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Upcoming webinars | Cardiovascular Disease & Risk Management, Lower Extremity Assessment

Be a part of our diabetes community while learning about the latest in diabetes care.
Plus, Coach Beverly provides an interactive question and answer session at the end of each live webinar.

 

 


Level 2 | Cardiovascular Disease & Risk Management

Airs live on  April 25, 2024, at 11:30 am PT

We discuss insulin resistance and the impact of hyperglycemia of vessel disease from the heart to the toes. Included is a discussion of identifying & preventing cardiovascular disease & a comprehensive review of the latest American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes for heart disease.

Topics:

  • The impact of insulin resistance & hyperglycemia on vessel disease.
  • State the complications & factors associated with vascular disease.
  • List management goals to reduce the risk of vascular disease.
  • Discuss strategies to promote health.

Intended Audience: Designed for healthcare professionals seeking to delve into evidence-based cardiovascular prevention and treatment strategies for those living with prediabetes and diabetes. This content is also helpful in preparation for diabetes certification exams.

Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working diabetes specialist and a nationally recognized diabetes expert.

Airs live on  April 30, 2024, at 11:30 am PT

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 Ankle Brachial Index and strategies to prevent lower extremity complications.

Topics:

  • Describe the risk factors for lower extremity complications.
  • Discuss prevention strategies.
  • Demonstrate steps involved in a lower extremity assessment.

Intended Audience:  A detailed course for healthcare professionals who want to learn the steps involved in providing a thorough lower extremity assessment and prepare for certification exams.

Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working diabetes specialist and a nationally recognized diabetes expert.

Earn 1.5 CEs 


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 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! 

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 | JR is out of lispro (Humalog) insulin and is panicking.

For last week’s practice question, we quizzed participants on JR is out of lispro (Humalog) insulin and is panicking. 42% 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.

Lightbulb and text: Rationale of the Week

Question: JR is a 19-year-old, living with type 1 diabetes. They use lispro (Humalog) insulin in their insulin pump.  They just heard from their pharmacy that lispro is in short supply and they don’t know when they will be getting in the next shipment.  JR tells you they are almost done with their current lispro vial and is panicking, asking what they should do.

What is the best response?

Answer Choices:

  1. Contact your provider to order lispro insulin in a prefilled pen to use for the pump.
  2. Ask provider to prescribe other rapid acting insulin that is available.
  3. If you can’t access your healthcare provider, and you need insulin for your pump urgently, you can purchase a vial of regular insulin over the counter.
  4. A & B
  5. All of the above.
Pie chart of insulin prescription options percentages.

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 incorrect. 7.8% chose this answer. “Contact your provider to order lispro insulin in a prefilled pen to use for the pump.”  This answer is correct, but it is not the BEST answer. Since insulin pens are more readily available and it is the same insulin formulation and concentration, JR can use the insulin from a lispro insulin pen in their pump. However, there is a better answer, so, keep reading. 

Answer 2 is incorrect. 21.35% of you chose this answer. “Ask provider to prescribe other rapid acting insulin that is available.” This answer is correct, but it is not the BEST answer. There are other rapid acting insulins such as NovoLog (insulin aspart) or the biosimilar insulin Admelog (insulin lispro injection) made by other manufacturers that are more readily available with the same insulin concentration. However, there is a better answer, so, keep reading. 

Answer 3 is incorrect. About 7.4% of respondents chose this. “If you can’t access your healthcare provider, and you need insulin for your pump urgently, you can purchase a vial of regular insulin over the counter.” This answer is correct, but it is not the BEST answer. Regular insulin is available for purchase over-the-counter without the need for a prescription and is FDA approved for used in an insulin pump.  However, there is a better answer, so, keep reading. 

Answer 4 is incorrect. 21.6% chose this answer. “A & B” 

Finally, Answer 5 is correct. 41.9% chose this answer. “All of the above.”  YES, this is the best answer, all 3 options are correct. Of course, we encourage individuals to consult with their healthcare provider, since everyone responds differently to switching insulins. We wanted to raise awareness with this question, since many individuals with diabetes who use insulin lispro and Humalog vials for their insulin pumps have encountered shortages. We can reassure them that there are several options to get them by until lispro and Humalog insulin are back on the shelf.  For more info, you can download our Insulin PocketCards

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 important learning activity!

Want to Learn more about recognizing and addressing Diabetes Distress?

Join us live on May 22nd & May 29th, 2024  for our

ReViVE 5 Diabetes Training Program: 

Unlocking Hidden Barriers to Diabetes Management

“ReVive 5” breathes new life into our relationship with diabetes, bringing a fresh perspective to both the person with diabetes and the provider.

The ReVive 5 program is built on sound research from the Embark Trial and will revolutionize your approach to diabetes self-management education.

We have reassembled the Embark training team and created a resource binder of fantastic tools that we are excited to share with you in our ReVive 5 Diabetes Training Program. You are invited to join us to learn a step-wise, proven approach to addressing hidden barriers to diabetes self-management and glucose management.

You don’t need to be mental health expert or diabetes technology wiz to join this training or to integrate these new strategies into your daily practice. 

ReVive 5 uses an integrated, evidence-based approach that provides health care professionals with a realistic 5-step approach to addressing the whole person, starting with emotional distress and incorporating a unique, but integrated approach to problem-solving glucose management difficulties. 

Intended Audience: 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 CDCES or BC-ADM Certification Exams.

ReVive 5 Program PDF Flyer

Can’t join live? That’s okay. Your registration guarantees you access to the recorded version of the series, along with podcasts and resources for one full year.

Accredited Training Program:

  • 15+ CEs – Includes the 7-hour ReVive 5 Training Program, Certificate, and 5 FREE bonus courses to supplement content.
  • A comprehensive set of assessment tools, educational materials, log sheets, and resources.

Join us to gain the confidence and learn the skills needed to support people with diabetes to move forward in their self-management and discover the expert within.

Team of Experts:
ReVive 5 is taught by a team of 3 Interdisciplinary Experts:

  • Lawrence Fisher, Ph.D., ABPP, Professor Emeritus, UCSF
  • Susan Guzman, PhD
  • Beverly Thomassian, RN, MPH, CDCES, BC-ADM

Speakers Interviews – Learn more about the ReVive 5 Team

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!

Accreditation: 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! 

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 | Euglycemic DKA – What is Best Intervention?

Question of the Week Diabetes Education Services

KT is a 54-year-old, who presents to the emergency room with nausea and vomiting. KT weighs 58kg, has been feeling very tired and has diabetes and hypertension.

Meds include: losartan, metformin, and empagliflozin.

Labs: Na 140, K 4.0, Chloride 99, Bicarb 15,  Glucose 189, Anion Gap 26, pH 7.1 and positive urine ketones.

After infusing 2 liters of normal saline, what would be the best intervention for KT?

  1. Give another 2 liters of NS with 20 meq/L of KCL
  2. Continue current therapy.
  3. Start insulin infusion with a dextrose-based solution.
  4. Give an amp of sodium bicarbonate.

Want to learn more about this question?

Keynote Presentation on DKA & Euglycemic DKA at

16th Annual Conference

Expanding the Universe of Diabetes Care hosted by CA ADCES

May 3-4th at Universal City, CA

2024 ADCES Conference in Universal City, CA

Beverly will be speaking on DKA and EDKA on Saturday – May 4, 2024 at 11:30 am

Below is Saturday’s schedule of topics and flyer for more information. We hope to see you there!

>>Register for the Conference

>>Flyer for Event

  • Discover the secrets to a successful and sustainable Diabetes Education Program – Tony Song, MBA
  • Exercise Success Part 3 & 4 – Jacqueline Thompson, MS, RD, CDCES, MES 
  • Dynamic Duo: Registered Dietitian & Pharmacist Co-Appointments in Diabetes Care – Christal Pham, PharmD, APh, CDCES, Melanie Barbee, MS, RDN, CDCES, DipACLM 
  • Advocacy Update: Breakdown the Barriers to Evidence-Based Diabetes Care – Teresa Martin MS RDN CDCES LD 
  • New criteria and treatment guidelines for DKA, Euglycemic DKA, and HHS – Beverly Thomassian, RN, MPH, CDCES, BC-ADM 
  • Exercise Success Part 4 – Jacqueline Thompson, MS, RD, CDCES, MES 
  • Diabetes Technology: Understanding the Differences in the Latest CGMs and Pumps – David Ahn, MD

Location: Hilton at Universal Studios, 555 Universal Hollywood Drive, Universal City, CA 91608 – Get your hotel reservations by April 2.
 
Group Link for room reservations4: Please refer to group code CDCES when booking. Guests can also call our In-House Reservations Dept. at 818-623-1434 from 7am-7pm, Monday-Sunday.  

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!

Accreditation: 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! 

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 | Why are CGM readings higher than BG readings?

For last week’s practice question, we quizzed participants on why CGM readings are higher than BG readings. 39% 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

Lightbulb and text: Rationale of the Week

Question: KS has type 1 diabetes, takes degludec and lispro for their diabetes medications and was recently prescribed CGM therapy to support glucose monitoring. At their visit they report sensor readings have been consistently higher than blood glucose readings.

What would be an important follow-up question to evaluate the potential cause of this difference?

Answer Choices:

  1. Re-assure them blood glucose never equals sensor glucose, so this difference is okay.
  2. Review current medication and supplement use.
  3. Discuss changes in diet and factors contributing to elevation in sensor glucose readings.
  4. Inquire about sleep habits and potential compression of glucose sensor
Pie chart showing glucose sensor reading causes.

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 incorrect. 21.74% chose this answer. “Re-assure them blood glucose never equals sensor glucose, so this difference is okay.” This answer is incorrect. Although it is true that sensor glucose does not equal blood glucose, there may be other factors contributing to consistent elevation in glucose trends. We would want to probe into other potential considerations before jumping to the conclusion that it is only the difference in measurement.

Answer 2 is correct. 39.37% of you chose this answer. “Review current medication and supplement use.” This answer is correct. Interfering substances such as acetaminophen and ascorbic acid (vitamin C) can contribute to higher glucose readings than actual glucose. The interfering substance depends upon the CGM manufacturer. The 2024 ADA Standards of Care reports the importance of reviewing medications and supplements used by persons with diabetes to identify possible interfering substances. They also recommend blood glucose monitoring if there is a concern of inaccurate data. Visit Section 7 of the 2024 Standards of Care to review the table of CGM manufacturers and potential interring substances. 

Answer 3 is incorrect. About 21.86% of respondents chose this. “Discuss changes in diet and factors contributing to elevation in sensor glucose readings.” This answer is incorrect. Although sensor glucose and blood glucose values are more likely to significantly differ after a meal, KS reports consistent elevation in sensor glucose values. Diet factors contributing to elevated sensor glucose readings would likely contribute to elevated blood glucose readings too; we may just see a delay. Diet factors alone would not explain the consistent difference in elevation.

Finally, Answer 4 is incorrect. 17.04% chose this answer. “Inquire about sleep habits and potential compression of glucose sensor.” This answer is incorrect. Compression of the sensor during sleep can contribute to false sensor glucose readings, but we most often see sudden decreases (low) in glucose values. This is suspected to be due to local changes in blood flow/concentration of the interstitial glucose caused by direct pressure on the sensor. Screening for compression lows is important when reviewing CGM data but does not provide the best answer for consistently elevated glucose trends.

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!

Want to learn more about this question?

Virtual DiabetesEd Training Conference – Join us Live on April 17th – 19th 2024 at 11:30 AM PST

Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, and “aha” moments for our Virtual DiabetesEd Training Conference April 17th – 19th, 2024.

Attendees will leave this conference with new tools and a refreshed understanding of the latest advances in person-centered diabetes care.  Our team highlights the ADA Standards of Care, medications, behavior change, technology, medical nutrition therapy, and more!

Our instructors co-teach the content to keep things fresh and lively. 

Friend Discount: 3 or more only $449 per person. Email us at [email protected] with the name and email of each registrant to get the discount!


Program Details

  • Dates: April 17-19th, 2024
  • Registration Fee: $399-$569 (see more about reg. options below)
  • Friend Discount: For 3 or more people, each person saves $50 off their registration. Email us at [email protected] with the name and email of each registrant to get the discount!
  • CEs: 30+ CEs | 18 units for Virtual Conference plus 10+ Bonus CEs. CEs can be applied toward CDCES’s initial application or renewal.
  • Speakers: View Conference Faculty

Registration Options

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!

Accreditation: 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! 

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 | JR is out of lispro (Humalog) insulin and is panicking.

Question of the Week Diabetes Education Services

JR is a 19-year-old, living with type 1 diabetes. They use lispro (Humalog) insulin in their insulin pump.  They just heard from their pharmacy that lispro is in short supply and they don’t know when they will be getting in the next shipment.  JR tells you they are almost done with their current lispro vial and is panicking, asking what they should do.

 What is the best response?

  1. Contact your provider to order lispro insulin in a prefilled pen to use for the pump.
  2. Ask provider to prescribe other rapid acting insulin that is available.
  3. If you can’t access your healthcare provider, and you need insulin for your pump urgently, you can purchase a vial of regular insulin over the counter.
  4. A & B
  5. All of the above.

Want to learn more about this question?

Join us live on May 22nd & May 29th, 2024  for our

ReViVE 5 Diabetes Training Program: 

Unlocking Hidden Barriers to Diabetes Management

“ReVive 5” breathes new life into our relationship with diabetes, bringing a fresh perspective to both the person with diabetes and the provider.

The ReVive 5 program is built on sound research from the Embark Trial and will revolutionize your approach to diabetes self-management education.

We have reassembled the Embark training team and created a resource binder of fantastic tools that we are excited to share with you in our ReVive 5 Diabetes Training Program. You are invited to join us to learn a step-wise, proven approach to addressing hidden barriers to diabetes self-management and glucose management.

You don’t need to be mental health expert or diabetes technology wiz to join this training or to integrate these new strategies into your daily practice. 

ReVive 5 uses an integrated, evidence-based approach that provides health care professionals with a realistic 5-step approach to addressing the whole person, starting with emotional distress and incorporating a unique, but integrated approach to problem-solving glucose management difficulties. 

Intended Audience: 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 CDCES or BC-ADM Certification Exams.

ReVive 5 Program PDF Flyer

Can’t join live? That’s okay. Your registration guarantees you access to the recorded version of the series, along with podcasts and resources for one full year.

Accredited Training Program:

  • 15+ CEs – Includes the 7-hour ReVive 5 Training Program, Certificate, and 5 FREE bonus courses to supplement content.
  • A comprehensive set of assessment tools, educational materials, log sheets, and resources.

Join us to gain the confidence and learn the skills needed to support people with diabetes to move forward in their self-management and discover the expert within.

Team of Experts:
ReVive 5 is taught by a team of 3 Interdisciplinary Experts:

  • Lawrence Fisher, Ph.D., ABPP, Professor Emeritus, UCSF
  • Susan Guzman, PhD
  • Beverly Thomassian, RN, MPH, CDCES, BC-ADM

Speakers Interviews – Learn more about the ReVive 5 Team

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!

Accreditation: 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! 

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.

April 2024 eNews | Does Yogurt Reduce Risk of Type 2 Diabetes? Liver Disease & Diabetes: A Call to Action, First Over-the-Counter CGM!

Happy April 

With the emerging sunshine and nature in bloom, it feels like a personal invitation to awaken from the winter slumber and take an outdoor stroll or enjoy the simple pleasure of planting. To celebrate Earth Day on April 22nd, we highlight how to incorporate native plants into daily life and support healthy ecosystems.

Our nutrition expert explores how yogurt decreases the risk of type 2 diabetes and dives into the science of this century’s old favorite food.

We discuss the importance of screening for undetected liver disease to provide early and focused treatment to prevent progression to liver failure. In addition, we feature a new FDA approved medication that treats liver disease and fibrosis with a list of diabetes medications that also offer effective treatment.

The new over-the-counter sensor, Stelo, is FDA-approved and should be available for purchase in late summer. We examine its features and limitations.

Our first “Connect with Coach Beverly” was a big hit, so we are offering it again in April. You are invited to submit your questions and join our lively discussion.

For our Question of Week Section, we ask, “Why don’t the CGM and meter reading match? And “What is the best treatment for steatosis?” Test your knowledge and prepare for exam success.

We are thrilled to offer our Free Webinars on CDCES and BC-ADM Prep, plus a bunch of other great programs. Hope to see you there.

Sending notes of joy and health,

Coach Beverly, Bryanna, Brent, Christine, Andrew, and Ginger


Featured Articles

Upcoming Webinars

Upcoming Events – See the complete calendar listing

Free Resource Catalog


Virtual DiabetesEd Training Conference – Join us Live on April 17th – 19th 2024 at 11:30 AM PST

Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, and “aha” moments for our Virtual DiabetesEd Training Conference April 17th – 19th, 2024.

Attendees will leave this conference with new tools and a refreshed understanding of the latest advances in person-centered diabetes care.  Our team highlights the ADA Standards of Care, medications, behavior change, technology, medical nutrition therapy, and more!

Our instructors co-teach the content to keep things fresh and lively. 

Friend Discount: 3 or more only $449 per person. Email us at [email protected] with the name and email of each registrant to get the discount!


Program Details

  • Dates: April 17-19th, 2024
  • Registration Fee: $399-$569 (see more about reg. options below)
  • Friend Discount: For 3 or more people, each person saves $50 off their registration. Email us at [email protected] with the name and email of each registrant to get the discount!
  • CEs: 30+ CEs | 18 units for Virtual Conference plus 10+ Bonus CEs. CEs can be applied toward CDCES’s initial application or renewal.
  • Speakers: View Conference Faculty
  • Conference Schedule >
  • Conference Flyer >


Click Here for Registration Options 


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!

Sign up for DiabetesEd Blog Bytes

* indicates required



Accreditation: 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! 

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.

AHHA Study – Recruiting People Living with Type 2 Diabetes

RESEARCH STUDY

Innovative Diabetes Education Program: AHHA Study
A NEW research opportunity for people with Type 2 Diabetes

Are you a diabetes health care professional or person with diabetes who is ready to get on track with your diabetes?

We want to encourage you to let your community know about an exciting research opportunity.

We are inviting people diagnosed with type 2 diabetes less than 5 years ago, who live anywhere in the U.S., with a most recent A1C of 7.5% or higher to click this link below to see if they qualify for the study.

If so, the Behavioral Diabetes Institute is conducting a research study examining how innovative new approaches to diabetes education might help to improve glucose outcomes and quality of life outcomes. Participants will be randomly assigned to take part in one of two different live, online, group education programs. Each group program will be lively and informative, and will meet once weekly for 5 weeks in a row.

Also, half of the participants will receive a continuous glucose monitor and free testing supplies.

To find out more and see if you might qualify, click below to apply. Or for more information, email them at [email protected] or call us at 858-336-8693.

 Get Started – Pre-Qualify Here

 

Rationale of the Week | Which statement is accurate regarding treatment of steatosis?

For last week’s practice question, we quizzed participants on steatosis treatment according to ADA. 57% 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 

Lightbulb and text: Rationale of the Week

 

 

Question: Up to 70% of people with diabetes have steatosis. Those at higher risk of moving to steatohepatitis include individuals with prediabetes and diabetes who also have cardiometabolic risk factors. 

According to ADA Standards, which of the following is an accurate statement regarding treatment of liver disease in diabetes?

 

Answer Choices:

  1. GLP-1 Receptor agonists help with weight loss but do not improve steatosis.
  2. Pioglitazone therapy is indicated for individuals with steatohepatitis.
  3. Avoid insulin therapy in individuals with steatosis and advanced cirrhosis.
  4. Statin therapy is not effective at LDL lowering for individuals with steatosis.
Therapies for steatosis effectiveness pie chart.

Common Native Plants in the U.S.

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 incorrect. 21.77% chose this answer. “GLP-1 Receptor agonists help with weight loss but do not improve steatosis.” This juicy answer is tempting, but it is not the best answer.  GLP-! RA’s, lower blood glucose levels and they also promote significant weight loss. This results in less glucose toxicity and a decrease in hepatic fat storage. Plus, they decrease the risk of cardiovascular disease which is co-associated with steatosis. See our Meds for Liver Disease Blog for more info.

Answer 2 is correct. 57.31% of you chose this answer. “Pioglitazone therapy is indicated for individuals with steatohepatitis.” Yes, this is the best answer.  Pioglitazone (Actos) reduces blood glucose, and several studies demonstrate it is an effective treatment for steatosis and steatohepatitis. It also reduces the progression of fibrosis and cardiovascular risk. Since pioglitazone can cause fluid retention and weight gain, avoid using it in those with heart failure.   See our Meds for Liver Disease Blog for more info.

Answer 3 is incorrect. About 7.31% of respondents chose this. “Avoid insulin therapy in individuals with steatosis and advanced cirrhosis.”  With advanced cirrhosis, many of the oral medications may not be safe to use. The ADA recommends using insulin therapy, since it is safe and effective for people experiencing cirrhosis. Since people with cirrhosis are at higher risk of hypoglycemia, close monitoring of glucose levels is recommended. See our Meds for Liver Disease Blog for more info.

Finally, Answer 4 is incorrect. 13.61% chose this answer. “Statin therapy is not effective at LDL lowering for individuals with steatosis.”  Lipid-lowering and antihypertensive meds need to be prescribed in people with steatosis as indicated. Statins are safe in individuals with steatohepatitis but avoid their use in those with decompensated cirrhosis.  See our Meds for Liver Disease Blog for more info.

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!

Want to learn more about this question?

Join us live on March 27th, 2024 for our

Critical Assessment in Diabetes Care | Fine-Tuning Diabetes Detective Skills

Level 2 | Standards of Care Intensive

Diabetes Webinar March 27, 2024, with Coach Beverly

This course integrates the American Diabetes Association’s (ADA) Standard of Care on elements of a comprehensive medical assessment (Standard 4) of the individual living with prediabetes, diabetes, or hyperglycemia. Through case studies & real-life situations, we discover often hidden causes of hyperglycemia & other complications, such as liver disease, sleep apnea, pancreatitis, autoimmune diseases, fractures, & more. We delve into therapy for complicated situations & discuss management strategies for other conditions associated with hyperglycemia such as Cystic Fibrosis, & Transplants.

Objectives:

  1. Identify common yet often underdiagnosed complications associated with type 1 & type 2 diabetes.
  2. State strategies to identify previously undiscovered diabetes complications during assessments.
  3. Discuss links between hyperglycemia & other conditions including transplant, cystic fibrosis, & liver disease.

Intended Audience: These courses are knowledge-based activities designed for individual or groups of diabetes educators, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in enhancing their diabetes assessment skills and preparing for certification.

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working diabetes specialist and a nationally recognized diabetes expert.

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Accreditation: 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! 

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.