For last week’s practice question, we quizzed participants on the effects of nocturnal hyperglycemia. 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: JR is 11 years old with type 1 diabetes and their parent shares their concern that the blood glucose seems to be rising overnight with morning hyperglycemia. The parent is worried that JR may be sneaking snacks in the night.
As a diabetes specialist, you know that this glucose rise is most likely due to:
Answer Choices:
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.
Answer 1 is correct. 63.38% chose this answer. “Overnight hormonal fluctuations.” YES, this is the best answer. There is an increased release of counterregulatory and growth hormones during the night, that is especially noteworthy during the teen years. These hormones contribute to insulin resistance and can cause morning hyperglycemia, often referred to as the Dawn Phenomena. For this reason, basal insulin dosing and rates need ongoing adjustment to address this nocturnal insulin resistance.
Answer 2 is incorrect. 31.14% of you chose this answer. “Nocturnal hypoglycemia followed by hyperglycemia.” Even though this phenomena, referred to as Somogyi effect, could cause morning hyperglycemia, there is no information in the test question that indicates JR is experiencing lows over night. Symptoms of hypoglycemia during the night might include; morning headaches, night sweats, vivid dreams or waking up hungry.
Answer 3 is incorrect. About 2.19% of respondents chose this. “Slow onset of diabetes ketoacidosis.” Even though hyperglycemia is associated ketoacidosis, JR has no symptoms of ketoacidosis like lethargy, fruity breath, urine ketones or dehydration.
Finally, Answer 4 is incorrect. 3.29% chose this answer. “Insulin pump or CGM malfunction.” While pump malfunction can lead to hyperglycemia, there is no information contained in the test question that would lead us to believe that JR is using any diabetes technology.
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!
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.
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!
Bring your colleagues and enjoy our friend discount.
Our team expertly translates the complex science of diabetes into understandable terms while keeping it real, practical, and fun.
Team of expert faculty includes:
All hours earned count toward your CDCES Accreditation Information
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!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
LT has just been diagnosed with stage 2, type 1 diabetes. They have 2 positive antibodies and their blood sugars are slightly elevated. They ask you if they are a candidate for “that therapy” that can protect their beta cells and slow progression of type 1 diabetes.
What is the most accurate response?
Click Here to Test your Knowledge
This course will transform your test anxiety into calm self-confidence and test-taking readiness.
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
All hours earned count toward your CDCES Accreditation Information
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!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
About 30% to 40% of people with diabetes will experience chronic kidney disease (CKD), and most won’t know they have worsening kidney function. According to a recent study, approximately 90% of people with CKD in the United States don’t even know they are experiencing a decline in kidney function. This lack of awareness is due to inadequate annual renal function testing.
A recently published study from the National Kidney Foundation and National Committee for Quality Assurance showed that fewer than 40% of adults with diabetes received the clinically recommended testing for chronic kidney disease in 2017.
To measure testing frequency, researchers looked at Kidney Health Evaluation for People with Diabetes (KED). Ked is a component of the Healthcare Effectiveness Data Information Set, built on the American Diabetes Association (ADA) and National Kidney Foundation recommendations.
To meet KED fulfillment criteria, the standards require that people with diabetes get tested for kidney disease at least annually using both:
In addition to low testing frequency overall, the study highlights disparities in KED fulfillment among Black Americans and socioeconomically disadvantaged groups, underscoring the urgent need to address these disparities to ensure equitable care for all.
Since only 40% of people with diabetes are getting GFR and UACR tested annually, a significant portion of individuals with diabetes are not be receiving the recommended kidney function monitoring. Regular kidney function testing is crucial to identify any signs of kidney damage early and take appropriate measures to prevent or slow down the progression of kidney disease in individuals with diabetes.
Annual GFR and UACR testing fulfillment is associated with improved diabetes care, earlier CKD diagnosis, and initiation of evidence-based kidney protective interventions, according to the results. In addition, annual KED testing increases the prescription of evidence-based drugs for blood pressure and blood sugar management, along with interdisciplinary care. However, researchers observed disparities in meeting these criteria among Black adults, those with Medicare-Medicaid dual eligibility status, residents of low-income neighborhoods, and individuals with limited education.
Diabetes care and education specialists, along with healthcare providers, can play a critical role in helping track annual testing and encouraging people with diabetes to undergo kidney function evaluation as part of their diabetes management plan. Increasing awareness about the importance of these tests and improving access to healthcare services can help enhance the annual GFR and UACR testing rate among people with diabetes, especially in under-resourced communities.
Additionally, individuals with diabetes can proactively discuss these tests with their healthcare providers to ensure they are engaged in preserving kidney health.
Fulfillment and Validity of the Kidney Health Evaluation Measure for People with Diabetes
Read more for a quick summary of what to look for when evaluating kidney function in our blog here.
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.
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!
Bring your colleagues and enjoy our friend discount.
Our team expertly translates the complex science of diabetes into understandable terms while keeping it real, practical, and fun.
Team of expert faculty includes:
All hours earned count toward your CDCES Accreditation Information
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!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Since there have been more than a dozen reports of intestinal blockage or ileus among people using semaglutide (Ozempic), the manufacturer is now required to add a new warning to its label. The FDA announced that the potentially rare but life-threatening condition must be included in the package insert so consumers know about this possible complication.
Warning signs of an intestinal blockage include bloating, abdominal cramps, constipation, nausea, vomiting, and constipation that doesn’t subside within a few days. Encourage individuals to report these signs and consult with a healthcare provider. This warning is essential to share with anyone using the GLP-1 RAs and GLP-1RA / GIP class of medications while the FDA and other researchers evaluate the risk of this potential complication.
According to WebMD, “the FDA has received more than 8,500 reports of gastrointestinal issues among people taking medications like Ozempic and Wegovy, the latter of which is approved for weight loss. Ileus is mentioned in 33 cases, including two deaths, of people taking drugs containing semaglutide, the active ingredient in Ozempic, Wegovy, and another widely used weight loss drug called Mounjaro.”
Semaglutide is one of the most widely used (GLP-1 Receptor Agonist) due to its impressive impact on blood glucose and substantial body weight loss. More data is needed to evaluate population risk and rates of complications. Warnings for intestinal blockages already exist for other popular diabetes drugs, including Wegovy and Mounjaro (tirzepatide).
For more information about classes of diabetes medications, download our Medication PocketCards.
In addition to the intestinal blockage warning, the FDA has also warned about the potential risk of hypoglycemia for “Concomitant Use with an Insulin Secretagogue (e.g., Sulfonylurea) or Insulin.
The new FDA warning states that semglutide (Ozempic) stimulates insulin release in the presence of elevated blood glucose concentrations. Individuals receiving OZEMPIC in combination with an insulin secretagogue (e.g., sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. When initiating OZEMPIC, consider reducing the dose of concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia.
These label updates are an essential warning that diabetes care and specialists can include as part of their education for people with diabetes considering starting this class of medication.
For more information about classes of diabetes medications, download our Medication PocketCards.
ADCES Hawaii Chapter & Coach Bev invite you to join this class that covers gastrointestinal health from top to bottom. Topics include; fatty liver disease diagnosis and treatment, intestinal complications associated with diabetes, keeping the microbiome healthy, and more. Join us to explore the magnificent wonders of diabetes and the gut.
Location: Honolulu Country Club, 1689 Ala Pu’umalu Street, Honolulu, HI
CEs: 6.5 CEs for physicians, nurses, pharmacists, physician assistants, dieticians & social workers.
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!
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.
For last week’s practice question, we review strategies for keeping glucose “under control.” 79% of respondents chose the best answer which is awesome. 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 13 years old and has type 1 diabetes and their time in range is usually less than 50%. JR’s mom finds empty soda bottles hidden in the back of JR’s drawer along with some candy bars.
JR’s mom is very upset about this discovery and asks you how to get this “situation under control”. What is the most appropriate response?
Answer Choices:
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. 7.87% chose this answer. “Empathize with her and acknowledge that non-adherence is very common in this age group.” Although this answer starts out with empathy, the second half reinforces the outdated concept of “non-adherence”. If JR is eating candy bars and drinking sodas, then hiding the evidence, indicates that JR might be experiencing big emotions around food restrictions that need exploration.
Answer 2 is incorrect. 6.30% of you chose this answer. “Gently ask her if she has noticed any other signs of disordered eating.” We can’t assume that JR has disordered eating because they are eating candy bars and drinking sodas, then hiding the evidence. This behavior may indicate that JR is experiencing big emotions around food restrictions that need exploration.
Answer 3 is incorrect. About 6.04% of respondents chose this. “Explore if they have established clear guidelines for daily carb counting.” Even though JR is eating candy bars and drinking sodas, then hiding the evidence, it doesn’t indicate that they additional information on carb counting or are in need of stricter guidelines.
Finally, Answer 4 is correct. 79.79% chose this answer. “Recognize her feelings and explore problem-solving strategies.” YES, GREAT JOB. This is the best answer. If JR is eating candy bars and drinking sodas, then hiding the evidence, this indicates that JR might be experiencing big emotions around food restrictions that need exploration.
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!
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.
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!
Bring your colleagues and enjoy our friend discount.
Our team expertly translates the complex science of diabetes into understandable terms while keeping it real, practical, and fun.
Team of expert faculty includes:
All hours earned count toward your CDCES Accreditation Information
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!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
JR is 11 years old with type 1 diabetes and their parent shares their concern that the blood glucose seems to be rising overnight with morning hyperglycemia. The parent is worried that JR may be sneaking snacks in the night.
As a diabetes specialist, you know that this glucose rise is most likely due to:
Click Here to Test your Knowledge
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.
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!
Bring your colleagues and enjoy our friend discount.
Our team expertly translates the complex science of diabetes into understandable terms while keeping it real, practical, and fun.
Team of expert faculty includes:
All hours earned count toward your CDCES Accreditation Information
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!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
We are excited to announce Diabetes Decoded: Expert Insights with Coach Beverly FREE podcasts, available on most streaming platforms!
Our new Diabetes Decoded Podcast Series makes it easy to access our library of FREE courses no matter where you are, so you can listen to this information on the go on your mobile device or while driving.
At Diabetes Education Services, our goal is to provide inclusive learning opportunities for healthcare professionals seeking certification or updates on the latest diabetes information. We have curated nine free course topics and plan to add two more to this FREE learning library by the end of the year.
Diabetes Decoded FREE Podcast Topics:
Our podcasts are an audio version of Coach Bev’s FREE webinars and stream on platforms such as Spotify, Amazon Music, Castbox, and Google Podcast! These websites have downloadable apps so you can take Coach Bev with you on your phone or listen to her in the car. Each of these apps has listening features that allow you to enjoy this handpicked library of free podcasts. Stay tuned for any updates or potentially podcast-exclusive information.
Podcasts are perfect for information sharing. As a company dedicate to improving diabetes care, we are excited to provide these for free so that more people can access and enjoy them without any cost. No CEs are provided, but our podcasts are chock full of helpful information and there is more to come!
New Diabetes Decoded Podcast Topics Coming Soon:
Thanks again for making a difference in the lives of people with diabetes. We appreciate all you do!
As diabetes technology is becoming commonplace in our practice, figuring out how to make sense of all the data can seem overwhelming. Dr. Isaacs has a special knack for breaking down the essential elements of the Ambulatory Glucose Profile (AGP) and other reports to provide participants with a clear road map for data interpretation. She includes tons of sample practice cases utilizing CGM, connected pens, and insulin pumps.
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.
Topics include:
Instructor: Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES, was awarded ADCES Diabetes Care and Educational Specialist of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She is the Director of Education & Training in Diabetes Technology at the Cleveland Clinic. She has numerous diabetes publications and research projects focusing on medications, CGM, and diabetes technology. You won’t want to miss this hands-on workshop with an international expert in the field.
All hours earned count toward your CDCES Accreditation Information
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!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.