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Level 2 | Older Adults & Diabetes Upcoming Webinar
Join us tomorrow May 13th @ 11:30am PST for Older Adults & Diabetes Webinar!!💻
We are living longer & more people are getting diabetes. The American Diabetes Association has updated the Older Adults Standards, with special attention to considering the reduction of medication & insulin therapy intensity. The older population has unique issues & special needs that require consideration as we provide diabetes self-management education. This online course highlights key areas of assessment, intervention, and advocacy for older clients living with diabetes.
Objectives:
- Self-management considerations for older individuals.
- Strategies to prevent complications & maintain optimal quality of life.
- The role of the Diabetes Care & Education Specialist as an advocate.
Learning Outcome:
The diabetes care team will have an increased knowledge of special considerations, individualized goals, and standards for older individuals with diabetes to include in their practice.
Why Attend These Webinars?
All hours earned count toward your CDCES Accreditation Information
Tech Data Toolkit Session 2 airs this week, but it’s not too late to register!
- Session 1 – May 8th with Beverly Thomassian at 11:30 am – 12:30 PST
- Session 2 – May 15th with Dr. Diana Isaacs at 11:30 am – 2:30 PST
*If you missed the first session please note recordings are available for OnDemand viewing.
Topics include:
- Review CGM key metrics and individualize time in-range goals
- Learn how to recognize patterns with the AGP report efficiently
- Utilize the AGP report as a discussion guide when meeting with a person with diabetes
- Recommend lifestyle and medication adjustments based on CGM data
- Strategies to recognize the expertise of the individual and collaborate on person-centered problem solving.
Learning Outcome:
Participants will be able to interpret the AGP and continuous glucose monitor (CGM) data and determine needed medication and lifestyle adjustments with a person-centered approach.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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.
May 2025 eNews Letter
Announcements
_________________________
- Vitamin D & Insulin Sensitivity
- Rediscovering Walking – From Rucking to Kicking Up Intensity
- Type 5 Diabetes Recognized
- Healing Shift: How a Chinese Restaurant Became My Refuge – Coach Bev
- Question of Week | Decoding AGP Report
- Rationale of the Week | What Stage of Change?
- 20% OFF Spring Sale Starts May 6th – Code Bloom20
Upcoming Programs
___________________________
Happy May!💚
We’re celebrating Tiffany’s birthday with a 20% Off Sale—plus a special newsletter featuring important diabetes updates you won’t want to miss!
I am sure you have read hopeful yet conflicting information on the promise of Vitamin D in reducing inulin resistance and the risk of type 2 diabetes. Nutrition expert Christine Craig helps us sort fiction from fact so we can pass along accurate recommendations to our clients and colleagues.
You know walking is excellent for improving health, but what about taking it up a notch with rucking or kicking the intensity? Walking is one of the most accessible activities, and it gives everyone an excuse to enjoy nature and those moments of awe.
Type 5 diabetes is now officially recognized by the International Diabetes Federation as a new form of diabetes. Increased awareness of type 5 diabetes may help prevent misdiagnosis due to features similar to type 1 diabetes. Learn more about this condition that primarily affects undernourished teenagers and young adults.
Coach Beverly is kicking off the launch of her new book, Healing Through Connection for Health Care Professionals.
This deeply personal book invites you into the pivotal moments that shaped her career and calling. In this month’s article, you can read about her earliest experiences at a Chinese Restaurant where she found refuge.
She will post a new story each month so you can access the behind-the-scenes stories of struggle, growth, and hope that fueled her passion for transforming diabetes care.
With gratitude and appreciation,
Coach Beverly, Bryanna, Tiffany, Christine, & Katarina
We are living longer & more people are getting diabetes. The American Diabetes Association has updated the Older Adults Standards, with special attention to considering the reduction of medication & insulin therapy intensity. The older population has unique issues & special needs that require consideration as we provide diabetes self-management education. This online course highlights key areas of assessment, intervention, and advocacy for older clients living with diabetes.
Objectives:
Self-management considerations for older individuals.
Strategies to prevent complications & maintain optimal quality of life.
The role of the Diabetes Care & Education Specialist as an advocate.
Rationale of the Week | Best technique to assess Protective Sensation in feet?
For last week’s practice question, we quizzed participants on Best technique to assess Protective Sensation in feet? 44% 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:
Question: Best technique to assess Protective Sensation in feet? Which of the following best describes the proper technique for using a 10-gram monofilament to assess protective sensation in a person with diabetes?
Answer Choices:
- Press the monofilament firmly against the skin until it bows for at least 2 seconds, then ask if the person if they feel pressure.
- Stroke the monofilament across the skin surface to assess for light touch sensation.
- Apply the monofilament to the dorsal surface on random sites without informing the individual when contact is made.
- Press the monofilament until it bends into a “C” shape at selected sites, holding for about 1 second before lifting.
Getting to the Best Answer
Answer 1 is incorrect. 18% chose this answer, “Press the monofilament firmly against the skin until it bows for at least 2 seconds, then ask if the person if they feel pressure.” This answer is tempting. You only need to apply the monofilament for one second and you don’t want to ask the person if they feel pressure when you are bending the monofilament into a C-shape on the plantar surface of four sites (as noted in the image below) . This could lead to them simply saying “yes” when you ask if “they feel it”.
Answer 2 is incorrect. 15% of you chose this answer, “Stroke the monofilament across the skin surface to assess for light touch sensation.” When using the monofilament, you only need to apply the monofilament for one second by bending it into a C-shape on the plantar surface of their feet on the four sites (as noted in the image below) to evaluate for sensation. This evaluation does not include stroking the monofilament.
Answer 3 is incorrect. About 22% of respondents chose this, “Apply the monofilament to the dorsal surface on random sites without informing the individual when contact is made.” You need to apply the monofilament for one second by bending it into a C-shape on the plantar surface of their feet on the four sites (as noted in the image below) to evaluate for sensation.
Finally, Answer 4 is correct. 44% chose this answer, “Press the monofilament until it bends into a “C” shape at selected sites, holding for about 1 second before lifting.” Yes, GREAT JOB. Simply apply the monofilament for one second to the sites on the image below, going above or below calluses. Ask the person to close their eyes and say yes when they feel the pressure as you bend the monofilament into a C-shape on the four plantar surfaces sites (as noted in the image below). If they can’t feel on one or more touch points, this is a sign they have “loss of protective sensation” and are at increased risk of foot injury.
For more information on Lower Extremities – we have some great resources.
Free Assessing Lower Extremity Handout
Free Webinar: 3 Steps to DeFeet Amputations
Register for our Level 2 – Lower Extremity Assessment Course- Earn 1.5 CEs
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!
Older Individuals are at Higher Risk of Foot Injury
Join us live on May 13th for our
Older Adults & Diabetes
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).
We are living longer & more people are getting diabetes. The American Diabetes Association has updated the Older Adults Standards, with special attention to considering the reduction of medication & insulin therapy intensity. The older population has unique issues & special needs that require consideration as we provide diabetes self-management education. This online course highlights key areas of assessment, intervention, and advocacy for older clients living with diabetes.
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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.
Question of the Week | Decoding AGP Report – Test Your Knowledge
AJ asks you why their blood glucose levels are “all over the place”. When you look at the AGP, you notice the coefficient of variation is 26%. What is the best response?
- Even though your coefficient of variation is above target, we can work to bring that down.
- It seems like you are making a big effort keep your glucose in target range.
- Given your glucose fluctuations, we may need to intensify your medication regimen.
- With some small changes in lifestyle activities, I am sure you can make improvements.
Want to learn more about this question?
Join us live on May 8th & May 15th
Tech Data Toolkit!
Gain confidence in interpreting Glucose Profile Report (AGP) & CGM data using a person-centered approach! Earn 4.0 CEs
If you are preparing for certification exams or want to up your game using CGM data to improve outcomes, this course is for you.
We still have room available for the May 8th kick off date.
Save 20% – Use code Bloom20 at checkout!
Join us live for this unique learning experience.
Session 1 – May 8th
with Beverly Thomassian at 11:30am to 12:30pm PST
Session 2 – May 15th
with Dr. Diana Isaacs at 11:30am to 2:30pm PST
Gain confidence in interpreting Glucose Profile Report (AGP) & CGM data using a person-centered approach.
As diabetes technology is becoming commonplace in our practice, figuring out how to make sense of all the data can seem overwhelming. Join Diana Issacs and Coach Beverly for a truly unique learning experience.
Dr. Isaacs has a special knack for breaking down the essential elements of the Ambulatory Glucose Profile (AGP) report to provide participants with a clear road map for data interpretation. She includes many sample practice cases utilizing CGM data for various types of people with diabetes including type 2 and people with type 1 not on pumps.
Coach Beverly will build on Dr. Isaacs’ presentation and switch the focus to the person living with diabetes. Using a case study approach, she will provide strategies to integrate the AGP with person-centered care that empowers individuals to experience increased confidence in their diabetes self-management.
By attending this interactive workshop, participants will become more confident in interpreting the AGP and continuous glucose monitor (CGM) data and determining needed medication and lifestyle adjustments with a person-centered approach.
Topics include:
Review CGM key metrics and individualize time in-range goals
Learn how to recognize patterns with the AGP report efficiently
Utilize the AGP report as a discussion guide when meeting with a person with diabetes
Recommend lifestyle and medication adjustments based on CGM data
Strategies to recognize the expertise of the individual and collaborate on person-centered problem solving.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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.
Rationale of the Week | Best treatment for Diabetes + Heart Disease?
For last week’s practice question, we quizzed participants on Best treatment for Diabetes + Heart Disease? 70% 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: BT has a history of stroke and new diagnosis of diabetes with an A1C of 6.9%.
Which of following treatment strategies is most appropriate for a person with new type 2 diabetes and established cardiovascular disease (CVD)?
Answer Choices:
- Start metformin and limit other meds to determine glucose response.
- Initiate lifestyle changes plus a statin and re-evaluate A1C in 3 months.
- Make sure BT is taking both an ACE and an ARB to reduce CV risk.
- Start a GLP-1 RA or SGLT2 with proven cardiovascular benefit.
Getting to the Best Answer
Answer 1 is incorrect. 7% chose this answer, “Start metformin and limit other meds to determine glucose response.” Based on ADA guidelines, we need to take a person’s CV and renal status into account when determining the most beneficial treatment for someone with newly diagnosed diabetes. Given the fact that BT has a history of a stroke, the MOST beneficial initial medication would be a SGLT-2 or a GLP-1 RA with proven CV benefit. Even though BT’s A1C is on target, starting either of these meds would lower their risk of another CV event. See Medication PocketCards
Answer 2 is incorrect. 14% of you chose this answer, “Initiate lifestyle changes plus a statin and re-evaluate A1C in 3 months.” Based on ADA guidelines, BT would absolutely need to be started on a statin with close monitoring of A1C coupled with lifestyle. However, we need to take a person’s CV risk status into account when determining the most beneficial treatment for someone with newly diagnosed diabetes. Given the fact that BT has a history of a stroke and new diabetes, the MOST beneficial initial medication would be a SGLT-2 or a GLP-1 RA with proven CV benefit. See Medication PocketCards
Answer 3 is incorrect. About 7% of respondents chose this, “Make sure BT is taking both an ACE and an ARB to reduce CV risk.” A person with diabetes plus hypertension and a history of stroke, would benefit from ONE of these. It is NOT recommended to take and ACE and ARB together, due the possibility of kidney complications. See HTN Med Cheat Sheets.
Finally, Answer 4 is correct. 70% chose this answer, “Start a GLP-1 RA or SGLT2 with proven cardiovascular benefit.” Based on ADA guidelines, we need to take a person’s CV risk status into account when determining the most beneficial treatment for someone with newly diagnosed diabetes. Given the fact that BT has a history of a stroke, the MOST beneficial initial medication would be a SGLT-2 or a GLP-1 RA with proven CV benefit. See Medication PocketCards.
Want to learn more about this topic? View our Level 2 Webinar – CV Disease and Decreasing Risk based on 2025 ADA Standards. Earn 1.5 CEs.
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!
You won’t want to miss our upcoming Tech Data Toolkit!
Join us live on May 8th & May 15th!! Use discount code “success10” for an additional 10% off!
Session 1 – May 8th
with Beverly Thomassian at 11:30am to 12:30pm PST
Session 2 – May 15th
with Dr. Diana Isaacs at 11:30am to 2:30pm PST
If you are preparing for certification exams or want to up your game using CGM data to improve outcomes, this course is for you.
Gain confidence in interpreting Glucose Profile Report (AGP) & CGM data using a person-centered approach!
We still have room available for the May 8th kick off date.
With diabetes technology entering all aspects of diabetes care, figuring out how to make sense of all the data can seem overwhelming. Join Diana Issacs and Coach Beverly for a truly unique learning experience. Dr. Isaacs has a special knack for breaking down the essential elements of the Ambulatory Glucose Profile (AGP) report to provide participants with a clear road map for data interpretation. She includes many sample practice cases utilizing CGM data for various types of people with diabetes including type 2 and people with type 1 not on pumps.
Coach Beverly will build on Dr. Isaacs’ presentation. She will expand the focus to include steps to collaborate with the person with diabetes. Using a case study approach, she will provide strategies to integrate the AGP with person-centered care that empowers individuals to experience increased confidence in their diabetes self-management.
By attending this interactive workshop, participants will become more confident in interpreting the AGP and continuous glucose monitor (CGM) data and determining needed medication and lifestyle adjustments with a person-centered approach.
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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.
Upcoming Tech Data Toolkit Webinar
Session 1 – May 8th
with Beverly Thomassian at 11:30am to 12:30pm PST
Session 2 – May 15th
with Dr. Diana Isaacs at 11:30am to 2:30pm PST
Decoding AGP Report Pop Quiz – Test Your Knowledge
Question: AJ asks you why their blood glucose levels are “all over the place”. When you look at the AGP, you notice the coefficient of variation is 26%. What is the best response?
A. Even though your coefficient of variation is above target, we can work to bring that down.
B. It seems like you are making a big effort keep your glucose in target range.
C. Given your glucose fluctuations, we may need to intensify your medication regimen.
D. With some small changes in lifestyle activities, I am sure you can make improvements.
 |
|
|---|
If you are preparing for certification exams or want to up your game using CGM data to improve outcomes, this course is for you.
We still have room available for the May 8th kick off date.
Save 10% – Use code Success10 at checkout!
Join us live for this unique learning experience.
May 8th, 2025 from 11:30 am to 2:30 pm PST and
May 15th from 11:30 am to 12:30pm
Gain confidence in interpreting Glucose Profile Report (AGP) & CGM data using a person-centered approach.
As diabetes technology is becoming commonplace in our practice, figuring out how to make sense of all the data can seem overwhelming. Join Diana Issacs and Coach Beverly for a truly unique learning experience.
Dr. Isaacs has a special knack for breaking down the essential elements of the Ambulatory Glucose Profile (AGP) report to provide participants with a clear road map for data interpretation. She includes many sample practice cases utilizing CGM data for various types of people with diabetes including type 2 and people with type 1 not on pumps.
Coach Beverly will build on Dr. Isaacs’ presentation and switch the focus to the person living with diabetes. Using a case study approach, she will provide strategies to integrate the AGP with person-centered care that empowers individuals to experience increased confidence in their diabetes self-management.
By attending this interactive workshop, participants will become more confident in interpreting the AGP and continuous glucose monitor (CGM) data and determining needed medication and lifestyle adjustments with a person-centered approach.
Topics include:
- Review CGM key metrics and individualize time in-range goals
- Learn how to recognize patterns with the AGP report efficiently
- Utilize the AGP report as a discussion guide when meeting with a person with diabetes
- Recommend lifestyle and medication adjustments based on CGM data
- Strategies to recognize the expertise of the individual and collaborate on person-centered problem solving.
Accreditation Info
Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002.
Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
Taking the CDCES Exam?
Our CEs count toward the 15 CE requirements to sit for the exam! When applying to take the exam with the Certification Board for Diabetes Care & Education (CBDCE) you’ll just need to select “CDR” or “Commission on Dietetic Registration” for your CE hours source.*
Renewing Your CDCES or BC-ADM certification?
Our CEs count towards the 75 CEs needed to renew your CDCES or BC-ADM for our courses/programs that have received Prior Approval through the CDR.*
Question of the Week | Best technique to assess Protective Sensation in feet?
Which of the following best describes the proper technique for using a 10-gram monofilament to assess protective sensation in a person with diabetes?
- Press the monofilament firmly against the skin until it bows for at least 2 seconds, then ask if the person if they feel pressure.
- Stroke the monofilament across the skin surface to assess for light touch sensation.
- Apply the monofilament to the dorsal surface on random sites without informing the individual when contact is made.
- Press the monofilament until it bends into a “C” shape at selected sites, holding for about 1 second before lifting.
Want to learn more about this question and get ready for certification exam success?
Join us live on April 29th for our
Lower Extremity Assessment
Level 2
Can’t make it live? Don’t worry – you have access to the recorded version for a year after purchase!
People with diabetes are at increased risk of Lower Extremity Complications. This course reviews the steps involved in performing a detailed assessment of the lower extremities, including how to use a monofilament and tuning fork to detect neuropathy. We also discuss the significance of the Ankle Brachial Index and strategies to prevent lower extremity complications.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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.
Celebrating Earth Day: How Native Plants Support Wildlife and Our Well-Being
In honor of Earth Day, April 22, 2025, we’re shining a light on the power of native plants in creating vibrant, resilient ecosystems—for wildlife and for people.
Native plants—those that have evolved naturally in a specific region—play a crucial role in supporting local pollinators, birds, butterflies, and other wildlife. These plants provide essential food, pollen, and shelter that many species rely on for survival. And while the benefits to the environment are clear, cultivating native plants also boosts human well-being. Thriving ecosystems support cleaner air and water, increased biodiversity, and create opportunities for people to reconnect with nature.
🌻 A Journey Toward Native Planting
When Coach Beverly moved into her home 26 years ago, she planted what many of us do—flowers and grasses that looked appealing and could withstand local heat. With an acre of land surrounding her home and office, she had space to experiment, adding a wide variety of foliage and trees for beauty and shade.
But like many at that time, she wasn’t yet aware of the importance of native plants—or how their presence (or absence) affects the animals, insects, and birds that share our space.
Over time, as she learned more about habitat loss and the plight of pollinators, she began to rethink her approach. Through research, visits to a nearby native nursery, and the help of trusted websites, she and her husband began the transformation: reshaping their land into a space that supports bees, butterflies, frogs, birds, lizards, and more. Today, their yard is not only beautiful but also an oasis for wildlife—and a model of sustainable gardening.
💧 Water: A Simple Yet Powerful Addition
In addition to plants, providing a water source can be a game-changer for thirsty pollinators and wildlife. Whether it’s a birdbath, a shallow dish, or a small pond, water invites life into any garden.
Last year, Coach Beverly dug a small frog pond. Within weeks, frogs, toads, and birds made themselves at home. A year later, the pond teems with tadpoles, mosquito fish, dragonflies, water beetles, and countless other tiny creatures.
The pond has become a source of daily joy and fascination for family and visitors alike—a reminder of how deeply nature nurtures our spirits. It has also been a powerful tool for stress relief and mental well-being.
🌿 Nature as Therapy
For those managing diabetes, chronic conditions, or everyday stress, spending time in nature and caring for living things can be deeply therapeutic. And it doesn’t have to be complicated.
Start small:
- Plant a few herbs or flowers in containers
- Scatter wildflower seeds on a patch of earth
- Nurture a potted tomato plant on a sunny windowsill
For the more adventurous, creating a native plant garden is a wonderful excuse to get outdoors, move your body, and take pride in a growing, living space. There’s something special about tasting a sun-warmed tomato that’s been nurtured from seed to fruit.
🌸 Not Sure What’s Native in Your Area?
A great place to start is the article Audubon – 20 Common Types of Native Plants, which outlines beneficial plants found across the U.S. To make it local, cross-reference with your zip code using tools like the Native Plant Finder – NWF by the National Wildlife Federation.
For example, in Chico, California, the California Christmas-Berry is drought-tolerant and a favorite food source for local birds.
🌳 Here are a few native plant ideas to consider:
- Trees: Oak, Pine, Dogwood, Willow
- Colorful blooms: Coneflower, Sunflower
- Edible treats for people and birds: Blueberries, Elderberries, Serviceberries
Need help sourcing plants? The Plant Native website offers a helpful directory of native nurseries throughout the U.S.
🌱 Every Action Counts
Many people feel overwhelmed or discouraged by the state of the planet. But there is also a growing awareness of our power to make change—and hope rooted in action.
Whether it’s planting a single native shrub, providing a bowl of water, or simply observing and appreciating the life around us, every effort makes a difference.
Visit www.earthday.org and Project Regeneration for more ideas and inspiration on how to help the Earth thrive.
💚 Final Thoughts
Each person has the ability to nurture the planet and themselves, starting right at home. Native plants are a simple, beautiful way to support both biodiversity and human well-being.
So this Earth Day, consider taking that first step. Plant something. Provide water. Let nature in. And know that even the smallest actions ripple outward in meaningful ways.
🌎 Happy Earth Day from Coach Beverly and the Diabetes Education Services team.
