Subscribe
eNewsletter
Ready to get certified?
Free CDCES Coach App
Download
Free Med Pocket Cards
eNewsletter
Free CDCES Coach App
Free Med Pocket Cards
For last week’s practice question, we quizzed participants on which feature most strongly supports a diagnosis of hyperosmolar hyperglycemic state (HHS) rather than diabetes ketoacidosis (DKA). 59.77% 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
A 32-year-old with newly discovered diabetes is brought to the emergency department with polyuria and lethargy. They have been sleeping more than usual.
Initial labs show:
Based on the following labs, which feature most strongly supports a diagnosis of hyperosmolar hyperglycemic state (HHS) rather than diabetes ketoacidosis (DKA)?
Answer A is incorrect: 14.21% chose this answer, “Markedly elevated plasma glucose.” This answer is tempting, because glucose levels do become markedly elevated with HHS. However, very high glucose levels can also occur with DKA. So this answer doesn’t differentiate between these two hyperglycemic crises.
Answer B is incorrect: 21.38% chose this answer, “Absence of significant metabolic acidosis.” This juicy answer is tempting, since with HHS there is the absence of metabolic acidosis. However, based on the question details, there is no information on pH or ketone status, so we can’t make that assumption.
Answer C is incorrect: 4.64% chose this answer, “Out of range potassium level.” The potassium level of 3.7 is within normal range and doesn’t help us differentiate between HHS and DKA.
Answer D is correct: 59.77% chose this answer, “Elevated effective serum osmolality.” YES, this is the BEST Answer. Great Job! One of the main features of HHS, is increased serum osmolality (greater than 300), due to a combination of elevated glucose and dehydration.
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!
Sale Ends on February 16th, 2026!
Several years ago, I was nominated for Diabetes Educator of the Year. Being put forward by colleagues I deeply respected and admired was profoundly meaningful—and, honestly, a little overwhelming.
The nomination felt like recognition of decades of clinical work, teaching, mentoring, and advocacy for person-centered diabetes care. After submitting the detailed application, I allowed myself to feel hopeful. I imagined sharing my philosophy of judgment-free diabetes care with audiences across the country, offering a message of healing for both healthcare professionals and the people they serve. I even choreographed my walk-up dance in my head, ready to hit the ground running.
Then the email arrived from the board: I hadn’t been selected.
I won’t pretend it didn’t sting. I was devastated. Awards matter because they symbolize recognition; they affirm that your voice has value. When I wasn’t chosen, I found myself sitting with a familiar response that many healthcare professionals have experienced: a complicated mix of disappointment, sharp self-doubt, and the well-worn instinct to minimize the hurt and simply move on.
But once the initial ache softened, something important came into focus. I realized that while awards can amplify a message and provide a platform for it, they are not the source of the message itself. And my message was still burning—undiminished—inside me.
For years, I had been witnessing something under the surface of diabetes care and, more broadly, of healthcare. Earnest and compassionate clinicians were giving their all to provide the best care, but felt they weren’t breaking through or reaching people in ways that led to significant change. Many were questioning their worth, their effectiveness, and even their decision to enter healthcare at all.
I heard it in hallway conferences. In mentoring meetings. In calm moments after lectures when someone would come up to me and say, “I thought it was just me.”
I knew then that the story I was burning to share couldn’t be reduced to a title or an award category. The message I was holding wasn’t just about diabetes education and achieving an A1C of less than 7%. It was about the emotional gift of caring—and the healing strength of connection.
Not winning that award forced a reckoning moment: How could I share my message on a bigger stage?
The answer surprised me with its clarity. Write a book.
I wrote Healing through Connection for Healthcare Professionals because this story matters, award or no award.
The lived experiences and emotional well-being of healthcare professionals matter. You can make a bigger impact in the care you provide by taking inventory of your inner dialogue and beliefs.
Working with people living with diabetes can be filled with connection, joy, and revitalization. By leaving judgment at the door and accepting each other as we are – messy, complicated, and beautiful- you can deepen your connection. The unvoiced grief, the unresolved trauma, the silent resilience, can all have a voice at the table. As a healthcare professional, you deserve healing too.
Not winning hasn’t stopped me from sharing my message; it motivated me to find a different way to share it.
It pushed me to write honestly about:
This book is not a rebuttal to an award committee.
It’s a love letter to healthcare professionals who keep showing up even when recognition is scarce.
Today, when a nurse, pharmacist, dietitian, or physician tells me, “This book made me feel less alone,” I know I chose the right path.
I didn’t win an award, but I found my voice and shared my authentic life story in my book. This book is my commitment transparency with the hopes that it gives you permission to share your truth.
I wrote Healing through Connection so that other healthcare professionals can share their story and create a healing space for themselves and the people in their care.
Because in the end, the greatest legacy is knowing that your message touched the lives of your community and created space for more compassion, for us and those in our care.
Coach Beverly is thrilled to invite you to join this celebration of completing her book and finally getting the Audible and Kindle version up on Amazon.
We will be discussing why this book matters now more than ever. She will share real stories from her clinical practice and ask you to share yours.
Coach Bev will discuss the process involved in writing this book and how she found her voice. We will wrap up with a question-and-answer session. We hope you can join us.
Invite your friends and colleagues too!
Maria, a 52‑year‑old woman with type 2 diabetes for 8 years, attends a follow‑up visit. Her A1C has risen from 7.8% to 9.2% over the past year. She reports feeling “overwhelmed” and says she didn’t want to start the medication her clinician recommended at the last visit. She explains, “I’m scared of side effects, and I feel like needing medication means I failed.”
Which of the following responses is the least appropriate (i.e., the WRONG thing to say) to Maria?
In this course, William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, examine the powerful role of psychosocial factors in diabetes self-management. Through innovative strategies, participants will learn how to recognize and address common barriers to effective self-care and cardiometabolic medication initiation and maintenance, while fostering respectful, stigma-free clinical encounters.
Through a collaborative and person-centered approach, the course emphasizes communication strategies that enhance motivation, build confidence, and reinforce the value of self-management. Participants will develop skills in diabetes-focused action planning, addressing medication hesitancy, and providing ongoing support and resources to sustain behavior change over time. The goal is to help clinicians make diabetes care more doable, meaningful, and effective for people living with diabetes.
Featured Articles & Announcements ___________________________ |
Webinars & Programs
___________________________
Greetings, healthcare colleagues!
As healthcare professionals, we’re often invited into the most tender moments of people’s lives. In these moments, you may notice your heart swell with compassion, sorrow, or deep gratitude. While this emotional labor is rarely acknowledged, I want you to know: I see it. I hear it.
We recognize the love and care you give each day. Whether it’s an after-hours check-in, helping with food access, volunteering at a community event, or offering a much-needed hug.
This February, let’s take a moment to honor you and the quiet heroism of showing up again and again with an open heart.
In this newsletter issue, I share how not being selected for a diabetes educator award led me to a deeper realization and lit a fire to share my message by writing a book.
We also highlight the power of professional connections and the importance of membership in shaping a healthcare future that reflects our values and vision. A special thanks to Sarah Hormachea, RD, MS, CDCES, BC-ADM for her meaningful insights and guest article contribution.
In celebration of fiber, don’t miss nutrition expert Christine Craig’s article featuring the unsung benefits of fiber plus a high five list.
A tech-focused feature from Dr. Beattie explores how technology and diabetes distress can be linked, along with tools to address it.
You are the heartbeat of health care! Here’s to leading with love this month and every month.
With hearts full of gratitude,
Coach Beverly, Bryanna, Astraea & Katarina
Basic & e-Deluxe CDCES Boot Camp Bundle includes:
CDCES Boot Camp | 50+ CEs
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam.
✔ Earn CE/CPE credit through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR. For more information on accreditation, visit the registration page on our Online Store and click the “Accreditation” tab.
✔ Learn at your pace with expert-led, exam-focused content
✔ Everything you need—organized, practical, and in one place
✔ Perfect for self-directed learners who want complete, person-centered content for clinical practice and exam prep.
✔ Build knowledge, sharpen test-taking skills, and prepare with confidence—on your schedule.
Focused. Flexible. Proven.
Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more!
If you’re renewing your CDCES or BC-ADM certification this live conference, paired with a handful of free bonus courses, serves as the ideal renewal companion!
Join this FREE, pharmacist-focused webinar Co-led by Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, Endocrinology Clinical Pharmacy Specialist and Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM.
Leave with a practical roadmap for achieving Certification Diabetes Care and Education Specialist (CDCES) or Board Certification in Advanced Diabetes Management (BC-ADM).
For last week’s practice question, we quizzed participants on recommendations for facilitating positive health behavior change, according to 2026 ADA Standards. 81.75% 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
KC has type 2 diabetes, diagnosed 5 years ago. They report low physical activity, frequent sugar-sweetened beverage intake, and high stress related to work. Last A1c was 8.2%. KC reports previous advice to “exercise more and drink less soda,” but reports making minimal changes. They express interest in improving health but feels overwhelmed by where to start.
Which of the following responses best aligns with the 2026 ADA Standards of Care recommendations for facilitating positive health behavior change?
Answer A is incorrect: 2.38% chose this answer, “Advise KC to stop sugary drinks and record physical activity minutes daily.” Although the Standards of Care do recommend avoiding sugar-beverage consumption and increased activity, this answer is prescriptive and not collaborative. Simply telling the patient what to do without assessing motivation or barriers does not align with ADA recommendations for patient-centered behavior change.
Answer B is correct: 81.75% chose this answer, “Ask KC, “What makes improving your health important to you right now?”” This question is an example of a response using the strategy of motivational interviewing (MI). MI is a patient-centered counseling method that explores readiness, addresses ambivalence, helps patients identify barriers to behavior change and encourages confidence while setting goals. The 2026 ADA Standards of Care recommend using MI, along with other strategies, to help individuals with diabetes adopt sustainable lifestyle behaviors, including diet, physical activity, and stress management.
Answer C is incorrect: 3.57% chose this answer, “Focus the visit on intensifying glucose lowering medications first and revisit lifestyle changes at the next appointment.” While medication intensification may be a first step and necessary approach to support KC is their diabetes management, it fails to first address KC’s goals and desires. In addition, the 2026 ADA Standards of Care emphasize integrating behavior change support alongside pharmacologic therapy.
Answer D is incorrect: 12.3% chose this answer, “Recommend KC find social support for activity at the local gym and work with KC to set goals to avoid sugar-sweetened beverages.” While this option does consider strategies of social support and goal-setting it lacks assessment of readiness and barriers and again is a more prescriptive approach vs. collaborative approach.
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!
A 32-year-old with newly discovered diabetes is brought to the emergency department with polyuria and lethargy. They have been sleeping more than usual.
Initial labs show:
Based on the following labs, which feature most strongly supports a diagnosis of hyperosmolar hyperglycemic state (HHS) rather than diabetes ketoacidosis (DKA)?
Making a connection is healing for the person in our care and for us too.
This is why I developed what I call the ABC Worksheet — a simple framework rooted in forging genuine connections rather than focusing on corrections:
This simple ABC approach shifts the tone of care. Instead of asking, “Why aren’t you doing this?” we ask, “I’m curious, what’s the hardest thing about managing your diabetes right now?”
Diabetes is just one aspect of their complete humanity. Diabetes is a common chronic condition that disrupts the usual orchestration of glucose management. No one can give themselves diabetes. And, the individual with diabetes is not to blame for this glucose dysregulation. It’s due to a combination of genetics, early childhood experiences, and social factors that shape health.
I give all of us permission to free ourselves from being responsible for patients’ choices. Our job is to listen and help the individual discover their own internal wisdom. The best way to tap into their self-knowledge is to allow space for reflection and to ask permission before offering our well-intentioned insights.
As I write in my book, “Engaging in active listening is considered a therapeutic intervention on its own. When we focus on listening with curiosity first, something powerful happens. A bridge is built – a connection is made.”
This bridge of active listening provides the perfect segue to dive into diabetes distress and the emotional weightiness of life with diabetes.
Diabetes distress acts like a brake. If we don’t first address fear, shame, or diabetes overwhelm, not even the best diabetes education plan will stick. But when we assess emotional well-being early, we release that brake — and forward movement becomes possible. (Here is a link to Diabetes Distress Screening Tools)
And here is the beautiful part: this approach doesn’t just help the person with diabetes. It sustains us.
“In the end, a person-centered approach doesn’t only support the person with diabetes—it also supports the healthcare professional by fostering authentic connection, shared responsibility, and a greater sense of purpose in your work.”
Investing in connection reduces burnout and increases the likelihood of success. It frees us from being responsible for their choices. We are simply the coach, helping them discover the wisdom they already possess. This partnership can restore our purpose and allow us to be present in this healing journey. Compassion is re-energizing for us and for the person in our care.
So instead of saying, “I know you don’t want to get diabetes complications, so you need to really work on your weight loss goals,” we greet the person and ask them, how are you feeling?
Instead of focusing on their weight at the scale, we ask them, how are you feeling in your body?
Instead of focusing on the weight they have gained, we focus on the behavior changes they have made (meeting with the RDN, eating more veggies, and decreasing their soda intake).
How good does that feel for both the health care provider and the person in their care? It feels great.
Download the ABC’s of Teaching Through Connection Worksheet and begin integrating Awareness, Belonging, and Collaboration into your daily practice.
And if this message resonates with you, I invite you to explore Healing through Connection for Healthcare Professionals. Coach Beverly wrote this book to help you care for others while finding yourself in the process.
👉 Download the Worksheet
👉 Order the Book Here
Let’s move from judgment to partnership.
Let’s lead with connection and curiosity.
Coach Bev 💜
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory & practice.
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
For last week’s practice question, we quizzed participants on J.C.’s family history and lab work, and what it reveals. 80.92% 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
J.C. is a ten-year-old female with a family history of type 1 diabetes. Her 7-year-old brother was diagnosed with type 1 diabetes two years ago. J.C. has no complaints and reports feeling well. She enjoys playing sports, including basketball and soccer. Her current BMI is 22.1 (93rd percentile for age). She denies any polydipsia, polyuria, or polyphagia. Her lab work demonstrates a fasting blood sugar of 71 mg/dL, an A1c of 5.0%, normal kidney function, and normal electrolytes. Her diabetes autoantibody panel shows positive glutamic acid decarboxylase (GAD) and islet antigen 2 (IA-2) antibodies, negative zinc transporter 8 (ZnT8) antibodies, and negative insulin antibodies.
What does her lab work reveal?
Answer A is correct: 80.92% chose this answer, “Stage 1 Type 1 diabetes.” J.C. has stage 1 type 1 diabetes. She has two positive autoantibodies and normoglycemia.
Answer B is incorrect: 13.36% chose this answer, “Stage 2 Type 1 diabetes.” J.C. still has normoglycemia. Stage 2 type 1 diabetes is characterized by positive autoantibodies and dysglycemia (Impaired fasting glucose, Impaired glucose tolerance, or elevated A1c over 5.7% or 10% increase in A1C).
Answer C is incorrect: 4.2% chose this answer, “Stage 3 Type 1 diabetes.” J.C. does not have lab work confirming diabetes by the standard diagnostic criteria, and she is asymptomatic. Stage 3 type 1 diabetes is characterized by overt hyperglycemia and symptoms of diabetes with autoimmunity present.
Answer D is incorrect: 1.53% chose this answer, “Type 2 diabetes.” J.C. does not have type 2 diabetes. She does have a BMI in the overweight category, but she does not have hyperglycemia. She also has positive autoantibodies associated with type 1 diabetes. Type 2 diabetes is not immune-mediated.
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!
Welcome to our selection of comprehensive CDCES Boot Camp Online Prep Bundles that are specifically designed for healthcare professionals who are studying for the Certified Diabetes Care and Education Specialist (CDCES) exam.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
We offer a selection of prep bundles to meet everyone’s needs! See the descriptions below to review what is included in each option.
CDCES Boot Camp | Basic Exam Prep Bundle: This option is perfect for someone who wants just the Online Courses and materials all in one place, our Online University. This bundle includes Levels 1, 2, and 3 & Toolkits which equates to over 30 courses, 50 CEs/CPEUs, and 400+ online practice questions.
CDCES Boot Camp | e-Deluxe Exam Prep Bundle: This bundle has all of the courses from the Basic Bundle, along with the ADCES Certification Review Guide Practice Questions e-book with 400+ practice questions.
