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For last week’s practice question, we quizzed participants on the benefits of once weekly insulin Icodec. 82% 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 by clicking here.
A 62-year-old person with type 2 diabetes has an A1C of 9.1% despite metformin, SGLT-2i and a GLP-1 receptor agonist. You are considering once-weekly insulin icodec when it becomes available.
Which of the following is the most appropriate rationale for selecting insulin icodec (Awiqli) therapy?
What is the BEST response?
Answer A is incorrect. 5.42% chose this answer, “Eliminates the risk of hypoglycemia compared to daily basal insulin.”Although this insulin has a long steady half-life, it still peaks between day 2 to 4, with a slight increased risk of hypoglycemia during this period. And, since it is insulin, the risk of hypoglycemia is always a consideration.
Answer 2 is incorrect. 5.07% of you chose this answer, “Provides superior A1C reduction compared to all daily basal insulins.” Answer B is incorrect. Insulin icodec is considered non-inferior and has a similar glucose lowering impact when compared to other available basal insulins. However, since it only requires once a week injection, it may be easier to stick with in the long term.
Answer C is incorrect. About 7.17% of respondents chose this: “Does not require dose titration due to its long duration of action.” The manufacturers recommend adjusting doing units no more than every few weeks, depending on glucose response and safety.
Finally, Answer 4 is correct. 82.34% chose this answer, “Reduces injection frequency while improving time-in-range.” Yes great job. This is the best answer. On this ultra long insulin, people only need one basal insulin injection a week. Studies also indicate that this insulin improves time in range with less glucose variability.
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!
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Glucagon-like peptide-1 (GLP-1) receptor agonists and GLP/GIP class of medications have seen significant advancements in the past year and 2026 promises to offer even more advancements.
The FDA granted accelerated approval in March 2026 for a high-dose (HD) injectable version of Wegovy of 7.2 mg once weekly. Until now, the highest approved dose for Wegovy—the weight loss formulation of the GLP-1 receptor agonist semaglutide—was 2.4 mg weekly.
Many individuals on the maximum 2.4 mg dose eventually reach a weight loss plateau, prompting researchers to explore whether higher dosing could extend weight reduction. Clinical trials demonstrate that increasing the dose to 7.2 mg weekly can lead to additional weight loss of up to ~20–21% from baseline, representing a meaningful advancement for those needing further support.
As expected, gastrointestinal side effects increase with higher doses, particularly, nausea, vomiting, diarrhea and early satiety. As with the other incretin medications, encourage smaller, lower fat meals that are high in nutrients. Remind individuals to keep hydrated and if the nausea persists, they may benefit from anti-nausea medications.
A major step forward in pediatric diabetes care is the recent expansion of tirzepatide (Mounjaro) into younger populations. With emerging data and regulatory progress, tirzepatide is being recognized as a potential option for youth with type 2 diabetes and extra weight, offering another powerful new tool to improve metabolic measures for young people with diabetes.
This update reflects a broader shift toward earlier, more effective interventions in youth with diabetes and elevated body weight, aligning with current guidelines that emphasize person-centered, individualized care.
A new advancement in weight management is the availability of Oral Wegovy (oral semaglutide), now with dosing options up to a maximum of 25 mg once daily. This expanded dosing offers a non-injectable alternative for individuals seeking the benefits of GLP-1–based therapy for weight management, while maintaining meaningful efficacy.
As with other oral semaglutide formulations, administration technique is critical—it should be taken on an empty stomach with a small amount of water, with no food, beverages, or other medications for at least 30 minutes to optimize absorption.
Higher-dose oral therapy may help individuals who have reached a weight plateau or who require more intensive pharmacologic support, aligning with evolving treatment strategies that prioritize person-centered care and individualized therapy.
As always, it is important to provide guidance on gradual dose escalation and management of gastrointestinal side effects, ensuring individuals are supported every step of the way.
In an effort to streamline GLP-1 therapy across formulations, Rybelsus (oral semaglutide) 1.5 mg, 4 mg, and 9 mg doses, is being rebranded as Oral Ozempic. The original Rybelsus 3, 7, and 14 doses will eventually be phased out. This naming alignment reflects the same active molecule—semaglutide—used in injectable Ozempic and Wegovy, helping reduce confusion and reinforce class familiarity among individuals and providers.
As with prior oral semaglutide formulations, proper administration remains key: it should be taken on an empty stomach with a small amount of water, with no food, beverages, or other medications for at least 30 minutes to ensure optimal absorption.
This update represents another step toward clarifying and simplifying diabetes treatment options.
We have also updated our Insulin PocketCard to include the newly approved ultra-long-acting insulin icodec.
This once weekly insulin may be especially valuable for:
This is where your role as a healthcare professional becomes even more powerful—matching the right therapy to the right person.
As healthcare professionals, staying current with these advancements allows us to:
Join us as we break down the latest in diabetes care, guidelines, and emerging therapies— you can bring confidence, clarity, and compassion to your clinical practice by joining our Virtual DiabetesEd Training Conference.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Question of the Week:
RZ is 47 years old with type 2 diabetes and hypertension. RZ takes metformin 1000 mg BID, plus lisinopril 20mg daily. RZs LDL is 140 mg/dL. Based on the most recent ADA Standards, what is the LDL Cholesterol target for RZ?
What is the BEST response?
A. LDL less than 100 mg/dL.
B. LDL less than 55 mg/dL
C. Determine LDL target based on ASCVD risk
D. LDL less than 70 mg/dL
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
For last week’s practice question, we quizzed participants on the next steps after 12% weight loss. Over 85% 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 by clicking here.
Question of the Week:
KC is a 62-year-old individual with type 2 diabetes who presents for follow-up after initiating a weight loss program 3 months ago. They report consuming approximately 1,000–1,100 kcal/day and have lost 12% of their body weight, with a current rate of weight loss averaging 5% in the last month.
Their diet excludes most grains and fruits, and they report occasional fatigue and constipation. Current medications include metformin, tirzepatide, and atorvastatin.
Based on current standards of care, what is the most appropriate response regarding nutrition and weight changes?
Answer 1 is incorrect. 1.82% chose this answer, “Continue the current plan, KC is achieving intentional weight loss while enrolled in a weight loss program.” Although KC is achieving clinically significant weight loss, they have multiple risk factors for nutrition deficiencies, including intake <1,200 kcal/day, rapid weight loss (>4% per month), age >50, and restriction of nutrient-dense food groups.1 These risk factors warrant further evaluation before continuation without modification.
Answer 2 is incorrect. 3.03% of you chose this answer, “Titrate GLP-1 receptor agonist to optimize weight loss outcomes.” While GLP-1 receptor agonists are effective for weight management, further intensification may not be appropriate in the setting of already rapid weight loss and inadequate intake. Additional assessment and individualization of outcome goals is recommended before intensification is initiated.
Finally, Answer 3 is incorrect. 9.7% chose this answer, “Initiate screening for micronutrient deficiencies and assess protein and fiber intake.” While monitoring weight change is necessary, automatically discontinuing weight loss efforts may not be recommended. Instead, care should focus on optimizing nutritional adequacy, potentially incorporating supplementation, and adjusting the treatment plan to support safe, sustainable weight-loss goals while minimizing nutrition and medical risk.
Answer 4 is correct. 85.5% of respondents chose this: “KC has achieved weight loss of more than 10%, consider ceasing weight loss efforts to prevent nutrition deficiencies.” GREAT JOB! KC meets several high-risk criteria for nutrient deficiencies, including low caloric intake (<1200 calories per day), rapid weight loss (>4% per month), older age, and limited dietary variety. The current standards of care recommend screening for micronutrient deficiencies within these high risk groups. Screening is guided by clinical judgement but nutrients of concern include iron, calcium, magnesium, zinc, B1, B12, Vitamin C, and fat-soluble vitamins A, D, E, and K.1 It is also recommended to ensure adequate protein intake to preserve lean mass and ensure adequate fiber and fluid intake to address constipation in individuals consuming very low-calorie intake.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Question of the Week:
A 62-year-old person with type 2 diabetes has an A1C of 9.1% despite metformin, SGLT-2i and a GLP-1 receptor agonist. You are considering once-weekly insulin icodec when it becomes available. Which of the following is the most appropriate rationale for selecting insulin icodec (Awiqli) therapy?
What is the BEST response?
A. Eliminates the risk of hypoglycemia compared to daily basal insulin.
B. Provides superior A1C reduction compared to all daily basal insulins.
C. Does not require dose titration due to its long duration of action.
D. Reduces injection frequency while improving time-in-range.
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
There is a lot of exciting news contained in this month’s newsletter. The world of diabetes pharmacology is advancing at a breakneck pace, and we are here to keep you abreast of advances that will impact your clinical practice and your care for people with diabetes.
The first article describes the pharmacology and dosing considerations for icodec (Awiqli), an ultra-long-acting insulin scheduled for release in the second quarter of 2026. As we wait for its release, you can consider people with type 2 diabetes in your care who might benefit from this once-weekly basal insulin.
There has been significant movement in the GLP-1/GIP med class, from high-dose Wegovy to Mounjaro’s pediatric approval, highlighted in our next article. You are going to love our updated PocketCards, which neatly consolidate this shifting landscape at a glance for easy reference. Continued below…
In a thoughtful comparison of the ADA and the American College of Cardiology dyslipidemia treatment guidelines, Christine Craig, MS, RDN, CDCES, concludes that both recognize the critical impact of dietitians and MNT in addressing elevated lipid levels.
Sarah Beattie, DNP, CDCES, highlights the importance of eye exams and encourages the use of remote retinal screening for those without access to an eye care professional in their area.
Test your knowledge with a quiz that investigates potential candidates for once-weekly insulin and check out our rationale of the week too.
Lastly, we hope to see you at our Virtual Conference. Diana Issaacs, PharmD, CDCES, BC-ADM, will dive into the newly approved diabetes meds and insulins, helping you sort out how to best use these tools in clinical practice.
In celebration of Spring,
Coach Beverly, Bryanna, and Katarina
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
For last week’s practice question, we quizzed participants on checkpoint inhibitors triggering hyperglycemia. 34% 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 by clicking here.
Betty, a 60-year-old female, is receiving pembrolizumab, an immune checkpoint inhibitor, as treatment for melanoma. She is worried about the potential adverse effects. She is very concerned about the risk of developing diabetes. Her recent lab work shows normal fasting blood glucose and hemoglobin A1c.
Answer 1 is incorrect. 24.22% chose this answer, “A gradual onset of mild hyperglycemia due to insulin resistance, similar to type 2 diabetes.” This answer is incorrect. Immune checkpoint inhibitor medications do not cause mild hyperglycemia but instead cause significant hyperglycemia and DKA similar to type 1 diabetes.
Answer 2 is incorrect. 24.22% of you chose this answer, “A steroid-induced hyperglycemia that resolves after tapering off steroid therapy.” This answer is incorrect. Though steroid treatment is often needed, hyperglycemia in immune checkpoint inhibitor-associated diabetes is not resolved after tapering off steroids.
Answer 3 is incorrect. About 17.58% of respondents chose this: “A mild, transient fasting hyperglycemia that requires no treatment.” This answer is incorrect. Though steroid treatment is often needed, hyperglycemia in immune checkpoint inhibitor-associated diabetes is not resolved after tapering off steroids.
Finally, Answer 4 is correct. 33.98% chose this answer, “A rapid-onset insulin-deficient diabetes that can present as diabetic ketoacidosis.” This answer is correct. Due to immune checkpoint inhibitor-induced immune system alterations, hyperglycemia and insulin deficiency can rapidly develop, often leading to DKA.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Question of the Week:
KC is a 62-year-old individual with type 2 diabetes who presents for follow-up after initiating a weight loss program 3 months ago. They report consuming approximately 1,000–1,100 kcal/day and have lost 12% of their body weight, with a current rate of weight loss averaging 5% in the last month.
Their diet excludes most grains and fruits, and they report occasional fatigue and constipation. Current medications include metformin, tirzepatide, and atorvastatin.
Based on current standards of care, what is the most appropriate response regarding nutrition and weight changes?
What is the BEST response?
A. Continue the current plan, KC is achieving intentional weight loss while enrolled in a weight loss program
B. Titrate GLP-1 receptor agonist to optimize weight loss outcomes
C. KC has achieved weight loss of more than 10%, consider ceasing weight loss efforts to prevent nutrition deficiencies.
D. Initiate screening for micronutrient deficiencies and assess protein and fiber intake
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
