Rationale of the Week | Low carb diets and SGLT-2’s a good mix?
For last week’s practice question, we quizzed participants on SGLT-2’s & low carb diets. 60% 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: ST is a 56-year-old presenting for MNT and diabetes education. Their last A1c was 7.4%, and they are currently taking 1000 mg of Metformin and 10 mg of empagliflozin daily for glucose management. They recently read that a very low-carbohydrate eating pattern can help individuals with type 2 diabetes reduce A1C and the need for additional medications and are motivated to implement diet changes.
What would be your primary considerations and guidance in response to ST?
Answer Choices:
- ST is motivated for change, encourage their desire to implement a very low-carbohydrate diet as it is safe for all individuals with diabetes.
- ST should avoid a very low-carbohydrate diet.
- A very low-carbohydrate diet may be appropriate if ST transitions off the SGLT2 inhibitor.
- ST should follow a fixed carbohydrate intake at each meal to align with their medication regimen.
Getting to the Best Answer
Answer 1 is incorrect. 10.61% chose this answer. “ST is motivated for change, encourage their desire to implement a very low-carbohydrate diet as it is safe for all individuals with diabetes.” While very-low-carbohydrate diets has evidence for reducing A1c and need for additional medications, they may not be universally safe for all individuals. Keep reading to learn more.
Answer 2 is incorrect. 12.77% of you chose this answer. “ST should avoid a very low-carbohydrate diet.” A very-low-carbohydrate diet is not inherently contraindicated for individuals with diabetes, but careful planning and potential discontinuation of the SGLT2 inhibitor is recommended to reduce the risk of euglycemic ketoacidosis.
Answer 3 is correct. About 59.53% of respondents chose this. “A very low-carbohydrate diet may be appropriate if ST transitions off the SGLT2 inhibitor.” Use SGLT2 inhibitors with caution when implementing a low carbohydrate diet and strong consideration should be made to cease this medication if implementing a very low carbohydrate diet, less than 50 grams of carbohydrate per day. Very low carbohydrate diets may increase the risk of euglycemic ketoacidosis by lowering insulin levels. After additional clinical review, a very-low-carbohydrate diet can be considered for ST if they transition off the SGLT2 inhibitor. Educating ST about the difference between physiological ketosis and pathological ketoacidosis may also be considered.
Finally, Answer 4 is incorrect. 17.09% chose this answer. “ST should follow a fixed carbohydrate intake at each meal to align with their medication regimen.” While fixed carbohydrate intake can sometimes simplify diabetes management, it does not align with ST’s interest in very-low-carbohydrate eating patterns. The current medication regimen does not necessarily require a fixed carbohydrate plan. Simply educating on this approach without additional shared decision making may not provide an individualized dietary intervention.
Reference: American Diabetes Association Professional Practice Committee; 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024. Diabetes Care 1 January 2024; 47 (Supplement_1): S77–S110. https://doi.org/10.2337/dc24-S005
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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- Question of the Week | What defines overbasalization according to 2025 ADA Standards?
- Upcoming Webinars!
- Rationale of the Week | Diabetes & Malnutrition Risk
- Cheat Sheet Updates – Reflect 2025 ADA Standards
- Question of the Week | ADA Standards identify another 1st Line med to treat kidney disease. Which one?
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.
Entering the Field of Diabetes Education – Building a Bridge Program
Building a Bridge to Welcome New Diabetes Specialists
We are geared up to help grow and mentor future diabetes specialists to meet the increasing and varied needs of our diabetes community, but we need your help.
Over the next 10 years we are “Building a Bridge” to welcome a thousand new diabetes educators into the field. If you know a healthcare professional seeking a new challenge and eager to pursue a meaningful and rewarding specialty, please invite them to consider becoming a Certified Diabetes Care and Education Specialist (CDCES).
To reach the goal of encouraging healthcare professionals to enter the field, we have created a new FREE webinar that outlines the benefits and steps involved in “Becoming a Diabetes Specialist.” We want to share this information with as many healthcare professionals as possible to encourage them to consider specializing in diabetes.
Our goal is to cast this net far and wide to address the rising prevalence of diabetes. Currently, 16% of people in the United States live with diabetes, and over 38% live with prediabetes according to the CDC. Diabetes is more prevalent in communities of color and impacts individuals with less income and resources. CDCES’s are influential in addressing health disparities and promoting equitable care through their work in health care settings across the country.
Why Become a CDCES?
On a personal note, becoming a CDCES is one of the best professional decisions I have ever made. This certification has opened the door to many opportunities and dramatically increased my job satisfaction.
Currently, there are 19,500 healthcare professionals with the CDCES credential, including registered nurses (RNs), nurse practitioners (NPs), registered dietitian nutritionists (RDNs), pharmacists, physicians, and physician assistants (PAs)es. At Diabetes Education Services, we are trying to enhance diversity within the CDCES community through our scholarship programs, to encourage a broader range of applicants to pursue certification. We are planning to offer more scholarships in the future to reach our goal of welcoming a thousand new educators into this profession.
There is more to be done, and we appreciate your help speaking to colleagues and letting them know about the benefits of becoming a CDCES. If you are part of a healthcare organization and want Coach Beverly to present the steps involved in becoming a Diabetes Specialist, we are happy to provide a virtual presentation at no cost. Please reach out to discuss details at [email protected].
Benefits of Becoming a CDCES
1. Improving Diabetes Outcomes and Quality of Life
- CDCES professionals advocate for effective diabetes management through person-centered care and education.
- Studies show that diabetes education improves glycemic management, reduces complications, and lowers hospitalization rates.
- Diabetes care specialists address the psychosocial aspects of diabetes and support problem-solving and well-being.
2. Addressing Health Disparities:
- CDCESs are essential in caring for diverse populations, including those disproportionately affected by diabetes.
- We are a part of advocating for equity and increased access to care.
3. Reducing Healthcare Costs:
- Diabetes education can significantly reduce healthcare costs by preventing complications such as heart disease, kidney failure, and lower extremity complications.
- CDCESs contribute to cost savings by promoting preventive care and self-management.
4. Expansion of Care Models:
- With a shift towards value-based care, there is a growing emphasis on preventive health services and chronic disease management, increasing demand for CDCESs in hospitals, clinics, and community health settings.
- CDCES professionals are vital in addressing the diabetes crisis in the U.S., improving both individual health outcomes and public health overall. Their expertise is increasingly in demand across various healthcare settings.
How to Become a Certified Diabetes Care and Education Specialist (CDCES)
- Educational Requirement: Hold a relevant degree such as in nursing, dietetics, pharmacy, or other health-related field.
- Professional Licensure: Maintain an active license in a qualifying health discipline (e.g., RN, RD, MD, etc.) or have a degree in an eligible field like public health or social work.
- Experience Requirement:
- A minimum of two years (to the day) of professional practice experience in the discipline under which one is applying for certification.
- Obtain at least 1,000 hours of diabetes education experience within the last five years, with at least 200 hours in the most recent year.
- Continuing Education: Complete at least 15 hours of continuing education in diabetes management and care within 2 years before applying.
- Exam Application and Preparation:
- Apply for the CDCES exam through the Certification Board for Diabetes Care and Education (CBDCE).
- Prepare using study materials, review courses, and practice exams related to diabetes education.
- Pass the CDCES Exam: Successfully pass the 175-question certification exam, which covers topics including assessment, care and education strategies, standards and practices.
- Maintain Certification: You can renew your certification every five years through continuing education, fulfilling practice hour requirements, or retaking the exam.
Visit the official CBDCE website or relevant professional bodies for more detailed guidance or recent updates.
Visit our CDCES Prep Page for more information and to register for FREE Webinars with lots of helpful information.
Building a Bridge Program: At Diabetes Education Services, our goal is to mentor the next generation of Certified Diabetes Care and Education Specialists (CDCES). We are committed to welcoming healthcare professionals with diverse experiences and backgrounds to enter the diabetes field. Our online programs and scholarship programs aim to provide emerging CDCES professionals with the knowledge, skills, and confidence to address the unique challenges encountered by people with diabetes from all walks of life, while also preparing them for certification.
Interested in becoming a CDCES but not sure where to start?
Our 2-Step FREE Webinars Series Will Guide You
Our FREE webinars will help you discover the steps required to become a CDCES and will transform your test anxiety into calm self-confidence and test-taking readiness.
- Want to learn more about the qualifications to take the CDCES exam? Register for our Free “Becoming A Diabetes Specialist” Step 1 Webinar.
- Taking the CDCES Exam in the next 6 months? Register for our Step 2, “Prep to Take the CDCES Exam” Free Webinar.
Step 1: Becoming a Diabetes Specialist (CDCES)
If you are a health care professional considering becoming a CDCES and want to learn more about eligibility and benefits of joining the Diabetes Education Community, this FREE webinar is for YOU. Coach Beverly will provide clarification on requirements, exam content, and study strategies to prepare for success.
Step 1: Webinar Topics
- Benefits of becoming a CDCES
- CDCES eligibility requirements for 2025
- Exam outline and study strategies to succeed
2025 Step 1 Webinar
Handouts
Step 2: Preapring to Take the CDCES Exam
We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers. We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers.
Step 2: Webinar Topics
- Test content updates for 2025
- Strategies to experience exam success
- Review of study tips and test taking practice questions
2025 Step 2 Webinar
Handouts
Can’t join us live?
Don’t worry, if you register, 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
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.
Question of the Week | What do the NEW 2025 ADA Standards Say?
What do the NEW 2025 ADA Standards Say?
According to the Newly Published 2025 Standards of Care, which of the following statements reflect the latest guidelines to treat hyperglycemic crises?
- Administer low dose basal insulin analog in addition to intravenous insulin infusion to improve glucose management.
- If serum pH is below 7.4, administer IV bicarb, along with a glucose infusion to resolve severe acidosis.
- To differentiate between DKA and HHS, the most important lab indicators are the anion gap and glucose levels.
- Lactated Ringers is now the preferred intravenous solution for fluid resuscitation.
Want to learn more about this question?
Check out these upcoming class offerings!
Why Attend These Webinars?
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Question of the Week | What defines overbasalization according to 2025 ADA Standards?
- Upcoming Webinars!
- Rationale of the Week | Diabetes & Malnutrition Risk
- Cheat Sheet Updates – Reflect 2025 ADA Standards
- Question of the Week | ADA Standards identify another 1st Line med to treat kidney disease. Which one?
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.
December 2024 E-Newsletter
Happy December Subscriber
Greetings to my wonderful healthcare colleagues.
In this newsletter, we are excited to announce our ambitious ten-year goal that officially kicks off in 2025. We aim to welcome one thousand new diabetes educators with diverse lived experiences into our community of educators and advocates over the next ten years. We want to raise awareness about the rewards of becoming a diabetes specialist to our healthcare professional colleagues, who may be unaware that this specialty is an option.
Let’s get the word out to colleagues about the benefits of becoming a CDCES or BC-ADM. To increase access, we have created a free webinar on the steps involved in “Becoming a Diabetes Specialist” that will air for the first time on December 18th. We are excited to open the doors to new colleagues and encourage them to seek certification. As the rates of diabetes continue to rise, we need all hands on deck.
We also highlight the 2024 Nobel Prize winners who discovered a link that might help treat both type 1 diabetes and celiac disease. We clarify the new requirements for renewing our CDCES and recognize all the Diabetes Awareness Activities that our colleagues made happen in their communities.
We enjoy several seasonal recipes by our guest contributor, Dawn DeSoto, RD, and CDCES, which are perfect for the winter season. Challenge yourself with our Question and Rationale of the Week.
Thank you for all the love and care you have provided this year. I know you touch the lives and hearts of many people who boldly try their best to self-manage their diabetes, and we are grateful for you!
With gratitude and appreciation,
Coach Beverly, Bryanna, Tiffany, Christine, Andrew, and Ginger
|
Announcements ___________________________ |
Interested in becoming a CDCES but not sure where to start?
Our 2-Step FREE Webinars Series Will Guide You
Our FREE webinars will help you discover the steps required to become a CDCES and will transform your test anxiety into calm self-confidence and test-taking readiness.
- Want to learn more about the qualifications to take the CDCES exam? Register for our Free “Becoming A Diabetes Specialist” Step 1 Webinar.
- Taking the CDCES Exam in the next 6 months? Register for our Step 2, “Prep to Take the CDCES Exam” Free Webinar.
Step 1: Becoming a Diabetes Specialist (CDCES)
If you are a health care professional considering becoming a CDCES and want to learn more about eligibility and benefits of joining the Diabetes Education Community, this FREE webinar is for YOU. Coach Beverly will provide clarification on requirements, exam content, and study strategies to prepare for success.
Step 1: Webinar Topics
- Benefits of becoming a CDCES
- CDCES eligibility requirements for 2025
- Exam outline and study strategies to succeed
Step 2: Preapring to Take the CDCES Exam
We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers.We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers.
Step 2: Webinar Topics
- Test content updates for 2025
- Strategies to experience exam success
- Review of study tips and test taking practice questions
CDCES or BC-ADM - Which Certification is Right for me?
Are you considering pursuing certification in diabetes care, but are not sure which certification is right for you and how to get started?
Coach Beverly is excited to share her insights on determining the best certification choice and the pathway to success. She will share her personal journey on achieving both her CDCES and BC-ADM over 20 years ago and how these credentials have impacted her opportunities as a diabetes specialist and president of her own company. We hope you can join us!
Webinar Topics
- Discuss the similarities and differences between the CDCES and BC-ADM credentials
- CDCES or certified diabetes care and education specialist
- BC-ADM or board certification in advanced diabetes management
- List the academic and experiential qualifications to take both exams
- Explore which certification best match your personal and professional goals
- Describe the steps to study and prepare for exam success for both certifications
Join us LIVE or watch the most recent recording below
Can’t join us live?
Don’t worry, if you register, 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.
CDCES & BC-ADM Exam Requirements
Preparing for the CDCES Exam?
Visit our Resource Page!
Preparing for the BC-ADM Exam?
Visit our Resource Page!
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!
Recent Blog Bytes
- Question of the Week | What defines overbasalization according to 2025 ADA Standards?
- Upcoming Webinars!
- Rationale of the Week | Diabetes & Malnutrition Risk
- Cheat Sheet Updates – Reflect 2025 ADA Standards
- Question of the Week | ADA Standards identify another 1st Line med to treat kidney disease. Which one?
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.
Free Certification Prep Webinars
Interested in becoming a CDCES but not sure where to start?
Our 2-Step FREE Webinars Series Will Guide You
Our FREE webinars will help you discover the steps required to become a CDCES and will transform your test anxiety into calm self-confidence and test-taking readiness.
- Want to learn more about the qualifications to take the CDCES exam? Register for our Free “Becoming A Diabetes Specialist” Step 1 Webinar.
- Taking the CDCES Exam in the next 6 months? Register for our Step 2, “Prep to Take the CDCES Exam” Free Webinar.
Step 1: Becoming a Diabetes Specialist (CDCES)
If you are a health care professional considering becoming a CDCES and want to learn more about eligibility and benefits of joining the Diabetes Education Community, this FREE webinar is for YOU. Coach Beverly will provide clarification on requirements, exam content, and study strategies to prepare for success.
Step 1: Webinar Topics
- Benefits of becoming a CDCES
- CDCES eligibility requirements for 2025
- Exam outline and study strategies to succeed
Step 2: Preapring to Take the CDCES Exam
We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers.We will review examination process, sample test questions, and the reasoning behind choosing the BEST answers.
Step 2: Webinar Topics
- Test content updates for 2025
- Strategies to experience exam success
- Review of study tips and test taking practice questions
CDCES or BC-ADM - Which Certification is Right for me?
Are you considering pursuing certification in diabetes care, but are not sure which certification is right for you and how to get started?
Coach Beverly is excited to share her insights on determining the best certification choice and the pathway to success. She will share her personal journey on achieving both her CDCES and BC-ADM over 20 years ago and how these credentials have impacted her opportunities as a diabetes specialist and president of her own company. We hope you can join us!
Webinar Topics
- Discuss the similarities and differences between the CDCES and BC-ADM credentials
- CDCES or certified diabetes care and education specialist
- BC-ADM or board certification in advanced diabetes management
- List the academic and experiential qualifications to take both exams
- Explore which certification best match your personal and professional goals
- Describe the steps to study and prepare for exam success for both certifications
Join us LIVE or watch the most recent recording below
Can’t join us live?
Don’t worry, if you register, 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.
CDCES & BC-ADM Exam Requirements
Preparing for the CDCES Exam?
Visit our Resource Page!
Preparing for the BC-ADM Exam?
Visit our Resource Page!
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!
Recent Blog Bytes
- Question of the Week | What defines overbasalization according to 2025 ADA Standards?
- Upcoming Webinars!
- Rationale of the Week | Diabetes & Malnutrition Risk
- Cheat Sheet Updates – Reflect 2025 ADA Standards
- Question of the Week | ADA Standards identify another 1st Line med to treat kidney disease. Which one?
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 | A1C 13.6% – Next Important Step?
For last week’s practice question, we quizzed participants on what steps to address an elevated A1C. 56% 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: KT is a 17-year-old with newly diagnosed diabetes and an A1C of 13.6%. The provider starts KT on 30 units of basal insulin and 10mg empagliflozin (Jardiance). KT is asked to get C-peptide levels checked and their C-peptide level is 0.9 ng/mL.
Based on this information, what is the next most important step?
Answer Choices:
- Add bolus insulin and stop empagliflozin
- Discuss the importance of starting CGM
- Evaluate auto immune markers
- Decrease basal insulin and start metformin
Getting to the Best Answer
Answer 1 is incorrect. 20.78% chose this answer. “Add bolus insulin and stop empagliflozin.” Since KT’s c-peptide level is 0.9ng/mL, it is between the normal range of 0.5 and 2.0 nanograms per milliliter (ng/mL). This means there is no urgent need to start KT on basal bolus insulin therapy, as long as we have basal insulin on board and we are monitoring blood glucose levels. According to ADA Standards, we can continue both the basal insulin and Jardiance and even consider adding metformin or a pediatric approved GLP-1 RA. Once we have the type 1 antibody results, we can determine best path forward.
Answer 2 is incorrect. 14.29% of you chose this answer. “Discuss the importance of starting CGM.” While it is important to monitor glucose levels, this is not the MOST important next step. To determine if KT has type 1 diabetes, we quickly need to evaluate if they are experiencing autoimmunity by testing for these; autoantibodies to insulin, GAD, islet antigen 2, ZnT8. If one or more of these comes back positive, it verifies KT has immune mediated type 1 diabetes and has a clear indication for basal bolus insulin therapy.
Answer 3 is correct. About 56.40% of respondents chose this. “Evaluate auto immune markers.” YES, GREAT JOB. This is the best answer. Since KT’s C-peptide is within the normal range, we need to evaluate immune markers. To determine if KT has type 1 diabetes, we quickly need to evaluate autoimmunity by testing for; autoantibodies to insulin, GAD, islet antigen 2, ZnT8. If one or more of these comes back positive, it verifies KT has immune mediated type 1 diabetes and is an indication for basal bolus insulin therapy.
Finally, Answer 4 is incorrect. 8.53% chose this answer. “Decrease basal insulin and start metformin.” Given that KT’s C-peptide is in normal range, we certainly could consider adding metformin and decreasing basal insulin. However, KT may still be in the honey moon phase and may be producing some insulin. For this reason, to determine if KT has type 1 diabetes, we quickly need to evaluate autoimmunity by testing for; autoantibodies to insulin, GAD, islet antigen 2, ZnT8. If one or more of these comes back positive, it verifies KT has immune mediated type 1 diabetes and is an indication for basal bolus insulin therapy.
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 December 17, 2024 for our
Meds Management Update for Type 2 Diabetes
Level 2 Standards of Care Intensive
In this exciting webinar, Coach Beverly walks participants through the “Management of Hyperglycemia in Type 2 Diabetes” as outlined by the most recent American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes guidelines. She kicks it off with a brief overview of the different classes of medications and then uses a case study approach to apply the ADA algorithm.
Objectives:
- Describe the role of Diabetes Care & Education Specialists in advocating for optimal therapeutic approaches.
- Discuss the application of the new ADA/EASD Guidelines to improve glucose and reduce CV and renal risk.
- List strategies to initiate & adjust oral & injectable therapy using a person-centered approach.
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Question of the Week | What defines overbasalization according to 2025 ADA Standards?
- Upcoming Webinars!
- Rationale of the Week | Diabetes & Malnutrition Risk
- Cheat Sheet Updates – Reflect 2025 ADA Standards
- Question of the Week | ADA Standards identify another 1st Line med to treat kidney disease. Which one?
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our Level 2 | Meds Management Update for Type 2 Diabetes 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.
Question of the Week | Low carb diets and SGLT-2’s a good mix?
ST is a 56-year-old presenting for MNT and diabetes education. Their last A1c was 7.4%, and they are currently taking 1000 mg of Metformin and 10 mg of empagliflozin daily for glucose management. They recently read that a very low-carbohydrate eating pattern can help individuals with type 2 diabetes reduce A1C and the need for additional medications and are motivated to implement diet changes.
What would be your primary considerations and guidance in response to ST?
- ST is motivated for change, encourage their desire to implement a very low-carbohydrate diet as it is safe for all individuals with diabetes.
- ST should avoid a very low-carbohydrate diet.
- A very low-carbohydrate diet may be appropriate if ST transitions off the SGLT2 inhibitor.
- ST should follow a fixed carbohydrate intake at each meal to align with their medication regimen.
Want to learn more about this question?
Check out these upcoming class offerings!
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Recent Blog Bytes
- Question of the Week | What defines overbasalization according to 2025 ADA Standards?
- Upcoming Webinars!
- Rationale of the Week | Diabetes & Malnutrition Risk
- Cheat Sheet Updates – Reflect 2025 ADA Standards
- Question of the Week | ADA Standards identify another 1st Line med to treat kidney disease. Which one?
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.
Cheat Sheet Updates – Reflect 2025 ADA Standards
With the publication of the ADA Standards of Care, Coach Beverly embarks on the yearly arduous yet rewarding task of updating our Cheat Sheet Library! As part of the new CDR Accreditation requirements, handouts and slides used as part of the educational courses and resources have to be free of commercial bias and be “logo-free.” The CDR Accrediting Committee ensures that participants attending live or online training programs are presented with content free of conflict of interest, based on evidence, and without brands, ads, and logos.
We are proud to meet the rigorous standards set by the CDR Accreditation Committee and have a 25-year history of intentionally avoiding conflict of interest by not accepting contributions or funds from diabetes-related companies or industries and creating original materials.
Cheat Sheet Updates based on 2025 Standards
ADA Standards of Care 2, Diagnosis and Classification of Diabetes include additional details on screening for type 1 and type 2 diabetes and diabetes in pregnancy, which is captured in our Diagnosis and Classification Cheat Sheet. The diagnostic testing methods and criteria, remained the same as in past years, with an increased emphasis on using A1C as the preferred diagnostic tool, given its accessibility, greater convenience (fasting not required), greater preanalytical stability, and fewer day-to-day perturbations during stress, changes in nutrition, or illness.
Diagnosis and Classification Cheat Sheet Highlights.
- Screen for presymptomatic type 1 diabetes, by testing autoantibodies to insulin, GAD, islet antigen 2, or ZnT8 for those with type 1 phenotypic risk (younger age, ketoacidosis, etc.)
- For Type 2 diabetes, the suggested screening age for everyone starting at age 35 remained the same as did the BMI cut-off of 23 for Asian Americans and 25 for all others.
- Additional risk factors for earlier screening were added and a few were modified from last year. The elevated blood pressure cut-off was decreased from 140/90 to 130/80. In addition to regular screening for those taking antiretroviral medications, ADA added monitoring for hyperglycemia in those taking high-risk medicines (steroids, antipsychotic meds) or a history of pancreatitis and re-checking glucose levels annually or if any signs of hyperglycemia.
- In the diabetes and pregnancy section, the ADA more strongly recommended screening all women at the first prenatal visit to help detect undiscovered hyperglycemia and initiate early treatment. Before 15 weeks of gestation, test individuals with risk factors and consider testing all individuals for undiagnosed diabetes at the first prenatal visit using standard diagnostic criteria if not screened preconception.
Insulin Storage Cheat Sheet Highlights.
Immunization Schedule for People with Diabetes 2025
This chart details the types of vaccines, when, and how often they are recommended for people with diabetes. There were two new additions this year. A single RSV dose is recommended for those 60 years and older and the COVID-19 vaccine and boosters are suggested starting at six months of age.
This standard emphasized reminding people with diabetes to avoid the live attenuated influenza vaccine and it included additional clarification on the pneumonia vaccines.
We hope you will stop by our complete
Cheat Sheet Complete Library!
Feel free to download and share these info sheets and share with colleagues and people living with diabetes!
ADA Standards of Care 2024 Webinar Update
Join us live on February 1, 2024, at 11:30 am PST
This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the annual updates to the American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provides critical teaching points & content for healthcare professionals involved in diabetes care & education.
Topics:
- A review of changes & updates to the annual ADA Standards of Medical Care in Diabetes.
- Identification of key elements of the position statement.
- Discussion of how diabetes educators can apply this information in their clinical setting.
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, 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.
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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.
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