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Rationale of the Week | Medical Nutrition Therapy Coverage
For last week’s practice question, we quizzed participants on medical nutrition therapy coverage. 63% 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: SJ is a 68-year-old recently referred for medical nutrition therapy (MNT). They are on a fixed income and are concerned about their out-of-pocket expense for their upcoming visit. SJ has Medicare (CMS) as their primary insurance.
What can we tell SJ about Medicare’s coverage for MNT services?
Answer Choices:
- Medicare provides full coverage and no cost share for all Medical Nutrition Therapy referrals.
- Medicare provides 3 hours of MNT services for the initial referral and calendar year and 2 hours after referral in subsequent years.
- Medicare provides coverage for diagnosis of diabetes, non-dialysis CKD stage 3- 5, and post-kidney transplants.
- Both B and C.
- All of the Above.
Getting to the Best Answer
Answer 1 is incorrect. 5.12% chose this answer. “Medicare provides full coverage and no cost share for all Medical Nutrition Therapy referrals.” While it is true that Medicare provides full coverage and no out-of-pocket cost share, not ALL MNT referrals are covered. Despite continued work towards increasing MNT access, currently, Medicare only provides coverage for specific diagnoses. Referrals must also come from a physician (MD and DO). Medicare does not accept referrals from an NP or PA. Keep reading for more information.
Answer 2 is incorrect. 13.72% of you chose this answer. “Medicare provides 3 hours of MNT services for the initial referral and calendar year and 2 hours after referral in subsequent years.” This answer is true but not the best answer. Medicare will provide coverage of up to 3 hours of MNT services for the first year of referral and 2 hours every calendar year thereafter with physician referral. If a provider determines medical necessity, most often from a change in diagnosis, treatment regimen, or medical condition, a second referral will allow additional hours of MNT services.
Answer 3 is incorrect. About 6.28% of respondents chose this. “Medicare provides coverage for diagnosis of diabetes, non-dialysis CKD stage 3- 5, and post-kidney transplants.” This answer is true but not the best answer. Medicare provides coverage for diabetes diagnoses, non-dialysis CKD stages 3-5, and post-kidney transplants within the last 36 months.
Answer 4 is correct. 62.56% chose this answer. “Both B and C.” Answer D is correct and the best answer.
Finally, Answer 5 is incorrect. 12.33% chose this answer. “All of the Above.” Answer E is incorrect and not the best answer. While advocacy for expansion of MNT services to cover other diagnosis is an active effort, at the time of writing, coverage remains for only the prior mentioned diagnoses.
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 in Sunny San Diego for our
Annual DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at [email protected] with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
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 | Best Move to Get Glucose to Goal?
LS wears an insulin pump and uses lispro insulin. LS has an average basal rate of 0.6 units and hour, a 1:15 carb ratio and a 1:50 correction ratio. Based on the ambulatory glucose profile, LS is experiencing elevated glucose levels from 4am to 7am.
To get glucose to target, what is the best next step?
- Add basal insulin glargine to prevent Somogyi effect.
- Increase the basal rate to prevent glucose elevations.
- Make sure LS isn’t consuming carbohydrates after 10pm.
- Ask LS to double check their CGM insertion site.
Want to learn more about this question?
Join us live on August 20, 2024, for our
Insulin Calculation Workshop | From Pumps & Beyond
Level 4 | Advance Level & Specialty Topics
Determining basal & bolus rates for multiple daily injections or insulin pumps can seem overwhelming. This course provides participants with a step-by-step approach to determining basal rates, bolus ratios & how to problem-solve when blood glucose levels aren’t on target. During this course, Coach Beverly provides abundant case studies to give participants hands-on practice & build confidence when calculating insulin doses for a variety of situations.
Objectives:
- Describe using formulas to determine appropriate insulin dosing.
- Discuss strategies to determine & fine-tune basal insulin dose.
- Describe how to determine & fine-tune bolus rates including coverage for carbs & hyperglycemia.
- Using a case study approach, utilize calculations to determine the best insulin dosing strategy.
Learning Outcome:
Participants will have an increased knowledge of how to calculate bolus/basal insulin therapy based on person-specific factors and will be able to recommend insulin adjustments based on individual needs.
Target Audience:
This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research.
CDR Performance Indicators:
- 10.3.1
- 10.5.3
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 15 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert.
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 Level 4 | Insulin Calculation Workshop | From Pumps & Beyond awards 1.5 CPEUs in accordance with the Commission on Dietetic Registration’s CPEU Prior Approval Program.
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.
Bryanna’s Birthday August Sale
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We love her wicked sense of humor, organizational skills, and extensive knowledge, all packaged together with her big-hearted humanity. Bryanna is also the proud mama of Biscuit and Muffin, who she often features as the feline stars in her “Cat Bakery.” Thank you, Bryanna, for your generosity and for leading our team with your expertise, humanity, and kindness. |
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 diabetes certification exams. CBDCE & ADCES does not endorse any preparatory or review materials for the certification exams, except for those published by CBDCE & ADCES.
**To satisfy the requirement for renewal of certification by continuing education for the Certification Board for Diabetes Care & Education (CBDCE), continuing education activities must be applicable to diabetes and approved by a provider on the CBDCE List of Recognized Providers (www.ncbde.org). CBDCE does not approve of continuing education. Diabetes Education Services is accredited/approved by the Commission of Dietetic Registration which is on the list of CBDCE Recognized Providers.
Rationale of the Week | Understanding Ankle Brachial Index – What is True?
For last week’s practice question, we quizzed participants on understanding ankle brachial index. 68% 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: People of color living with diabetes are at increased risk of lower extremity complications and amputations. Ankle-Brachial Index (ABI) measures lower extremity vessel disease in individuals with diabetes and is an important tool to evaluate risk of future complications.
Which of the following is true regarding ABI?
Answer Choices:
- ABI result of less than 0.90 indicates peripheral arterial disease.
- ABI compares brachial systolic blood pressures between left and right arms.
- People with bounding pulses in lower extremities benefit from ABI testing.
- ABI testing can only be conducted by a vascular specialist.
Getting to the Best Answer
Answer 1 is correct. 67.75% chose this answer. “ABI result of less than 0.90 indicates peripheral arterial disease.” GREAT JOB. The ABI is a ratio that measures arterial perfusion in the upper extremities compared to the lower extremities. In brief, the ABI compares the systolic brachial pressure in the arm to the systolic pressure of the lower extremity (using the posterior tibial or dorsalis pedis pressure). To indicate adequate arterial circulation, the lower extremity pressure should be equal to the brachial pressure, or a ratio of 0.99 or better. Therefore, an ABI of less than 0.99 indicates decreased arterial circulation in lower extremities; an alert of peripheral arterial disease (PAD) People with peripheral arterial disease may also complain of pain in calves, legs or buttocks when walking that is relieved by stopping movement. Discovery of PAD requires referral to a specialist to determine next steps to treat PAD and to mitigate future risk of lower extremity complications and heart disease. For more info, we offer a FREE webinar called 3 Steps to DeFeet Amputation. Assess, Screen Report.
Answer 2 is incorrect. 9.0% of you chose this answer. “ABI compares brachial systolic blood pressures between left and right arms.” The ABI is a ratio that measures arterial perfusion in the upper extremities compared to the lower extremities. In brief, the ABI compares the systolic brachial pressure in the arm to the systolic pressure of the lower extremity (using the posterior tibial or dorsalis pedis pressure). For more info, we offer a FREE webinar called 3 Steps to DeFeet Amputation. Assess, Screen Report.
Answer 3 is incorrect. About 14.5% of respondents chose this. “People with bounding pulses in lower extremities benefit from ABI testing.” Bounding pulses in the lower extremity is a positive sign of adequate lower extremity circulation. For more info, we offer a FREE webinar called 3 Steps to DeFeet Amputation. Assess, Screen Report.
Finally, Answer 4 is incorrect. 8.75% chose this answer. “ABI testing can only be conducted by a vascular specialist.” ABI can be conducted in a variety of medical settings as long as the health care professional has completed training on how to perform an accurate ABI, For more info, we offer a FREE webinar called 3 Steps to DeFeet Amputation. Assess, Screen Report.
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!
Why become a CDCES?
Three Reasons from Coach Beverly
Read More: 3 Reasons to Become a CDCES “The best part of becoming a CDCES is working with my colleagues and people living with diabetes. As diabetes educators, we hear compelling and beautiful life stories. I am astounded by the barriers they face and inspired by their adaptability, problem-solving skills, and resilience.“ Reason 1: CDCES is a widely recognized certification by employers and health care professionals throughout the U.S. This credential demonstrates a specialized and in-depth knowledge in the prevention and treatment of individuals living with pre-diabetes and diabetes. Reason 2: Currently, 13% of people in the U.S. have diabetes and another 36% have pre-diabetes which means 49% of Americans are running around with elevated blood glucose levels. Given this epidemic, there will be plenty of future job opportunities. Reason 3: Having my CDCES along with my nursing degree, has opened many doors of opportunity; from working as an inpatient Diabetes Nurse Specialist in a hospital to working as a Manager of Diabetes Education in the outpatient setting to starting my own consulting company.
- Exam requirement updates and eligibility
- New test format starting in July 2024
- 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!
Don’t worry, we will send you a link to the recorded version.
Instructor
Coach Beverly Thomassian, RN, MPH, BC-ADM, CDCES
Author, Nurse, Educator, Clinician, and Innovator, Beverly has specialized in diabetes management for over twenty years and has successfully passed the CDCES exam six times. As president and founder of Diabetes Education Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes.
“Becoming a Certified Diabetes Care and Education Specialist (CDCES) is one of the best professional and personal decisions I have ever made.” – Coach Beverly Thomassian
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 diabetes certification exams. CBDCE & ADCES does not endorse any preparatory or review materials for the certification exams, except for those published by CBDCE & ADCES.
**To satisfy the requirement for renewal of certification by continuing education for the Certification Board for Diabetes Care & Education (CBDCE), continuing education activities must be applicable to diabetes and approved by a provider on the CBDCE List of Recognized Providers (www.ncbde.org). CBDCE does not approve of continuing education. Diabetes Education Services is accredited/approved by the Commission of Dietetic Registration which is on the list of CBDCE Recognized Providers.
Rationale of the Week | Metformin and Cancer
For last week’s practice question, we quizzed participants on the interaction of Metformin with cancer. 66% 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: JR is taking Metformin 1000mg BID but is worried about getting cancer and is thinking about stopping the metformin.
Which of the following is an accurate statement regarding diabetes, metformin and cancer?
Answer Choices:
- There is research suggesting that metformin may be associated with a decreased risk of certain cancers.
- Metformin is associated with B12 deficiency and anemia, so it is best to hold metformin for now.
- There is no additional benefit from metformin, since people with diabetes have a slightly lower risk of liver and uterine cancers.
- Metformin does not increase risk of cancer, but it can negatively impact renal function.
Getting to the Best Answer
Answer 1 is correct. 65.63% chose this answer. “There is research suggesting that metformin may be associated with a decreased risk of certain cancers.” Yes, this is the best answer. According to the ADA Standards, there is ongoing research on metformin’s potential role for decreasing and treating certain cancers due to it’s anti-inflammatory action at a cellular level. Metformin is the most common diabetes medication in use worldwide for good reason. It is affordable and effective. In addition to lowering blood glucose and LDL cholesterol, metformin increases gut microbiota diversity and has an excellent safety profile. See our Meds PocketCard for more info.
Answer 2 is incorrect. 5.47% of you chose this answer. “Metformin is associated with B12 deficiency and anemia, so it is best to hold metformin for now.” While it is true that some individuals experience B12 deficiency with metformin, the benefits of metformin outweigh the potential impact on vitamin B12 deficiency. It is important to evaluate anemia and nerve pain in people on metformin and provide B12 replacement therapy if indicated. See our Meds PocketCard for more info.
Answer 3 is incorrect. About 1.95% of respondents chose this. “There is no additional benefit from metformin, since people with diabetes have a slightly lower risk of liver and uterine cancers.” People with diabetes have increased risk of breast, liver and pancreatic cancers. Encouraging healthy lifestyle along with regular cancer screenings is an integral part of providing diabetes care. See our Meds PocketCard for more info.
Finally, Answer 4 is incorrect. 26.95% chose this answer. “Metformin does not increase risk of cancer, but it can negatively impact renal function.” This answer is FALSE. Many people with diabetes have recently shared with me that they are worried that metformin is “bad” for them and causes kidney damage. There is no data to support this and the opposite is actually true. Since metformin lowers A1C by 1-2% points, it protects the kidneys and blood vessels. Metformin is mostly cleared by the kidneys, so the GFR needs to be at least 30 mL/min to safely take metformin. However, metformin has no negative impact on kidney function and is considered a very safe and beneficial diabetes medication by the scientific and medical community, See our Meds PocketCard 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!
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We love her wicked sense of humor, organizational skills, and extensive knowledge, all packaged together with her big-hearted humanity. Bryanna is also the proud mama of Biscuit and Muffin, who she often features as the feline stars in her “Cat Bakery.” Thank you, Bryanna, for your generosity and for leading our team with your expertise, humanity, and kindness. |
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.
Hispanic Heritage Month – Celebrate & Advocate
We are thrilled to celebrate Hispanic Heritage Month, which runs from September 15th to October 15th. As a diabetes educator who has the honor of serving the Hispanic and Latinx community, it is a joy to celebrate the rich cultural contributions and heritage of this community.
This month also provides an important opportunity to raise awareness about the health issues, including diabetes, that affect this community. According to the Centers for Disease Control & Prevention, one in two Hispanic men and women are predicted to develop type 2 diabetes within their lifetime. Compared to their white counterparts, those living with diabetes are 50% more likely to die from complications.
Lack of access to healthcare and language barriers can play a role in limiting diabetes self-management knowledge, combined with socioeconomic factors that contribute to challenges in receiving needed care, education, and diabetes treatments.
Be authentically curious while promoting best health
Given that diabetes is a significant health issue for Hispanic and Latinx populations in the United States, here are some key points to consider during Hispanic Heritage Month:
- Education: Providing culturally sensitive diabetes education and resources in both English and Spanish can help individuals better understand the condition and its management.
- Promoting Healthy Eating: Encouraging enjoyment of traditional foods that are healthy and affordable, with an emphasis on whole grains, and high-fiber fruits, vegetables, and legumes.
- Physical Activity: Promoting physical activity as part of a healthy lifestyle. Organizing community events or activities during Hispanic Heritage Month can be a great way to encourage exercise.
- Access to Healthcare: Advocating for better access to healthcare, including regular check-ups and screenings for diabetes, can help individuals receive timely treatment and support.
- Community Engagement: Engaging with Hispanic and Latinx communities through cultural events and celebrations during Hispanic Heritage Month can serve as an opportunity to spread awareness and provide resources related to diabetes.
- Be Curious – According to Sandra Arevalo, MPH, RDN, CDN, CLC, CDCES, FADA, “Talking to clients about their background, culture and culinary customs is your best way to learn critical details about their lives. Most people are very proud to share facts about their culture, even more, when they find someone who is authentically curious and has an open mind.”
Hispanic Heritage Month provides a platform to address important health issues, such as diabetes, within Hispanic and Latinx communities. By decreasing barriers to education and access to healthcare, we can work towards reducing the prevalence of diabetes and improving the overall health and well-being of these important communities.
Education Resources in Spanish
- Diabetes Tip Sheets in Spanish (and other languages) published by ADCES
- NIDDK Diabetes Education in Spanish – includes the ability to create a customized search for educational materials in a variety of languages.
- Beyond Type 1 in Español – a Spanish-language website full of great information for people living with type 1 diabetes.
- ADA Spanish language web resource page
- DiabetesEd Patient Teaching Sheets in English and Spanish
Join us Live in Sunny San Diego for our
Annual DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at [email protected] with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
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.
August 2024 eNews | DSME & the 5 M’s, 3 Health Boosting Actions for Summer & Beyond, Bryanna’s Birthday August Sale – Save $100
Happy August
For this month’s newsletter, we want to share articles of hope and value for our community.
Our first article highlights a new framework for providing diabetes self-management education and increasing those cherished “AHA” moments. As part of the team researching the effectiveness of the AH-HA framework, I’m sold on this simple and effective approach to encouraging self-discovery. The AH-HA program incorporates the 5 M framework, developed by Martha Funnell and team, creating an atmosphere of collaboration and empowerment for program participants. We have outlined the AH-HA program and invite you to experiment with this fresh approach when working with individuals or in group settings.
If you are looking for simple summer strategies to boost health, we have outlined three actions people with diabetes can take to improve their well-being. These achievable actions that are easy to kick-start and will provide blood glucose and health benefits long after summer fades into fall.
We invite you to join us in celebrating Bryanna’s August birthday. For the past 4 years, Bryanna has been a beacon of leadership, serving as our Director of Operations and visionary Customer Experience Advocate. Her recent initiatives, such as revitalizing our shopping cart images and reinforcing our commitment to inclusion and advocacy, have been truly inspiring. To kick off her birthday celebration, she suggested a $100 off summer sale, a suggestion we wholeheartedly embraced. And of course, we made sure her beloved cats, Biscuit and Muffin, were included in the celebration.
More good news. We are overjoyed to welcome Tiffany as the new Customer Advocate and Administrative Assistant to our team. Her calm and caring personality and her depth of knowledge of social media and education companies make her a fantastic addition to our team. As we continue to expand our community outreach, you will notice a revitalization of our Instagram platform and our Facebook CDCES Prep Page thanks to Tiffany’s hard work.
We celebrate our community every day and are deeply appreciative for all the hard work and dedication you put into improving diabetes care. Your efforts do not go unnoticed and we are truly grateful for your contributions.
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Warmly, Coach Beverly, Bryanna, Tiffany, and Christine |
Featured Articles
- AH-HA – A Fresh Approach to DSME
- 3 Health Boosting Actions for Summer & Beyond
- Bryanna’s Birthday August Sale – Save $100
- Welcome Tiffany
- Question of the Week
- Rationale of the Week
- ReVive 5 –Ready for OnDemand Viewing
Upcoming Webinars
- 3 Steps to Save Feet- Aug 1
- Prep for BC-ADM- Aug 8
- Prep for CDCES FREE Webinar – Aug 14
- Insulin Calculation- Aug 20
- Solving Glucose Mysteries Type 1- Aug 22
- Solving Glucose Mysteries Type 2- Aug 27
- Aloha! Join us in Hawaii Conference on Oct 18th with Coach Beverly.
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We love her wicked sense of humor, organizational skills, and extensive knowledge, all packaged together with her big-hearted humanity. Bryanna is also the proud mama of Biscuit and Muffin, who she often features as the feline stars in her “Cat Bakery.” Thank you, Bryanna, for your generosity and for leading our team with your expertise, humanity, and kindness. |
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.
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.
Three Emerging Topics Shaping the Future of Diabetes Care
by Christine Craig, MS, RDN, CDCES
The vibrant food, music, and culture of New Orleans, along with networking opportunities, were undoubtedly highlights of ADCES 24 this year. Thought-provoking sessions on health equality, disordered eating in diabetes, and strategies to prevent therapeutic inertia made ADCES 24 an enriching experience for all attendees.
Three key topics emerged on advancements aimed at improving individualized care management and actively shaping the future of diabetes care.
Artificial Intelligence (AI) is here to stay.
Diabetes care and education specialists will benefit from an improved understanding of the applications and integrations available at our disposal. Integrating AI into clinical practice offers significant potential for personalized patient care, especially in managing chronic conditions like diabetes. AI-powered tools can analyze vast datasets to identify patterns and provide tailored recommendations, enhancing the precision of nutritional guidance and diabetes management plans. However, challenges remain, particularly when ensuring the quality of AI systems. These models may lack diversity, leading to biases affecting data accuracy and recommendations.
Addressing AI biases is crucial to ensure AI tools support equitable healthcare delivery and foster better outcomes for all individuals with diabetes.
Whole Person Care – CV Risk Calculator
As our Standards of Care suggest, whole-person diabetes care involves going beyond glucose management and focusing on whole-body systems. Cardiovascular metabolic kidney (CKM) syndrome requires a multifaceted approach, targeting the interconnected risk factors of cardiovascular disease, diabetes, and kidney dysfunction.1 Published in 2023, the PREVENT calculator,2 developed by the American Heart Association Cardiovascular-Kidney-Metabolic Scientific Advisory group, provides a 10-year and 30-year risk estimate for CVD, ASCVD, and heart failure. The PREVENT equation considers cardiovascular and other risk factors such as urine albumin-to-creatinine ratio, A1C, or social determinants of health (zip code). We can utilize this risk calculator, but to address cardio, metabolic, and renal disease we can merge the health care silos and offer integrative, comprehensive care models and treatment plans.
By Christine Craig, MS, RDN, CDCES
Type 1 Diabetes Key Updates
There are exciting advances in type one diabetes management including technology, organizational updates, and a focus on progression prevention. The latest advancements in automated insulin delivery (AID) technologies and new partnerships expand options for individuals with diabetes. These advances and additions to the competitive market are crucial for enhancing patient care and offering personalized management strategies.
On June 4th, 2024, JDRF became Breakthrough T1.3 This name change reflects the breakthroughs in research, access, and education and represents the diversity in the age of those living with type 1 diabetes. Prevention of type 1 diabetes progression is focused on immunotherapy approaches, aiming to preserve beta-cell function and delay the onset of the disease. Clinical trials have shown promise with therapies such as teplizumab-mzwv, an anti-CD3 monoclonal antibody, which has been approved by the FDA to delay the onset of type 1 diabetes in individuals at high risk. Early screening and identification of at risk through genetic and immunological markers are also being integrated into clinical practice, allowing for earlier intervention and more personalized prevention plans.
A new Consensus paper published in June of 2024 provides “Guidance for monitoring individuals with islet autobody-positive pre-stage 3 type 1 diabetes”.4 The paper reviews education, monitoring, and treatment initiation recommendations and discusses psychological support systems. This consensus notes that monitoring of stage 1 Type 1 Diabetes will most likely take place within primary care offices; however, specialists may be needed to support stage 2 monitoring and education. There will be new ICD-10 codes to allow improved monitoring of islet autobody-positive pre-stage individuals to ensure appropriate tracking and treatment when required. These developments reflect an emphasis on not just managing type 1 diabetes but actively working to prevent its progression and improve the quality of life for those at risk.
As diabetes care and education specialists, staying informed and engaged with the latest tools and approaches can improve quality of care. I encourage you to delve deeper into these topics, explore how AI can enhance your practice, integrate comprehensive care models like CKM into management, and keep abreast of the latest developments in type 1 diabetes treatment and prevention.
Together, we can continue to elevate the standard of care and improve outcomes for all individuals living with diabetes.
1. Krentz A, et al. Rising to the challenge of cardio-renal-metabolic disease in the 21st century: Translating evidence into best clinical practice to prevent and manage atherosclerosis. Atherosclerosis. Volume 396, 2024. https://doi.org/10.1016/j.atherosclerosis.2024.118528.
2. PREVENT Calculator: https://professional.heart.org/en/guidelines-and-statements/prevent-calculator
3. Breakthrough T1: https://www.breakthrought1d.org/
4. Phillip M. et al. Consensus Guidance for Monitoring Individuals with Islet Autoantibody–Positive Pre-Stage 3 Type 1 Diabetes. Diabetes Care. July 2024; 47(8):1276–1298. https://doi.org/10.2337/dci24-0042
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