required to become a CDCES and will transform your test anxiety into calm self-confidence and test-taking readiness.
If you are a health care professional considering becoming a CDCES and want to learn more about eligibility and benefits of joining the Diabetes Education Community, this FREE webinar is for YOU. Coach Beverly will provide clarification on requirements, exam content, and study strategies to prepare for success.
We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers. We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers.
Author, Nurse, Educator, Clinician, and Innovator, Beverly has specialized in diabetes management for over twenty years and has successfully passed the CDCES exam six times. As president and founder of Diabetes Education Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes.
“Becoming a Certified Diabetes Care and Education Specialist (CDCES) is one of the best professional and personal decisions I have ever made.” – Coach Beverly Thomassian
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.
What do the NEW 2025 ADA Standards Say?
According to the Newly Published 2025 Standards of Care, which of the following statements reflect the latest guidelines to treat hyperglycemic crises?
Register above or simply visit our website.
For more information or any questions, please email [email protected].
All hours earned count toward your CDCES Accreditation Information
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.
Happy December Subscriber
Greetings to my wonderful healthcare colleagues.
In this newsletter, we are excited to announce our ambitious ten-year goal that officially kicks off in 2025. We aim to welcome one thousand new diabetes educators with diverse lived experiences into our community of educators and advocates over the next ten years. We want to raise awareness about the rewards of becoming a diabetes specialist to our healthcare professional colleagues, who may be unaware that this specialty is an option.
Let’s get the word out to colleagues about the benefits of becoming a CDCES or BC-ADM. To increase access, we have created a free webinar on the steps involved in “Becoming a Diabetes Specialist” that will air for the first time on December 18th. We are excited to open the doors to new colleagues and encourage them to seek certification. As the rates of diabetes continue to rise, we need all hands on deck.
We also highlight the 2024 Nobel Prize winners who discovered a link that might help treat both type 1 diabetes and celiac disease. We clarify the new requirements for renewing our CDCES and recognize all the Diabetes Awareness Activities that our colleagues made happen in their communities.
We enjoy several seasonal recipes by our guest contributor, Dawn DeSoto, RD, and CDCES, which are perfect for the winter season. Challenge yourself with our Question and Rationale of the Week.
Thank you for all the love and care you have provided this year. I know you touch the lives and hearts of many people who boldly try their best to self-manage their diabetes, and we are grateful for you!
With gratitude and appreciation,
Coach Beverly, Bryanna, Tiffany, Christine, Andrew, and Ginger
Announcements ___________________________ |
Our FREE webinars will help you discover the steps required to become a CDCES and will transform your test anxiety into calm self-confidence and test-taking readiness.
If you are a health care professional considering becoming a CDCES and want to learn more about eligibility and benefits of joining the Diabetes Education Community, this FREE webinar is for YOU. Coach Beverly will provide clarification on requirements, exam content, and study strategies to prepare for success.
We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers.We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers.
Are you considering pursuing certification in diabetes care, but are not sure which certification is right for you and how to get started?
Coach Beverly is excited to share her insights on determining the best certification choice and the pathway to success. She will share her personal journey on achieving both her CDCES and BC-ADM over 20 years ago and how these credentials have impacted her opportunities as a diabetes specialist and president of her own company. We hope you can join us!
Author, Nurse, Educator, Clinician, and Innovator, Beverly has specialized in diabetes management for over twenty years and has successfully passed the CDCES exam six times. As president and founder of Diabetes Education Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes.
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.
Our FREE webinars will help you discover the steps required to become a CDCES and will transform your test anxiety into calm self-confidence and test-taking readiness.
If you are a health care professional considering becoming a CDCES and want to learn more about eligibility and benefits of joining the Diabetes Education Community, this FREE webinar is for YOU. Coach Beverly will provide clarification on requirements, exam content, and study strategies to prepare for success.
We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers.We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers.
Are you considering pursuing certification in diabetes care, but are not sure which certification is right for you and how to get started?
Coach Beverly is excited to share her insights on determining the best certification choice and the pathway to success. She will share her personal journey on achieving both her CDCES and BC-ADM over 20 years ago and how these credentials have impacted her opportunities as a diabetes specialist and president of her own company. We hope you can join us!
Author, Nurse, Educator, Clinician, and Innovator, Beverly has specialized in diabetes management for over twenty years and has successfully passed the CDCES exam six times. As president and founder of Diabetes Education Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes.
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.
For last week’s practice question, we quizzed participants on what steps to address an elevated A1C. 56% 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: KT is a 17-year-old with newly diagnosed diabetes and an A1C of 13.6%. The provider starts KT on 30 units of basal insulin and 10mg empagliflozin (Jardiance). KT is asked to get C-peptide levels checked and their C-peptide level is 0.9 ng/mL.
Based on this information, what is the next most important step?
Answer Choices:
Answer 1 is incorrect. 20.78% chose this answer. “Add bolus insulin and stop empagliflozin.” Since KT’s c-peptide level is 0.9ng/mL, it is between the normal range of 0.5 and 2.0 nanograms per milliliter (ng/mL). This means there is no urgent need to start KT on basal bolus insulin therapy, as long as we have basal insulin on board and we are monitoring blood glucose levels. According to ADA Standards, we can continue both the basal insulin and Jardiance and even consider adding metformin or a pediatric approved GLP-1 RA. Once we have the type 1 antibody results, we can determine best path forward.
Answer 2 is incorrect. 14.29% of you chose this answer. “Discuss the importance of starting CGM.” While it is important to monitor glucose levels, this is not the MOST important next step. To determine if KT has type 1 diabetes, we quickly need to evaluate if they are experiencing autoimmunity by testing for these; autoantibodies to insulin, GAD, islet antigen 2, ZnT8. If one or more of these comes back positive, it verifies KT has immune mediated type 1 diabetes and has a clear indication for basal bolus insulin therapy.
Answer 3 is correct. About 56.40% of respondents chose this. “Evaluate auto immune markers.” YES, GREAT JOB. This is the best answer. Since KT’s C-peptide is within the normal range, we need to evaluate immune markers. To determine if KT has type 1 diabetes, we quickly need to evaluate autoimmunity by testing for; autoantibodies to insulin, GAD, islet antigen 2, ZnT8. If one or more of these comes back positive, it verifies KT has immune mediated type 1 diabetes and is an indication for basal bolus insulin therapy.
Finally, Answer 4 is incorrect. 8.53% chose this answer. “Decrease basal insulin and start metformin.” Given that KT’s C-peptide is in normal range, we certainly could consider adding metformin and decreasing basal insulin. However, KT may still be in the honey moon phase and may be producing some insulin. For this reason, to determine if KT has type 1 diabetes, we quickly need to evaluate autoimmunity by testing for; autoantibodies to insulin, GAD, islet antigen 2, ZnT8. If one or more of these comes back positive, it verifies KT has immune mediated type 1 diabetes and is an indication for basal bolus insulin therapy.
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!
In this exciting webinar, Coach Beverly walks participants through the “Management of Hyperglycemia in Type 2 Diabetes” as outlined by the most recent American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes guidelines. She kicks it off with a brief overview of the different classes of medications and then uses a case study approach to apply the ADA algorithm.
Objectives:
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our Level 2 | Meds Management Update for Type 2 Diabetes awards 1.5 CPEUs in accordance with the Commission on Dietetic Registration’s CPEU Prior Approval Program.
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
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Diabetes Education Services offers education and training to diabetes educators in the areas of both Type 1 and Type 2 Diabetes for the novice to the established professional. Whether you are training to be a Certified Diabetes Care and Education Specialist (CDCES), practicing at an advanced level and interested in board certification, or a health care professional and/or Certified Diabetes Care and Education Specialist (CDCES) who needs continuing education hours to renew your license or CDCES, we have diabetes education information, resources and training; learning and teaching tools; and diabetes online courses available for continuing education (CE). Read our disclaimer for full disclosure.