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10 Steps to Survive the Holidays
Staying Centered During the Holidays: Support for People with Diabetes
The holiday season can bring joy—but also stress, disrupted routines, late nights, and rich meals that may affect blood glucose levels and emotional well-being. For people with diabetes, this time of year can stir feelings of self-doubt and distress, especially if glucose levels veer outside their usual target range.
To help you and your community feel more grounded, we’ve created two helpful resources:
🎁 Holiday Survival Guide
This handout offers 10 practical strategies to stay balanced and navigate holiday gatherings with confidence. Even trying just one or two of the suggestions can make a big difference.
💡 Reframe & Reset: Coping with Diabetes Distress
This companion sheet provides tools to recognize, reframe, and release feelings of shame, guilt, or overwhelm that can surface during the holidays—and beyond.
These printable Cheat Sheets are designed for easy sharing with your friends, clients, and colleagues. Feel free to distribute widely—they’re full of tips to promote self-compassion, support balanced choices, and bring more ease to the season.
1. Be a sleep warrior – People living in the United States are chronically underslept. Not getting enough sleep is associated with increased hunger, higher blood sugars, poor concentration, frequent illness, and impaired problem-solving. Make sure to give yourself the gift of at least 7 hours of sleep a night. This sleep will help you make the best choices for your health and will protect against illness and fatigue. You got this.
Goal: Get at least 7 hours of sleep a night. You deserve it.
2. Keep active – Holidays can put our exercise plans to the test, but we have a few ideas for you. Take an after-meal stroll instead of plopping on the couch. After meal walks lower post-meal blood sugars and increases energy by getting muscles activated. Just 10 minutes of walking after meals can make a big difference. You can even put music on and have a small dance session, anything to get your body moving.
Goal: Work toward 30 minutes of activity a day.
3. Don’t forget the Fiber – With all the snacks and tempting foods, whole healthy foods may take a back seat. Enjoy the abundance of seasonal vegetables, fruits, nuts, and grains that are fiber-rich and that decrease inflammation. Examples include; yams, squash, mandarin oranges, almonds, pistachios, quinoa, kale, brown rice, warm oatmeal, salads, and broth-based soups.
Goal: Strive to eat at least 25gms of fiber a day.
4. Enjoy the ultimate beverage – H20. Water is the perfect way to keep hydrated, replenished, and keeps appetite in check. Add a splash of flavor with a jigger of fruit juice or fresh cucumbers, lime slices, or a sprig of rosemary. Be creative. Sparkling waters come in a vast variety of flavors, are calorie-free, and contain no artificial sweeteners.
Goal: Keep hydrated by enjoying plenty of water.
5. Keep an eye on alcohol – While it’s true that red wine offers a beneficial anti-inflammatory compound called resveratrol, drinking too much alcohol can lead to unintended outcomes. Studies show that we make poorer food choices if alcohol is on board. This can offer special challenges in party settings, where temptations are abundant. A drink of alcohol contains about 100 calories and mixed drinks have even more. In addition, alcohol can lead to low blood sugars, especially for those taking insulin or sulfonylureas.
Goal: Limit alcohol to one drink a day for women, two drinks a day for men.
6. You are already sweet enough – Holidays and sugar go hand in hand. If possible, try and eat less than 6 teaspoons of added sugar (does not include natural sugars found in fruit and milk). This goal may not be realistic on all days, but aim for success most of the time. Excess sugar intake can cause inflammation and buildup of fat in the liver. One strategy is to limit sugar intake during the day and save your 6 teaspoons for that special dessert or parties. When looking at labels, it is helpful to know that 1 teaspoon equals 4 gms of sugar.
Goal: Limit sugar to 6 teaspoons a day.
7. Your teeth need extra special attention – Taking care of our teeth and gums improves health. Gum inflammation is associated with blood vessel inflammation. Swollen gums can also lead to an increase in blood sugars. During the holidays, find time for regular oral hygiene. Your mouth (and dental team) will thank you.
Goal: Brush teeth at twice daily and floss at least once daily.
8. Keep connected to friends and family who love you just the way you are! – As enjoyable as holidays can be, reuniting with family can also cause stress and stir-up emotions. Feeling out of sorts can lead to stress eating and decrease self-care. If possible, reach out to a trusted friend to share your feelings or keep a holiday journal. Consider bringing a favorite book along during your travels that you find inspiring and comforting. Give yourself permission to steal away for some quiet time.
Goal: Self-care is important during the holidays.
9. Enjoy an Oxygen Cocktail – Studies show that when humans venture into natural outdoor settings, heart rate and blood pressure improve. Take a moment to appreciate the feeling of the air on your skin, take a deep breath of fresh air, try to find nests in leafless trees, listen to the animal sounds and bird songs and just enjoy that moment.
Goal: Step into nature daily.
10. Take inventory of things that you are grateful for – Find a moment each day to reflect on a few things that brought you joy or good feelings. Maybe it was your cousin who lent you her favorite sweater. Or an Aunt who gave you the best hug. Special moments with a best friend or an after-dinner walk enjoying the fall leaves. These small moments of connection and beauty are one of the most treasured gifts of the holiday season that linger in our hearts and memory long after we say our goodbyes.
Goal: Take note of special moments.
Cyber Weekend Sale!
30% Off All Online Programs
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR
Our course CE credits are through the following accrediting bodies:
- AMA PRA Category 1 Credits™,
- ACPE,
- ANCC, and
- CDR
Our CEs count toward the CDCES exam and CDCES / BC-ADM renewal*!
*Certified Diabetes Care and Education Specialist and CDCES are registered marks owned by NCBDE. The use of DES products do not guarantee successful passage of the CDCES exam. NCBDE does not endorse any preparatory or review materials for the CDCES exam, except for those published by NCBDE.
Gestational Diabetes: Diabetes Care in the Fourth Trimester
Fourth Trimester and Diabetes Risk
The fourth trimester describes the time from delivery through the first 12 weeks postpartum. During this phase, attention often shifts to the newborn. However, for those who experienced gestational diabetes mellitus (GDM), engaging with their health care team can set the stage for long-term health and well-being.
Although only about 10% of individuals are affected by GDM, their risk of developing type 2 diabetes increases tenfold after delivery¹. Despite this heightened risk, studies ²,³ demonstrate that postpartum follow-up remains suboptimal. Comprehensive postpartum care planning started before delivery supports physical and psychological health for the long run
Screening for Elevated Blood Glucose After Delivery
Individuals with GDM usually transition off diabetes medications in the postpartum period ¹; however, it is important to ensure appropriate medication care plans are in place based on the individual’s need. As prior existing pre-diabetes or diabetes may be found in up to one-third ² of individuals during this stage, both the American Diabetes Association and ACOG recommend oral glucose tolerance testing (OGTT) using pre-pregnancy criteria at 4-12 weeks 3 after delivery. OGTT is recommended instead of A1c testing, within the first 12 weeks postpartum, because of changes in blood volume, blood loss during delivery, and the rapid glycemic variations after birth.
However, we know barriers follow-up care and screenings exist. One health system’s retrospective study ¹ showed that while most women receive care from an OB-GYN after delivery, only 29% completed the recommended blood glucose screening. Among those
with abnormal results, just 11% were prescribed glucose-lowering medications, and 21% received a referral for diabetes risk reduction. This study is not unique ¹,² in its findings, and it highlights the need for proactive outreach and post-delivery care.
Screening for Cardiometabolic Risk & Continuity of Care
Ongoing and additional screenings are recommended due to increased cardiometabolic health risks. If postpartum OGTT results are found normal, repeat pre-diabetes and diabetes screening is recommended at least every 1-3 years. ¹ Home blood pressure monitoring is recommended for individuals with history of hypertension. Checking a lipid panel within the first year postpartum for assessment of ASCVD risk, however lipid levels may take up to 3 months to return to pre-pregnancy levels and should not be performed before 6 weeks postpartum due to pregnancy-related changes in lipid metabolism. Routine screening for post-partum depression is also recommended, given the higher prevalence of depression symptoms during and post-GDM, impacting self-care and metabolic outcomes.
In addition to early screening, intervention strategies require a multidisciplinary approach focusing on recovery, prevention, and empowerment. Coordination between OB-GYN, primary care, diabetes care teams, and pediatric groups ensures continuity of care. Education on lifestyle and behavioral health management should be delivered with empathy and flexibility, recognizing the competing demands of new motherhood. A Diabetes Prevention Program subgroup analysis of women who received lifestyle
interventions 10 years after GDM found a 50% decreased incidence of development of diabetes, and a more recent meta-analysis 5 found lifestyle interventions reduced the incidence of diabetes by 24%. Interventions with a registered dietitian can support lactation, restore nutrient balance, and promote cardiometabolic risk reduction.
Encouraging a gradual return to physical activity, beginning with gentle movement and progressing to regular moderate exercise, is associated with improved insulin sensitivity, diabetes risk reduction, and enhanced mood. Incorporating lactation consultants into postpartum care supports ACOG recommendations for exclusive breastfeeding the first 6 months of life and continued up to 2 years of age with solid foods transition. Though challenges such as delayed milk production and reduced supply may occur 6 due to the history of insulin resistance, breastfeeding offers many health benefits and significantly lowers the risk of developing type 2 diabetes for both mother and child. 4 Finally, establishing a clear transition plan to primary care that promotes annual visits, family planning, and ongoing lifestyle support may enhance long-term health maintenance.
Flexible care delivery models that meet women where they are in this stage of life may further help overcome barriers and reduce disparities in postpartum follow-up.
Keeping Connected After Delivery
The fourth trimester represents a pivotal opportunity to ensure postpartum care and support to engage lifelong health. This time often shifts focus to the newborn, but for women with a history of GDM, this period is not only about recovery but also prevention of type 2 diabetes, cardiovascular disease, and future pregnancy complications. The diabetes care team can support postpartum screenings, nutrition, lifestyle interventions, and transition of care that close postpartum care gaps. Proactively outreaching and engaging during this critical phase can connect individuals to resources and long-term chronic disease prevention.
References:
- American Diabetes Association Professional Practice Committee; 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2025. Diabetes Care 1 January 2025; 48 (Supplement_1): S306–S320. https://doi.org/10.2337/dc25-S015
- Thomas D, Benson G, Gan A, et al. Fourth Trimester: Assessing Women’s Health Equity and Long-Term Cardiovascular Outcomes in a Large Midwestern Health System in 2021. Circulation: Cardiovascular Quality and Outcomes. 2023;17(1) https://doi.org/10.1161/CIRCOUTCOMES.123.010157
- D’Amico R, Dalmacy D, Akinduro JA, et al. Patterns of Postpartum Primary Care Follow-up and Diabetes-Related Care After Diagnosis of Gestational Diabetes. JAMA Netw Open. 2023;6(2):e2254765.
- Parikh NI, Gonzalez JM, Anderson CAM, Judd SE, Rexrode KM, Hlatky MA, Gunderson EP, Stuart JJ, Vaidya D; on behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; and the Stroke Council. Adverse pregnancy outcomes and cardiovascular disease risk: unique opportunities for cardiovascular disease prevention in women: a scientific statement from the American Heart
Association. Circulation. 2021;143:e902–e916. - Bracco, P.A., Reichelt, A.J., Alves, L.F. et al. Lifestyle intervention to prevent type 2 diabetes after a pregnancy complicated by gestational diabetes mellitus: a systematic review and meta-analysis update. Diabetol Metab Syndr. 2025;17(66)
https://doi.org/10.1186/s13098-025-01606-x - Geddes DT, Gridneva Z, Perrella SL. Breastfeeding after gestational diabetes mellitus: maternal, milk and infant outcomes. Curr Opin Clin Nutr Metab Care. 2025 May 1;28(3):257-262.
Cyber Weekend Sale!
30% Off Our Entire Collection of Online University Courses
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR
Our course CE credits are through the following accrediting bodies:
- AMA PRA Category 1 Credits™,
- ACPE,
- ANCC, and
- CDR
Our CEs count toward the CDCES exam and CDCES / BC-ADM renewal*!
*Certified Diabetes Care and Education Specialist and CDCES are registered marks owned by NCBDE. The use of DES products do not guarantee successful passage of the CDCES exam. NCBDE does not endorse any preparatory or review materials for the CDCES exam, except for those published by NCBDE.
Diabetes Tech and Distress
The world of diabetes technology is advancing at a record pace. There is no doubt that technology intends to make life with diabetes a bit easier. In the United States, over 50% of adults living with diabetes have experienced some level of diabetes distress.¹ The impact of diabetes technology on mental well-being is complicated. Diabetes technology, including insulin pumps, continuous glucose monitors (CGMs), and connected insulin pens, can either lessen or aggravate diabetes distress.
Understanding Diabetes Distress
The American Diabetes Association (ADA) defines diabetes distress as “significant negative psychological reactions related to emotional burdens and worries specific to an individual’s experience in having to manage a demanding chronic condition such as diabetes.”.² Diabetes distress is a natural reaction to the daily burden of managing diabetes. Signs of diabetes distress can include avoiding blood glucose monitoring, omitting medications, and struggling to achieve personal hemoglobin A1c targets.
The ADA recommends screening for diabetes distress at least annually. More frequent screening is recommended if clients are not meeting treatment goals, develop diabetes-related complications, and during times of life transitions.²
To access these validated diabetes distress screening tools in English and Spanish, I encourage you to visit this helpful website, DiabetesDistress.org
- Diabetes Distress Scale (DDS-17)
- Type 1 Diabetes Distress Scale (T1-DDS)
- The Type 2-Diabetes Distress Assessment System (T2-DDAS)
Can Technology Improved Diabetes Distress?
Let’s explore how diabetes technology can have a positive impact on diabetes distress.
✅ CGMs: With current CGMs, fewer fingerstick readings are needed to make treatment decisions. CGMs provide information on blood glucose trends and impending hyperglycemia or hypoglycemia, creating more peace of mind.
✅ Record Keeping: Various forms of diabetes technology can log blood glucose values, insulin doses, site changes, and total daily doses of insulin. This eliminates the need for clients to worry about detailed record-keeping.
✅ Automated Insulin Delivery: Automated insulin pumps can decrease decision fatigue by making automated adjustments to both basal and correction insulin doses. This approach to insulin delivery can also benefit individuals with an active lifestyle. Utilizing wearable insulin delivery devices and algorithms can reduce the mental burden of diabetes self-management.
✅ Connectivity: Remote data sharing supports communication with parents, caregivers, and friends to create a diabetes support team. Connectivity with healthcare providers enhances communication with the care team, allowing adjustments to treatment plans between clinic visits.
✅ Empowerment: The data trends can empower individuals living with diabetes to take control and gain confidence in making and evaluating medication and lifestyle adjustments in response to changes in glycemic control.
Can Technology Worsen Diabetes Distress?
As diabetes healthcare professionals, it is important to understand how diabetes technology can negatively impact diabetes distress.
❌ Information Overload: Diabetes technology generates an enormous amount of data. This can cause distress by constantly feeling the need to monitor glucose trends and numbers throughout the day and night, leading to feelings of anxiety and overwhelm.
❌ Alarms: Alarms on diabetes technology are rooted in safety, but for those living with these devices, this can lead to diabetes distress. Alarms can disrupt sleep or bring unwanted attention from others in public. Erroneous alarms for hyperglycemia or hypoglycemia can cause stress, frustration, and alarm fatigue.
❌ Perfectionism: Diabetes technology provides a continuous insight into glycemic control, which for some can create a need for perfection. Some clients feel like they fail when they don’t reach their time-in-range goal each day.
❌ Physical Impact: Wearable devices not only carry a psychological burden but can also cause physical distress. Skin irritation and allergic reactions to adhesives cause physical pain and embarrassment. Those who wish to keep diabetes private, wearing a CGM, insulin pump, or other wearable device that puts diabetes on display, causing distress.
❌ Technical issues: Losing connectivity with CGMs or an AID system can cause frustration and make it challenging to achieve optimal glycemic control. Insurance coverage, prior authorizations, out-of-pocket costs, and access to supplies for diabetes technology can all contribute to or worsen diabetes distress.
Diabetes Healthcare Professionals Help – Recognize and Address
The 7A’s Framework provides a useful interview tool when assessing for Diabetes Distress:
- Aware: Be aware of diabetes distress.
- Ask: Ask about diabetes distress.
- Assess: Use a validated screening tool for assessment.
- Advise: Explain diabetes distress.
- Assist: Develop an action plan.
- Assign: If you are not equipped to help, assign the client to another healthcare professional.
- Arrange: Set up follow-up as needed. 3
Here are some other actionable tips you can use to help those with diabetes distress:
- Refer clients to local or virtual diabetes support groups.
- Discuss with clients that diabetes distress is common and not a character flaw or failure
- Collaborate to choose the best technology based on their technology readiness, skill level, and comfort level.
- Set realistic goals for time-in-range and other data metrics.
- Educate clients on how to troubleshoot their devices regarding alarms or connectivity issues.
- Support a healthy relationship with diabetes tech.
References
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-
Alexander, D.S., Saelee, R., Betsy Rodriguez, B., Koyama, A. K., Cheng, Y. J., Tang, S., Rutkowski, R. E., & Bullard, K. M. (2025). Diabetes distress among US adults with diagnosed diabetes, 2021. Preventing Chronic Disease: Public Health Research, Practice, and Policy, 22(E07), 1-7. https://www.cdc.gov/pcd/issues/2025/24_0287.htm#:~:text=Among%20US%20adults%20with%20diabetes%2C%20an%20estimated%201.6%20million%20(6.6,income%20compared%20with%20their%20counterparts.
- American Diabetes Association Professional Practice Committee. (2025). Facilitating positive health behaviors and well-being to improve health outcomes: Standards of care in diabetes—2025. Diabetes Care, 48(Supplement_1): S86–S127. https://diabetesjournals.org/care/article/48/Supplement_1/S86/157563/5-Facilitating-Positive-Health-Behaviors-and-Well?searchresult=1
- American Diabetes Association. (n.d.). Professional development: Behavioral health toolkit. https://professional.diabetes.org/professional-development/behavioral-mental-health/behavioral-health-toolkit
- Healing through Connection for Healthcare Professionals by Beverly Thomassian
-
Cyber Weekend Sale!
30% Off Our Entire Collection of Online University Courses
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR
Our course CE credits are through the following accrediting bodies:
- AMA PRA Category 1 Credits™,
- ACPE,
- ANCC, and
- CDR
Our CEs count toward the CDCES exam and CDCES / BC-ADM renewal*!
*Certified Diabetes Care and Education Specialist and CDCES are registered marks owned by NCBDE. The use of DES products do not guarantee successful passage of the CDCES exam. NCBDE does not endorse any preparatory or review materials for the CDCES exam, except for those published by NCBDE.
Rationale of the Week | How does Mifepristone Work?
For last week’s practice question, we quizzed participants on How does Mifepristone work to treat hypercortisolism? 48.73% 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 by clicking here.
A 54-year-old with type 2 diabetes and hypertension is diagnosed with hypercortisolism. Despite lifestyle interventions and maximum doses of metformin, GLP-1 RA, and an SGLT2 inhibitor, her A1C remains 9.2%. They are started on mifepristone.
Which of the following best explains how mifepristone improves glycemic control in this setting?
- It decreases cortisol synthesis in the adrenal cortex, lowering circulating cortisol levels.
- It reduces ACTH release from the pituitary, leading to decreased adrenal stimulation.
- It blocks glucocorticoid receptors, preventing cortisol from exerting metabolic effects.
- It directly enhances insulin secretion and sensitivity, independent of cortisol pathways.
Getting to the Best Answer
Answer 1 is incorrect. 25.14% chose this answer, “It decreases cortisol synthesis in the adrenal cortex, lowering circulating cortisol levels.” As tempting as this answer is, mifepristone does not inhibit cortisol synthesis.
Answer 2 is incorrect. 15.21% of you chose this answer, “It reduces ACTH release from the pituitary, leading to decreased adrenal stimulation.” This medication does not directly reduce ACTH release from the pituatary.
Answer 3 is correct. About 48.73% of respondents chose this, “It blocks glucocorticoid receptors, preventing cortisol from exerting metabolic effects.” Mifepristone is a glucocorticoid receptor antagonist. By competitively binding to glucocorticoid receptors, it prevents cortisol from exerting downstream effects, including increased hepatic gluconeogenesis, peripheral insulin resistance, and lipolysis. This mechanism is particularly useful in people with hypercortisolism and concurrent type 2 diabetes, as it improves insulin sensitivity and lowers blood glucose without lowering circulating cortisol levels.
Finally, Answer 4 is incorrect. 10.99% chose this answer, “It directly enhances insulin secretion and sensitivity, independent of cortisol pathways.” This medication does not act directly on pancreatic β-cells or insulin receptors.
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!
Invite a colleague to our DiabetesEd Seminar in San Diego and get $75 off each registration.
Use code FriendDiscountSD during check out to save.
Join us live in San Diego October 22nd – 23rd, 2025 for our upcoming
DiabetesEd Training Seminar
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
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.
Tandem Turns Up the Tech for t:slim X2 and Mobi
Tandem Diabetes has leveled up insulin pump technology with a new algorithm and expanded its continuous glucose monitor (CGM) compatibility. The new algorithm, Control IQ+, is built upon the previous Control IQ algorithm, offering several updated features. In June 2025, Tandem diabetes announced Libre 3+ is joining the family of compatible CGMs. Let’s uncover the details of this new algorithm and review the compatible CGM options.
Tandem Control IQ+
Control IQ+ introduces several new features designed to enhance glycemic control.¹ These features are available for both the Tandem t:slim X2 and Mobi insulin pumps.
✅ Age: Control IQ+ is available for ages 2 years and up.
✅ Indication: This algorithm has approval for both Type 1 Diabetes and Type 2 Diabetes.
✅ Extended Bolus: This feature allows for extended boluses for up to 8 hours.
✅ Weight Range: The new algorithm now includes extended weight ranges from 20-440 lbs.
✅ Total Daily Dose of Insulin: For those with high insulin requirements, the total daily dose of insulin is now up to 200 units per day.
✅ Temp Basal Rate: The temp basal rate feature can be used for up to 72 hours while still staying in Control IQ+. Now users don’t need to stop the automated insulin delivery mode when requiring a temp basal rate for short-term needs like illness or exercise. The algorithm will continue to adjust the basal rate and give boluses if needed based on blood glucose levels.²
CGM Compatibility
Tandem announced in June 2025 the approval of Libre 3+ to its current family of compatible CGMs. Per Tandem Diabetes Care, the Libre 3+ will be compatible with the t:slim X2 pump and is only available through an early access program, with a broader access announcement expected later this year.³ Currently, the compatible CGMs are:
🩸Dexcom G6 (For t:slim X2 and Mobi)
🩸Dexcom G7 (For t:slim X2 and Mobi)
🩸Libre 2 + (For t:slim X2 only)
The Healthcare Professional’s Perspective
Now that you know what’s new with Control IQ+ technology and the current CGM compatibility, you can confidently help clients develop a personalized approach to insulin pump management. Diabetes healthcare professionals can also help existing Tandem insulin pump users update their software to the new Control IQ+ algorithm. Individuals living with diabetes depend on your expertise to guide them through the maze of diabetes technology. During education sessions, reviewing the basics of how the algorithm works and specific features of the pump can be reassuring for individuals in our care. Additionally, assessing carbohydrate counting skills and discussing how to administer food and correction boluses along with preventing and managing hypoglycemia, can make a big difference.
Join us at our live San Diego Conference to learn more about Diabetes Technology with Diana Isaacs, PharmD CDCES, BC-ADM, FADCES. Check out the events page to see all the exciting options!
References
- Tandem Diabetes Care. Tandem Diabetes Care launches new control-IQ+ automated Insulin delivery technology in the United States [News Release]. Retrieved August 1, 2025, from https://investor.tandemdiabetes.com/news-releases/news-release-details/tandem-diabetes-care-launches-new-control-iq-automated-insulin.
- Tandem Diabetes Care. Temp rate. Retrieved August 1, 2025, from https://www.tandemdiabetes.com/support-center/pumps-and-supplies/automated-insulin-delivery/article/temp-rate#:~:text=Temp%20Rate%2C%20also%20known%20as,delivers%2060%25%20of%20that%20value.
- Tandem Diabetes Care. Tandem Diabetes Care Announces t:slim X2™ insulin pump compatibility with Abbott’s FreeStyle Libre® 3 Plus sensor in the United States [News Release]. Retrieved August 1, 2025, from https://investor.tandemdiabetes.com/news-releases/news-release-details/tandem-diabetes-care-announces-tslim-x2tm-insulin-pump.
Invite a colleague to our DiabetesEd Seminar in San Diego and get $75 off each registration.
Use code FriendDiscountSD during checkout to save
Join us live in San Diego October 22nd – 23rd, 2025 for our upcoming
DiabetesEd Training Seminar
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
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 | Grandfather Avoiding Bolus Insulin
R.S. is a 60-year-old with type 2 diabetes who was recently placed on insulin lispro at meals. He has taken insulin glargine once a day for five years. Previously, non-insulin medications have been ineffective or not tolerated. He continues to have hyperglycemia despite the addition of insulin lispro. During his diabetes education visit today, he shared that he has not been taking his mealtime insulin lispro because he does not want to inject it in front of his grandchildren, who live with him. He feels overwhelmed by these additional injections but wants to get his blood glucose levels under better control so he can have the energy to play with his grandchildren and avoid losing his eyesight like his mother did.
As the diabetes care and education specialist, which of the following would be the most appropriate first step in addressing R.S.’s concerns?
- Stress with R.S. the importance of never missing his meal time lispro to prevent diabetes-related complications.
- Using open-ended questions, explore R.S.’s routine, stressors, and support systems to understand the barriers to his insulin use.
- Recommend R.S. switch to another non-insulin medication to make his regimen easier for him to manage.
- Since it appears R.S. did not understand how to take his insulin lispro, write out step-by-step instructions on how to take the insulin.
Invite a colleague to our DiabetesEd Seminar in San Diego and get $75 off each registration.
Use code FriendDiscountSD during check to save.
Join us live in San Diego October 22nd – 23rd, 2025 for our upcoming
DiabetesEd Training Seminar
Earn 30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
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.
Shining A Spotlight on Our Scholarship Winners!
We are delighted to celebrate our “Bridge Scholarships” for CDCES Prep Boot Camp and the Live Seminar Scholarships!
Celebrating Our Diabetes Education Scholarship Recipients
We are incredibly grateful for the overwhelming response to our Bridge Scholarships for both the CDCES Prep Boot Camp and Live Seminar Scholarships. Your passion, dedication, and commitment to advancing in diabetes care truly inspired us.
Each application we received was a powerful reminder of the incredible work being done across our healthcare community. Our panel of judges faced the challenging task of selecting recipients, carefully evaluating each application based on several important criteria: financial need, person-centered language, inclusivity, impact, volunteerism, and readiness to sit for the CDCES exam.
After thoughtful consideration, we are thrilled to announce the recipients of this round of scholarships! 🎉
These individuals represent the very best of what our community stands for—dedication, empathy, service, and the drive to grow professionally and personally. The scholarships they’ve received will not only recognize their hard work and achievements but also provide the support they need as they take the next step in their journey toward becoming Certified Diabetes Care and Education Specialists.
Please join us in congratulating our scholars! Their commitment to improving diabetes care and education will undoubtedly have a lasting impact on the communities they serve.
To our scholarship recipients: Congratulations! And to our entire community of healthcare professionals: Thank you for your continued passion, perseverance, and support. Together, we are building a stronger, more inclusive future in diabetes care.
San Diego Live Seminar Bridge Recipients
Jessika Junick
FNP-C
Roswell, NM
Christy Walowit
MS, RDN
Sacramento, CA
CDCES Bridge Boot Camp Recipients
Jue Lia Fong
BS, MSN, PHN
Los Angeles, CA
Shelagh Cooley
ADN, BA in Public Policy, Master's in International Development
South Hero, VT
Erica Otieno
Bachelor of Science in Dietetics - Registered Dietitian
Houston, TX
Alaina Hernandez
ARPN, FNP-C
Texarkana, TX
Lynsi Beers
Bachelor of Science in Foods & Nutrition, RDN, LDN
Pinehurst, NC
Eglazia Brown
Registered Nurse, BSN
Charleston, SC
Maribel Medina
RN
Chicago, IL
Emily D'Angelo
MS, RD, HWC
Hartford, CA
Trudee Murray
MS, BSN, CCRN-Pediatric, CPHQ
Sacramento, CA
Nicki Li
RDN
Lodi, CA
Jovanna Orozco
MS, RDN, LDN
Charlotte, NC
Tina Guadan Fogall
MS, RDN, CD
Bellevue, WA
Jacqueline Lee
AGACNP, CNP, RN, CCRN
Minneapolis, MN
Gina Duncan
FNP- BC
Brooklyn. NY
Cinthia Reyez
BSN, RN
Kansas City, MO
Oliver Thompson
MPH
Gooding, ID
Thendral Srinivasan
BSN
Cary, NC
Nayelie Benitez Santos
MS in Nursing, FNP
Corona, CA
Live in San Diego
DiabetesEd Training Seminar
Join us live October 22nd – 23rd, 2025!
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
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 | Time Restricted Eating – Best Approach
For last week’s practice question, we quizzed participants on Time Restricted Eating- Best Approach. 86% 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
MJ is a 56-year-old with type 2 diabetes (A1C 7.3%), HTN, and dyslipidemia. Current medications include metformin 1,000 mg twice daily, lisinopril, and atorvastatin. Activity includes walking 20–30 minutes most evenings. At their most recent visit, MJ is inquiring about using at 16:8 time-restricted eating plan and plans eating from 11 a.m. to 7 p.m. and will include coffee/unsweetened beverages outside that window. MJ checks their blood glucose once daily and there is no reported history of severe hypoglycemia.
What response would you provide MJ regarding the safety and effectiveness of an intermittent fasting, time-restrictive eating plan?
- Individuals with type 2 diabetes should include regular meals throughout the day to support stabilize blood sugars and prevent hypoglycemia.
- Review with MJ his motivations for the time-restricted eating plan and assess plan for dietary intake within the eating window.
- Encourage a time-restricted eating plan, evidence indicates it is more effective than calorie reduction alone for weight loss and A1c reduction.
- Recommend starting Incretin therapy, such as Ozempic or Mounjaro, to ensure effectiveness of time-restricted eating plan.
Getting to the Best Answer
Answer 1 is incorrect. 9% chose this answer, “Individuals with type 2 diabetes should include regular meals throughout the day to support stabilize blood sugars and prevent hypoglycemia.” Random control trials have indicated that time-restricted eating is a safe and practical dietary approach for individuals with type 1 and type 2 diabetes. While assessment and prevention of hypoglycemia is a priority, MJ’s current medication regimen is of low risk. Even with higher risk medications, such as insulin or sulfonylureas modifications of medication, timing or dose can be made to support safety.
Answer 2 is correct. 86% of you chose this answer, “Review with MJ his motivations for the time-restricted eating plan and assess plan for dietary intake within the eating window.” Great Job! Time-restricted eating can be a safe and effective strategy for MJ. Reviewing motivation and current eating patterns may improve the ability to apply balanced meals within the eating window.
Answer 3 is incorrect. About 3% of respondents chose this, “Encourage a time-restricted eating plan, evidence indicates it is more effective than calorie reduction alone for weight loss and A1c reduction.” While time restricted eating may be a practical strategy, it has not been shown to be superior to continuous energy restricted dietary intake for weight loss and A1c outcomes.
Finally, Answer 4 is incorrect. About 2% chose this answer, “Recommend starting Incretin therapy, such as Ozempic or Mounjaro, to ensure effectiveness of time-restricted eating plan.” While we may consider addition of an incretin therapy to support A1c, weight and cardiovascular risk reduction, time-restricted eating does not require the addition of these medications to be effective.
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!
Live in San Diego
DiabetesEd Training Seminar
Join us live October 22nd – 23rd, 2025!
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
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.
