As diabetes educators, we may find we spend a great deal of time listening to people’s life situation, empathizing and affirming their experience. This time is well spent and has a tremendous impact on our interactions with people living with diabetes. A recent study highlights how compassion plays a significant role in our clinical practice.

According to a HealthTap survey, patients and physicians alike rate the role of compassion as most important.

Below are the fours findings from the HealthTap Survey:

“1. When making a healthcare decision, 85 percent of patients said compassion was very important to them, while only 31 percent of patients said cost was very important.

2. Although wait time to see a medical provider is often considered a barrier to patients’ happiness, only 48 percent of patients cited it as a very important factor in healthcare satisfaction.

3. Eighty-nine percent of physicians cited compassion as a very important part of delivering the best care, which was higher than the importance physicians placed on education and command of medical knowledge (86 percent).

4. Nearly all — 94 percent — of physicians said being compassionate makes their patients more likely to follow their advice, which can significantly improve health outcomes.”

To learn more about compassion and healthcare read: “85% of patients value compassion over cost in healthcare: 4 findings” – Becker’s Hospital Review

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Free Upcoming Webinars with Coach Beverly Thomassian

FREE Preparing for the BCADM Exam – What you need to know | January 30th, 2019 @ 11:30 am – 12:40 pm PST

 

 

It is assumed that glucose meters are accurate if they are FDA cleared, but often that is not the case.

The FDA is currently reviewing and updating the guidelines for glucose meter accuracy.  The 2016 rules called for +/- 20% accuracy for most blood sugar ranges. Many diabetes advocacy groups appealed to the FDA to demand better accuracy since treatment decisions are based on these readings and can dramatically impact outcomes.

A research study by The Diabetes Technology Society Blood Glucose System Surveillance Program, found that in a recent analysis, only 6 of the top 18 glucose meters met the accuracy standards. They demonstrated this lack of consistent and accurate readings through extensive testing of the top meters at different sites (see partial chart below, click on chart for full table).

The new 2019 FDA drafted rules for personal use glucose meters will require:

• 95% within +/- 15% across the measuring range
• 99% within +/- 20% across the measuring range

This data and chart created by the Diabetes Technology Society outlines the accuracy of the most common meters. This published information will hopefully result in more accurate meters and better insurance coverage for meters that meet the standards.  This information is also critical to share with our diabetes participants and colleagues. Click here or on chart for full display

Want more information?

 Join us| Standards of Care 2020 Webinar airs Jan 21, 2020 | 1.5 CEs for $29

This 100 minute course is an essential review for anyone in the field of diabetes. We summarize the 2020 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provide critical teaching points and content for health care professionals involved in diabetes care and education.

Earn 1.5 CEs and get ready to lead the charge to implement best care practices for the New Year. 

Coach Beverly carefully reviewed the 2020 ADA Standards with special attention to critical additions and updates.

Topics Include:

• A review of changes and updates to the 2020 ADA Standards of Medical Care
• Identification of key elements of the position statement
• Discussion of how diabetes educators can apply this information in their clinical setting

This course is included in: Level 1 – Diabetes Fundamentals. Purchase this course individually for $29 or the entire bundle and save 65%.

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New studies continue to link physical exercise to the diversity in gut bacteria. One of the most powerful discoveries is that exercise alone has the ability to change your gut microbiome. A new study at the Institute of Biomedicine at the University of Turku in Finland, examines the correlation between endurance exercise and bacteria. 

Researchers found that exercise can boost the production of short-chain fatty acids (SCFAs). This bacteria helps with inflammation and keeping your get healthy.

The study enrolled 17 women who lived sedentary lifestyles, but were other wise healthy, into a 6-week program of bicycle endurance training. They did not change anything about their diet during this program.

“Overall, at the end of the program, the researchers found a decrease in so-called proteobacteria — that is, gut bacteria that have the potential of causing inflammation — and an increase in beneficial bacteria called Akkermansia, which have links with a better metabolism.” 

Previous studies have found the bacteria Akkermansia was more commonly found in people who are physically active and may even protect individuals from diabetes and obesity. 

The exercise also had an effect on cardio metabolic health. “We found that phospholipids and cholesterol in VLDL [very low-density lipoprotein] particles decreased in response to exercise. These changes are beneficial for cardiometabolic health,” Pekkala explains, “because VLDL transports lipids from the liver to peripheral tissues, converts into ‘bad’ LDL [low-density lipoprotein] cholesterol in the circulation, and thus has detrimental cardiovascular effects.”

The scientists believe that if the training program continued, they would have seen greater effects on the participants gut bacteria and overall health.

To learn more: “How endurance exercise affects your gut bacteria” – MedicalNewsToday

For more information, Join our Level 4 – New Horizons – Getting to the Gut 1.0 CE

Join us to learn about the exciting advances in our understanding of the pathology of diabetes and novel approaches to prevention. We will discuss trends in diabetes diagnosis and classification.  The role and importance of gut bacteria in the pathology of type 1 and type 2 will explored. A detailed discussion on emerging research and clinical trial on interventions to delay or prevent diabetes is also included.

 

 

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According to the National Credentialing Board for Diabetes Educators, (NCBDE) the  CDCES® Exam Content Outline will be updated starting July 1^st, 2019.

To celebrate this update, we will be basing our 2019 Questions of the Week on this content outline. (See a snippet of the NCBDE content outline to the left or click on it to see the complete outline.)

Question of the Week – January 22nd, 2019

These targeted questions are designed to help assess your knowledge on the topics critical to diabetes educators.

In addition, if you are preparing to take the exam, we strongly encourage you to go through each of these sub-categories and rate your knowledge on a scale of 1-5.  Based on this self-assessment, spend the majority of your study time on the topic areas you are least comfortable with. This approach will help you become familiar with the exam content and to use your limited study time wisely.

Assessment of the Diabetes Continuum – Learning  

For this question in this series, we focus on the Assessment Section, under learning. Here is the question that addresses learning goals and needs of the learner. Good luck!

To learn more about exam success, please join us live or watch now Free Preparing for CDCES® Webinar airing on Feb 1, 2019.

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Preparing for the BCADM Exam – What you need to know

Get Patients Pumped Up about Resistance Training

Resistance exercise uses more muscles than just walking. It uses upper body muscles that are rarely used in modern society today.  Resistance training also maintains or increases lean muscle. This helps to burn calories at rest throughout the day. This is important for weight control and diabetes management, especially as we age.

The ADA Standards of Care – Section 5 – Lifestyle Management, recommends that people should perform resistance training involving the major muscle groups at least 2 times per week.  How do educators help patients get started?There are many different ways incorporate resistance and strength training. Examples include free weights, resistance bands, rubber tubing, or even our own body weight, just to name a few.

The key is choosing a resistance program that steadily and systematically loads muscles to increase their ability to take greater loads.  

Focus on strengthening major muscle groups:  Start with 6-8 exercises that target major muscle groups (upper body, core and lower body).  It is also important to work opposing muscle groups.  For example, work both biceps and triceps not just biceps.

Getting Started

Start with 2 sets of 8 repetitions for each of the exercises twice a week. With a goal of working up to 2-3 sets of 12 repetitions twice a week. Slow, controlled movement using full range of motion is the goal with each repetition.

Determining level of resistance
Start with a weight or resistance level that is challenging, but doesn’t completely fatigue the muscle after 1 repetition.

Perform that exercise for 2 sets.

• If rating is less than “somewhat hard”, increase resistance.
• If rating is somewhat hard to hard, start with this resistance.

Perform the exercise to momentary fatigue counting the number of repetitions. If person can do more than 12 repetitions without fatigue, then increase the resistance by about 5% in the next session.  If there is momentary fatigue in less than 12 repetitions, keep the resistance the same the next time.

Indicators of fatigue include increased speed of movement, deteriorating exercise form and full available range of motion (ROM) is not completed.

What kind of resistance training equipment do you recommend?

• Look for products that offers multiple options.
• Exercises bands often come in a light, medium, and heavy resistance.
• Look for adjustable weights that give options for increasing weight within one weight.

Weight Max: The average person performing good quality resistance training keeps it at 70-80% of 1 Repetition Maximum (max amount of weight they could use to complete 1 repetition )

Precautions: Make sure patients consult with a provider before exercising if they have any of the following conditions:

• Proliferative retinopathy or current retinal hemorrhage.
• Neuropathy, either peripheral or autonomic or foot injuries (including ulcers)
• High blood pressure (especially if not well controlled)
• Serious illness or infection.

Keeping Safe during exercise:

• Have a blood glucose meter accessible to monitor glucose levels before, possibly during, or after exercise or any time that symptoms of hypoglycemia occur.
• Immediately treat hypoglycemia with glucose tabs or 15 gram carbohydrate source.
• Stay properly hydrated with frequent intake of small amounts of cool water.
• Wear proper footwear, and check feet daily for signs of trauma such as blisters, redness, or other signs of irritation.

Product resources:  Here are just a few places to find exercise bands and weights.

• Online sellers include Amazon
• Goods stores like Dicks Sporting Goods, Sports Authority
• Walmart has Adjustable Free weights. Brands to look for include Athletic Works or Gold’s Gym
• Contact a local outpatient Physical Therapy clinic.

Training Routine Resources

• TheraBand Resistance Training Manual – They have a Theraband Academy that is very good and has Spanish materials. It is free to sign up
• Weight Watchers 10-minute time crunch training with resistance bands DVD (Weight Watchers store, Online)
• Sit and Be Fit (Mary Ann Wilson: videos, You-tube, TV show)
• Go 4 Life – a NIH website that celebrates active aging through exercise. Go4Life.nia.nih.gov
• Diabetes Breakthrough by Osama Hammy M.D., Ph.D. and Sheri Colberg Ph.D.(book)
• Local YMCA (resistance training classes: offered only in some locations)

Other Considerations:
If patients are concerned about starting a resistance training program because they have had injuries in the past, muscle imbalances, or unique physical circumstances, recommend they see a Physical Therapist to identify potential issues and create a program that is specific to their needs. Physical Therapists are truly the movement specialists!

Special thanks to our guest contributor, Diane Britton PT, CDCES, CEEAA. She has been a Physical Therapist for the last 24 years working with adults in a variety of settings, including home health. Diane holds specialties in diabetes, aging and exercise, lymphedema and chronic illness. She resides in Colbert, WA.

Sample Exercise Instruction – Click for Complete Patient Handout

Studies have shown, moving to the the United States can make you vulnerable to rapid and unhealthy weight gain and have lasting effects on your digestive health. Immigrants are particularly susceptible to obesity after a short time living within the United States, but why? A new study was released that monitored the digestive health of immigrants coming to Minnesota from Southeast Asia to better understand the relation between the microbiome and overall health.

“We found that when people come to the U.S.A., they almost immediately begin losing some of their native microbes,” says Dan Knights, a quantitative biologist at the University of Minnesota and the study’s senior author. 

Many of the microbes that immigrants lose are native to where they originate from and help break down and extract nutrients from local foods. The study reveals that moving to the states actually causes a person to acquire more of the “American” microbiome, a microbiome that tends to to be less diverse and features fewer strains of bacteria. The native strains are often lost are not replaced with new bacteria.

The study goes on to consider whether or not the change in microbiome correlates with the risk of obesity. “And while we don’t know whether this loss of diversity is causing obesity, we know that it’s at least associated with more obesity.” 

The American diet seems to require less bacteria to help break down important nutrients. “By tracking everyone’s food logs, the researchers found that an Americanized diet — featuring less fiber and more processed sugars — played a role in disrupting immigrants’ microbiomes. Some of the bacteria in our guts feed, and survive, on particular fibers found in grains and greens — and die off when they don’t get enough.”

The diet within the United States may require less gut bacteria. Many studies have been released supporting that the more diverse a gut bacteria, the healthier a human can be. If we are only feeding our gut bacteria sugar and processed foods, the nutrient-fed bacteria will eventually die. 

The change in gut bacteria for those who immigrate to the states brings up an important question on how what you eat can affect overall health. As human populations continue to migrate, it is important to know the affects a move may have on your health. Researchers suggest incorporating your traditional diet as much as possible to maintain a healthy gut! 

To learn more: “Immigrating To The U.S.? Get Ready For A New Gut Microbiome (And Maybe More Pounds)” – NPR

For more information, Join our Level 4 – New Horizons – Getting to the Gut 1.0 CE

Join us to learn about the exciting advances in our understanding of the pathology of diabetes and novel approaches to prevention. We will discuss trends in diabetes diagnosis and classification.  The role and importance of gut bacteria in the pathology of type 1 and type 2 will explored. A detailed discussion on emerging research and clinical trial on interventions to delay or prevent diabetes is also included.

 

 

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Our Diabetes Detective Team scans the diabetes news to discover the most relevant info that Diabetes Educators need in their daily practice. 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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