Getting to the Gut, Meet Your Microbiome | Free Webinar and Celebration
November is National Diabetes Month. We are celebrating with our annual Gut Bacteria Webinar. Join Us!
FREE Webinar – Getting to the Gut, Meet Your Microbiome
Join the wonderment as we explore the role of our Microbiome.
“This Webinar is filled with Bev’s energy, knowledge, and passion for diabetes that she replicates in all her teachings. She puts a demand on herself to be a mentor to all. Her information is well organized, full of current/relevant research, and helps CDCES’ view into the future as a changing world impacts diabetics. I find her to be the most exciting and engaging educator and … OUTSTANDING teacher!!” – recent participant
This one-hour complimentary journey will expand your view of how the trillions of bacterial hitchhikers profoundly influence our health. We will discuss how foods, the environment, and our medical practices have impacted our gut bacteria over time and strategies we can take to protect these old friends.
Webinar topics:
- Discuss the latest research on our microbiome
- State the relationship between gut health and diabetes risk
- Describe 3 strategies to get our microbiome back to better health.
Studying for the CDCES exam?
Join us for our FREE webinar
Preparing for the CDCES Exam 2020
November 5, 2020, from 11:30 a.m. – 12:45 p.m. (PST)
Unsure about updates for the 2020 exam?
Coach Beverly offers this FREE webinar to help get you to prepare for the CDCES Exam. All her tips and tricks are meant to ease your mind and reflect the updates to the CDCES content outline.
Topics Covered Include:
- Implications of new certification name, CDCES for our specialty
- Exam requirement updates for 2020
- Exam eligibility and test format
- Strategies to succeed along with a review of study tips and test-taking tactics.
- We will review sample test questions and the reasoning behind choosing the right answers.
- Learn how to focus your time and prepare to take the CDCES Exam. We provide plenty of sample test questions and test-taking tips!
Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator who has passed her CDCES Exam 6 times. She is a nationally recognized diabetes expert for over 25 years.
See our Preparing for CDCES Resource Page >>
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!
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Accreditation: Diabetes 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.
National Diabetes Month Resources | Focus on Youth
Taking Care of Youth Resources
Almost 200,000 people under the age of 20 are living with type 1 or type 2 diabetes. This makes diabetes the most common chronic condition in school-age youth in the United States.
Living with diabetes is challenging, no matter their age. Being a young person with diabetes presents the additional challenge of managing glucose during a period of intense hormonal fluctuations and the complexity of managing a social life, extra-curricular activities, and risk-taking behaviors. For caregivers, advocating for the rights of school-age children with diabetes can be time-consuming and full of challenges.
The National Institute of Health (NIH) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), has put together a Toolkit for health care professionals and caregivers alike to help navigate this challenging time.
Health Professional Toolkit – To help raise awareness about the best care for youth with diabetes, this toolkit by the NIDDK, includes social media posts that you can easily copy and share.
Juvenile Diabetes Research Foundation – Type 1 Diabetes Resources and Support
Articles on NIDDK Website
Diabetes care and the Adolescent Population: Navigating the Transition of Roles and Responsibilities. In this Q & A session, David Schwartz, Ph.D., shares insights on how providers can facilitate shared responsibility for diabetes care while minimizing conflict between adolescents and their parents/guardians.
Managing Diabetes at School – In a perfect world, all teachers and other school staff would understand how to manage diabetes. In the reality, parents and caregivers need to provide information to the school and work with staff to keep children safe and healthy, no matter what the school day brings. This link includes information and a downloadable Diabetes Medical Management Plan.
The Role of the Community Environment in Managing Diabetes Risk – this diabetes discoveries and practice blog are full of interesting, short articles and presentations on a range of critical and timely topics. You can sign up to receive blog notifications too.
Guiding Principles for the Care of People with Diabetes – These Guiding Principles aim to identify and synthesize areas of general agreement among existing guidelines to help guide primary care providers and health care teams to deliver quality care to adults with or at risk for diabetes.
National Diabetes Month Helpful Resources
- ADA’s Risk Quiz: 60-second online risk assessment for type 2 diabetes. ADA created a self-assessment and aversion to fill out the assessment for others. There’s also a printable version in English & Spanish that can be distributed to help ascertain risk. This is a great first step in helping individuals consider coming in for an appointment
- Sweet People Club: Theresa Garnero founded the Sweet People Club which provides education, support, and community for individuals with prediabetes or type 2 and their families. She has excellent resources on meal planning and active living, plus she provides a free guide on flexible meal planning.
- Spanish Language Resources: language can be a barrier to adequate and quality care. ADCES has created a number of free downloads for people with diabetes and prediabetes, which have been translated into Spanish.
- Free Monofilaments: Lower Extremity Amputation Prevention (LEAP) provides monofilaments for free (just send them an envelope with postage!). Use these monofilaments, which delivers 10 grams of pressure, to identify those at risk of developing foot problems. (The ADA Foot Examination Pocket Chart fully explains how to conduct a foot exam, including a picture explanation of how to use a monofilament).
Websites that offer FREE handouts for diabetes education
ADA’s FREE Living with Type 2 Diabetes Program: ADA’s program includes six digital, printable journeys to teach how to live well with diabetes; a monthly e-newsletter with tips, stories, and more resources; six free issues of the Diabetes Forecast® magazine; access to an online community and local events. (The program is available in both English and Spanish).
ADA Diabetes Education Library Offers over 170 topics on diabetes that are searchable by topic and language. A treasure trove of educational info.
CDC Diabetes Prevention Program Curricula and Handouts This site offers excellent resources for those interested in offering Diabetes Prevention Education.
National Diabetes Education Program is an online library of resources compiled by the
Preparing for the CDCES Exam | Free Webinar | November 5, 2020
Studying for the CDCES exam?
Join us for our FREE webinar
Preparing for the CDCES Exam 2020
November 5, 2020, from 11:30 a.m. – 12:45 p.m. (PST)
Unsure about updates for the 2020 exam?
Coach Beverly offers this FREE webinar to help get you to prepare for the CDCES Exam. All her tips and tricks are meant to ease your mind and reflect the updates to the CDCES content outline.
Topics Covered Include:
- Implications of new certification name, CDCES for our specialty
- Exam requirement updates for 2020
- Exam eligibility and test format
- Strategies to succeed along with a review of study tips and test-taking tactics.
- We will review sample test questions and the reasoning behind choosing the right answers.
- Learn how to focus your time and prepare to take the CDCES Exam. We provide plenty of sample test questions and test-taking tips!
Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator who has passed her CDCES Exam 6 times. She is a nationally recognized diabetes expert for over 25 years.
See our Preparing for CDCES Resource Page >>
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!
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Accreditation: Diabetes 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.
What Kind of Diabetes? Rationale of the Week October 20, 2020
Our October 20th Question of the week quizzed test takers on determining the type of diabetes based on lab results and the history. 68% of respondents chose the correct answer, while 32% did not. We thought that this was an important topic to discuss further, so we can pass on correct info to people living with diabetes.
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question
Question: JR has had prediabetes for several years, with A1c’s of 6.0-6.4%. JR is now experiencing sudden hyperglycemia and an A1c is 9.2%, GAD is positive, transglutaminase is negative and TSH is 1.4.
What is the most likely diagnosis?
Answer Choices:
- Latent autoimmune diabetes.
- Hyperglycemia due to secondary causes.
- Celiac induced hyperglycemia.
- Type 1 diabetes.
As shown above, the most common choice was option 1, the second most common answer was option 4, then option 2, and finally option 3.
Getting to the Best Answer
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.
Answer 1 is correct. 68.74% chose this answer. “Latent autoimmune diabetes.” To diagnose LADA, the Immunology of Diabetes Society has established three main criteria including: (1) adult age of onset (>30 years); (2) presence of any islet cell autoantibody; and (3) absence of insulin requirement for at least 6 months after diagnosis.
Even though we don’t know the age of this person, the sudden increase in blood glucose and one positive autoantibody (GAD – glutamic acid decarboxylase) plus an elevated A1c without urgent need for insulin therapy, indicate a diabetes 1.5 or LADA. LADA is a slower moving autoimmune attack of the pancreas, but also has features of type 2 diabetes, with some insulin resistance. People with LADA will need insulin therapy, usually with in 6 months, to help with beta cell preservation and prevent glucose toxicity. They are also at risk for other autoimmune co-conditions like thyroid and celiac disease.
Answer 2 is incorrect. 12.25% of you chose this answer, “Hyperglycemia due to secondary causes.” This is a juicy answer, but there is no other factors in the included in the question that indicates any other “secondary” cause (like medications or tube feedings). Also, a positive GAD is a specific test that measures and indicates autoimmune diabetes.
Answer 3 is incorrect. About 6.03% of respondents chose this, “Celiac induced hyperglycemia.” This answer is tempting, since the question mentions transglutaminase, which is a autoimmune blood test for celiac disease. However, the test comes back negative, so there is no celiac disease. Most importantly, there is no diagnosis category of “celiac induced hyperglycemia.”
Finally, Answer 4 is incorrect. 12.98% chose this answer, ” Type 1 diabetes.” Based on the info in the test question, especially that JR had prediabetes” and the fact that only the GAD is positive and the A1c is only modestly elevated, this person is best described as having LADA.
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!
Studying for the CDCES exam?
Join us for our FREE webinar
Preparing for the CDCES Exam 2020
November 5, 2020, from 11:30 a.m. – 12:45 p.m. (PST)
Unsure about updates for the 2020 exam?
Coach Beverly offers this FREE webinar to help get you to prepare for the CDCES Exam. All her tips and tricks are meant to ease your mind and reflect the updates to the CDCES content outline.
Topics Covered Include:
- Implications of new certification name, CDCES for our specialty
- Exam requirement updates for 2020
- Exam eligibility and test format
- Strategies to succeed along with a review of study tips and test-taking tactics.
- We will review sample test questions and the reasoning behind choosing the right answers.
- Learn how to focus your time and prepare to take the CDCES Exam. We provide plenty of sample test questions and test-taking tips!
Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator who has passed her CDCES Exam 6 times. She is a nationally recognized diabetes expert for over 25 years.
See our Preparing for CDCES Resource Page >>
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!
[yikes-mailchimp form=”1″]Accreditation: Diabetes 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.
[yikes-mailchimp form=”1″]Confessions of an RD Sugar Addict & Low-Sugar Recipes
The holidays are upon us in the midst of a pandemic.
In past holiday seasons, I would check in with my clients to see how the holiday season was affecting their health. We would talk about getting enough sleep and adapting exercise routines to adjust for cold weather and shorter days.
We would talk about stress management tools to help cope with the pressures to overeat and the pressures to eat foods that we have been attempting to avoid.
This year is challenging because we are already taxed by the unbelievable stress of living in a pandemic.
I have found that I am already struggling with insomnia and less exercise. I have been overeating and craving sweets. In fact, I think that I have developed a sugar addiction during these last 7 months. I have been substituting ice cream, donuts, and chocolate for the hugs that I used to take for granted. I am missing gatherings, parties, and shared dinners with friends.
I started to look at the total amount of free sugar that I was consuming. On some days it added up to over 12 teaspoons per day! And I am a dietitian.
Sugar is a powerful stimulant of serotonin that is lacking in my brain these days. I thought that I was developing a cavity and this woke me up.
I had to make a commitment to cut back on sugar.
I thought about the World Health Organization’s sugar recommendation of lowering our free sugar intake to less than 5% of our total daily calories. This works out to about 6 teaspoons a day, depending on the person.
Free sugar applies to
- Added sugars such as:
- glucose
- fructose
- sucrose
- Naturally occurring sugars such as in:
- fruit juice
- honey
- syrups
Whole fruit and milk sugar are not included in free sugar.
I started to look at the total amount of free sugar that I was consuming. On some days it added up to over 12 teaspoons per day! And I am a dietitian.
The average American consumes 17 teaspoons of sugar daily. This translates to 57 pounds of sugar consumed each year.
Hidden Sugars are Tricky to Find
Many people don’t realize that a lot of the sugar they take in are “hidden” in processed foods, according to the World Health Organization.
- 12 oz of soda may contain up to 10 teaspoons of sugar.
- Starbuck’s 12 oz Vanilla Latte contains about 7 teaspoons of sugar.
- 1 Tablespoon of ketchup contains 1 teaspoon of sugar.
- Fun size trick or treat plain M & M’s contain 3 teaspoons of sugar.
- 1 piece of apple pie contains up to 8 teaspoons of sugar.
- 6 oz of fruit-flavored yogurt has 6 teaspoons of sugar.
Research does show that for some people eating sugar produces characteristics of craving and withdrawal, along with chemical changes in the brain’s reward center, the limbic region. These changes are linked to a heightened craving for more sugar.
I am grateful to be able to consciously choose to lower my sugar intake to improve my health.
I am grateful that the whole fruit can be used as a sweet substitute for my sugar cravings.
I love the new fall crop of apples, pears, kiwi, and persimmons.
Delicious Naturally Sweet Recipes
Below are my recipes for baked apples and poached pears that are a delicious holiday dessert.
Simple Baked Apples
- 5 – 6 medium apples, peeled and cut into chunks
- 2 Tablespoons butter or coconut oil, melted
- 1 teaspoon cinnamon
- ½ cup chopped walnuts
- Preheat the oven to 350 degrees
- Place the apples in a medium baking dish
Mix the melted butter or coconut oil, walnuts, and cinnamon together and pour over the apples. Bake in the preheated oven until the apples are soft, about 20 – 30 minutes. Stir once during the baking.
Enjoy!
Poached Pears (Naturally Sugar-Free)
- 1 cup red wine
- 1 orange zest and juice
- 1 cinnamon stick
- 1-inch ginger root peeled
- 3 cloves whole
- 2 Conference pears, peeled, sliced in half, and core
- 1 Tablespoon sliced toasted almonds
- 2 Tablespoons thick plain Greek yogurt
Pour the wine into a small saucepan along with the orange zest and juice and all of the spices
Bring almost to a boil and add the pear halves. Turn down the heat and let the pears simmer gently for 20 – 30 minutes, or until they have slightly softened. Carefully turn the pears over a few times throughout the cooking time to ensure they color evenly. When the pears are cooked remove them from the wine and place them on plates. Add a tablespoon of yogurt to each plate and sprinkle with toasted almonds.
Visit our Joy of 6 Page for sugar info and resources to share with your clients!
Written by Dawn DeSoto RD, CDCES, our resident Nutrition Content Writer
Labor Day Sale | Save 15%
For one day only, we are offering 15% off our entire Online Store to celebrate Labor Day and offer a gift to our community.
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!
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Accreditation: Diabetes 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.
Important Immunization Update for People with Diabetes
To be honest. the vaccination recommendations for diabetes have been shrouded in a veil of mystery for me, until this year.
Thankfully, the 2022 ADA Standards are wonderfully clear in describing the vaccination schedule and types for people living with diabetes. We created this simple chart that you are free to download and share with your colleagues and in your work setting.
What percent of People with Diabetes Get Vaccinated?
Even though these vaccine recommendations are well established, I thought it would be interesting to find out what percentage of people actually get the complete compliment of recommended vaccinations.
According to the CDC data, among those with diagnosed diabetes, the vaccination coverage for influenza, pneumococcal, and shingles was lowest among lower income adults and varied by race and ethnicity. Hepatitis B vaccination coverage was lowest among poor adults, and it decreased with age.
As diabetes specialists, we can have a significant impact on encouraging people with diabetes to receive these important vaccinations. We can work within our health care systems to establish systems and surveillance to monitor vaccine participation. Partnering with community health workers and liaisons can create bridges to increase vaccination rates.
Vaccination Rates for People with Diabetes:
- Influenza vaccine, about 60% of people with diabetes get their annual shot.
- Pneumonia vaccine only 53% of people with diabetes have recieved this vaccine.
- Hepatitis Vaccine Series: Only 33.2% of people with diabetes have received their Hepatitis Vaccines as of 2018.
- Herpes Zoster Series: Only 27.2% adults 60 and older with diabetes had ever received their Herpes Zoster vaccine.
- HPV Vaccine: About 59% of people in the U.S. have completed their HPV vaccine series.
Given that most experts predict that severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) and influenza viruses will both be active in the U.S. during the 2021–2022 season, getting the influenza vaccine is especially important.
Most people don’t know that getting the Influenza vaccine decreases risk of death.
New data is revealing that the influenza vaccine doesn’t just lower the risk of getting the flu, it also lowers risk of all cause mortality and cardiovascular events and death. This simple annual intervention is recommended for all individuals with diabetes 6 months and older.
See Table 4.5 in ADA Standard 4, 2022 for complete info
DiabetesEd Boot Camp | Level 3
This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with diabetes and preparing for the BC-ADM or the CDCES certification Exam.
- February 8, 2022 – Class 1 – Diabetes – Not Just Hyperglycemia
- February 10, 2022 – Class 2 – Standards of Care & Cardiovascular Goals
- February 15, 2022 – Class 3 – Insulin Therapy – From Basal/Bolus to Pattern Management
- February 17, 2022 – Class 4 – Insulin Intensive – Monitoring, Sick Days, Lower Extremities
- February 22, 2022 – Class 5 – Meds for Type 2 – What you need to know
- February 24, 2022 – Class 6 – Exercise and Medical Nutrition Therapy
- March 1, 2022 – Class 7 – Screening, Prevention, and Treatment of Microvascular Complications
- March 3, 2022 – Class 8 – Coping and Behavior Change 1.5 CEs
- March 8, 2022 – Class 9 – Test-Taking Coach Session (48 Questions) No CE
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!
[yikes-mailchimp form=”1″]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.
Lower Birth Weight Tied to Earlier Type 2?
A study examining 48,000 people in Scotland over a 14 year period showed those born with a birth weight below 2.893 kg (6.38 lbs) developed type 2 earlier and at a lower BMI than those with a birth weight above 3.572 kg (7.87 lbs).
The results show a potential association between low birth weight and a more severe phenotype of type 2 diabetes, where less insulin is produced.
“It has long been established that being born with low birth weight is associated with increased risk of diabetes and cardiovascular disease in later life. This probably reflects a combination of genetics and intrauterine environment,” the study’s author Christian Paulina said.
Those with a birth weight under 2.893 kg were diagnosed with diabetes at the average age of 50, whereas the average age of diagnosis for those with birth weight above 3.572 kg was 51.3. The researchers noted that for every 1 kg in extra birth weight, diagnosis age was pushed out by .8 years.
More research is needed for clinical applications, but researchers hope to improve birth weight by reducing maternal smoking or improving maternal nutrition. Read the full study 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!
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