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For last week’s practice question, we quizzed participants on JR wanting treatment for pancreatic parasites, and what would be the best response. We share the scoop on pancreatic parasites below. 94.8% 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
JR is hospitalized with influenza. They have a history of prediabetes but now have persistent glucose readings between 220–260 mg/dL and are started on basal-bolus insulin.
JR is upset and states: “I’ve been reading that pancreatic parasites can cause of diabetes. No one is treating my infection.”
What is the BEST response?
Answer A is correct: 94% chose this answer, “It sounds like you are worried about a parasite infection. Tell me more about what you’ve read.” Great job. A is the best answer because it uses person-centered, nonjudgmental communication, as recommended by the ADA. It avoids dismissive language and explores misinformation respectfully. It preserves the therapeutic alliance.
Since many of you mentioned that patients are asking about parasites causing diabetes – here is the scoop. This false rumor is based on a video from a scientist named Hulda Clark that has since been debunked. Clark falsely claimed that most diseases, including AIDS, Cancer and diabetes, were caused by different parasites and could be cured with an electric “zapper.” Authorities took action against Clark’s “zapper” and other examples of her unproven treatments that she claimed could “cure all diseases” both before and after her death. Read more here
John Buse, MD a professor at the University of North Carolina School of Medicine, said there is a long-standing theory that infection by certain viruses could trigger the body’s immune response that leads to type 1 diabetes, but that no link has been established between a parasitic infection and any type of diabetes. He also said there is no evidence that methanol (another proposed false claim) — a poison — would have any different effect on someone with diabetes than on a person without high blood sugar.
Answer B is incorrect: 3% chose this answer, “Yes. We will be treating that issue soon, but first we need to focus on your insulin doses.” Option B offers a false narrative saying that they are going to treat the parasitic infection then shifts focus to the blood glucose, without recognizing JR’s emotional distress.
Answer C is incorrect: 2% chose this answer, “I can see how you would be concerned, but here is no such thing as pancreatic parasites.” Option C does initially recognize the emotions but then ends with a dismissive tone, that may make JR feel defensive and unheard.
Answer D is incorrect: 1% chose this answer, “Sadly, prediabetes always progresses to diabetes when people are acutely ill, and you will probably be discharged on insulin therapy.” Option D completely ignores the emotional distress in addition to making assumptions that may not be true.
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!
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
Have you ever left a medical appointment thinking, “I wish I had asked that question,” or “I wish someone really understood what this feels like”?
Managing type 2 diabetes is not just about numbers. It is about decisions. Emotions. Responsibilities. Fatigue. Food. Family. And sometimes feeling like you are carrying all of it alone.
That is why Coach Beverly and DiabetesSisters are proud to launch a new chapter in diabetes support on the West Coast!
Coach Beverly has been a nurse for 40 years and a diabetes specialist for 30. For two decades, she led a hospital-based diabetes support group that became a trusted space for women to gather, learn, and feel understood.
Now, she is bringing that experience to a new West Coast Type 2 Diabetes Support Group with DiabetesSisters.
What drew her to diabetes care was not only the science but the opportunity to make a difference in how women experience living with this condition.
She noticed that many conversations focused on what was not working. Very few recognized the daily effort required to manage a condition no one asked for.
She believes women deserve more than instruction. They deserve encouragement.
As she often reminds participants:
You are already doing more than you think.
This new diabetes support program on the West Coast is built around something simple and powerful: connection.
When women gather in Coach Beverly’s group, they talk about the realities of living with type 2 diabetes, including:
One woman shares something she has never said out loud. Another nods in recognition. And just like that, isolation begins to soften.
Peer support has been shown to strengthen confidence and encourage meaningful behavior change. Our 2024 survey data show that 90 percent of participants felt confident making behavioral changes, and 88 percent felt confident taking steps to support their diabetes management.
But beyond the numbers, there is something deeply human about being seen.
As one participant shared: “I feel so much more connected and less alone in my diabetes journey through the monthly meetings. DiabetesSisters is an amazing resource and community.”
That is the experience this new West Coast program is creating.
Because this is a new program on the West Coast, you have the opportunity to join from the very beginning.
At your first session, you can expect:
At the end of each meeting, you may choose one small, realistic commitment to focus on before the next session. Not a complete life overhaul. Just one doable step.
This is not about perfection. It is about progress. It is about living well while managing diabetes.
If you are a healthcare professional, this new diabetes support program on the West Coast offers an additional layer of care for women living with diabetes.
Diabetes management does not end in the exam room. Women benefit from structured peer support that addresses emotional health, daily decision-making, and lived experience.
Coach Beverly’s group complements clinical care and reinforces self-management behaviors. We welcome referrals for women living with type 2 diabetes who may benefit from additional support.
If you are living with type 2 diabetes and wondering whether this new group is for you, Coach Beverly has a simple invitation:
Come once.
And there is a seat waiting for you.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory & practice.
According to the 2026 ADA Standards of Care, what individuals should be recommended to have a bone density evaluation using dual-energy X-ray absorptiometry to evaluate for bone loss?
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
Featured Articles & Announcements ___________________________ |
Webinars & Programs
___________________________
March is National Nutrition Month, and I love the core of this year’s theme, “Discover the Power of Nutrition.” Nutrition does have the power to help individuals and communities thrive, especially our cherished community of people with prediabetes and diabetes.
This month, we recognize the impact that nutrition and Registered Dietitian Nutritionists (RDNs) make on people’s lives. All of us have been asked, “Just tell me what I can eat.” We share the basics with our clients and then refer them to our trusted and knowledgeable RDN colleagues, who expertly guide them through medical nutrition therapy and create customized meal plans that encourage folks to “maintain the pleasure of eating”.
In our first article, Christine Craig, MS, RDN, CDCES, explores the role and real impact of RDNs in a variety of settings. Ms. Craig also recognizes that we need to keep inviting people with diabetes to meet with dietitians, as MNT can lower A1C levels by 0.3 – 2%.
Explore our Carb Counting Made Easy Resource Page, featuring handouts, links, and our most frequently requested resources.
Coach Bev provides straightforward strategies (and a New Worksheet) that outline the steps to provide judgment-free coaching to the people in your care. Please, share this worksheet with your colleagues and let us know what you think!
Have you had people with diabetes ask you if those glucose watches really work? Me too! Dr. Beattie discusses which devices are approved for glucose sensing and which are not.
Diabetes Sisters and Coach Bev have teamed up to offer a virtual support group on the West Coast. Thank you in advance for sharing this resource with your clients.
Test your knowledge with a quiz that boldly broaches the topic of Pancreatic Parasites.
Lastly, we heard you! We moved up the dates of our CDCES and BC-ADM Bundles, so you have more time to prepare for exam success.
Celebrating the power of nutrition and RDNs!
Coach Beverly, Bryanna, Astraea & Katarina
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
For last week’s practice question, we quizzed participants on which of the following would NOT justify providing individual DSMES instead of group DSMES. 55.1% 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
After the initial assessment JM is scheduled for an individual visit instead of a group DSMES class.
According to Medicare guidelines, which of the following would NOT justify providing individual DSMES instead of group DSMES?
Answer A is correct: 55.1% chose this answer, “When scheduling, JM requested an individual appointment” Answer A is correct; it does NOT justify individual DSMES. Although diabetes care should be patient-centered, patient preference alone does not meet Medicare criteria for individual DSMES. Medicare requires the referring provider document justification of barriers to group learning which can include clinical, educational, or psychosocial need.
Answer B is incorrect: 12.74% chose this answer, “The referral for DSMES stated JM has a language barrier” Answer B is incorrect and does justify individual DSMES. Language barriers can significantly limit participation in group DSMES. Medicare recognizes a referral with stated language and communication needs as valid justification for an individual visit.
Answer C is incorrect: 15.61% chose this answer, “A group DSMES class is not available within the next 3 months” Answer C is incorrect and does justify individual DSMES. Medicare will approve individual DSMES if no group class is available for two months or longer from the date on the referral.
Answer D is incorrect: 16.56% chose this answer, “JM was referred for training on starting insulin therapy” Answer D is incorrect and does justify individual DSMES. A referral for initiation of insulin therapy requires individualized instruction. This can include injection technique, dose adjustment, hypoglycemia prevention, and problem-solving. Medicare considers this
an appropriate reason for individual DSMES.
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!
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
JR is hospitalized with influenza. They have a history of prediabetes but now have persistent glucose readings between 220–260 mg/dL and are started on basal-bolus insulin.
JR is upset and states: “I’ve been reading that pancreatic parasites can cause of diabetes. No one is treating my infection.”
What is the BEST response?
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
Cardiovascular disease remains the leading cause of mortality in individuals with both type 1 and type 2 diabetes, emphasizing the importance of risk reduction.
The current Standards of Care in Diabetes from the American Diabetes Association (ADA) recommend comprehensive risk reduction through screening, pharmacologic therapy to achieve individualized blood pressure and lipid goals, and lifestyle interventions focused on diet and physical activity.
The 2026 Dyslipidemia Guideline from the American College of Cardiology and the American Heart Association (ACC/AHA), together with guidance from multiple professional societies, provides updated recommendations for assessing cardiovascular risk assessment and treatment.
Both guidelines emphasize the importance of screening (with new additions within the ACC/AHA guidelines), pharmacologic treatment for primary and secondary prevention and highlight lifestyle management to reduce atherosclerotic cardiovascular disease (ASCVD).
The 2026 ADA Standards of Care recommend individualized medical nutrition therapy (MNT) based on an individual’s eating patterns, preferences, age, comorbidities, treatment plan, and metabolic goals.1 Recommended patterns include Mediterranean-like diet, Dietary Approaches to Stop Hypertension (DASH), and plant-based approaches, all of which are associated with reduced ASCVD risk.
Key strategies include increasing plant-based proteins, reducing saturated fat (replacing it with monounsaturated and polyunsaturated fats), increasing dietary omega-3 fatty acids, increasing fiber rich carbohydrates (particularly soluble fiber), and increasing plant stanols or sterols.1 Limited research exists regarding ASCVD prevention specifically for individuals living with type 1 diabetes, so most recommendations are extrapolated from type 2 diabetes research, including dietary approaches, with implied benefit for both groups.1
The 2026 Dyslipidemia Guideline has comparative recommendations, encouraging a dietary pattern rich in fruits, vegetables, nuts, legumes, whole grains, and fiber, while reducing saturated fat and replacing it with mono and polyunsaturated fats. It noted that dietary patterns that reduce saturated fat and increase unsaturated fat was more effective than restricting dietary cholesterol.2
The guideline reinforces the cardiovascular benefits of the Mediterranean, DASH, and vegetarian eating patterns and highlights the under-recognized Portfolio dietary pattern, which was shown to lower LDL by approximately 26 mg/dL. This dietary pattern emphasizes inclusion of 50 grams of plant-based protein per day, 45 grams of nuts, at least 10 grams of viscous fiber, and 2 grams of plant sterols per day.3
Additional guidelines are given for hypertriglyceridemia depending upon level of elevation2. If triglycerides (TGs) are 150-499, added sugars are limited to 6% of calories, total fat is 30-35%, and alcohol is to be avoided. If TGs are 500-999, added sugars are limited to <5% of calories, total fat to 20-25%, and it is recommended to abstain completely from alcohol. If TGs are over 1000 mg/dl, added sugars are eliminated, total fat is limited to 10-19%, and again, alcohol abstinence is recommended.
For all groups, 150 minutes of activity is recommended, and 5-10% weight loss is considered for individuals who may benefit. Consideration of the amount, type, and quality of carbohydrates shows efficacy in lowering TGs. In addition to LDL and TG lowering, dietary patterns aim to improve overall metabolic health, including weight reduction, reduced inflammation, and improved blood pressure and glucose control.2
45% of CVD-related deaths are linked to poor diet quality4; however, the Dyslipidemia Guidelines call out the conundrum of individual variability in LDL response to dietary changes, particularly reductions in saturated fat intake2. While replacing saturated fats with foods high in monounsaturated and polyunsaturated fats is consistently associated with LDL-C reduction4, individual responses vary widely.5
These individual differences mean that two people on the same heart-healthy diet may see different LDL outcomes.
For example, some genetic variants affect how efficiently the body clears LDL particles.5 Inflammation and insulin resistance may influence dietary LDL lowering, since hyperinsulinemia impacts hepatic lipid synthesis, clearance, and LDL particle composition.6 Variations in bile acid synthesis and reabsorption also contribute, since bile acids play a key role in cholesterol homeostasis. Finally, overall dietary and other lifestyle patterns affect LDL response, highlighting the importance of comprehensive and personalized strategies.
Healthful dietary patterns reflect the synergy of the overall diet, not just a single macronutrient change.
The ADA Standard of Care and the ACC/AHA Dyslipidemia guidelines align in recommending dietary patterns based on whole foods, increased fiber intake, reduced red meat and processed meat consumption, reduced saturated fat intake, and comprehensive lifestyle interventions. However, gaps remain.
More research is needed to clarify how specific individual differences influence dietary needs, how dietary patterns affect emerging lipid markers (ApoB, endothelial function, inflammation, etc.), nutrition interventions impacting cardiovascular risk reduction for individuals with type 1 diabetes, and the long-term impact of nutrition interventions over a lifetime4.
Cardiovascular risk reduction requires team-based care, addressing not only diet but social determinants of health, activity, tobacco cessation, sleep hygiene, and pharmacotherapy to manage cholesterol, blood glucose, blood pressure, and comorbidities increasing risk. As evidence evolves, diabetes health care professionals can help translate these guidelines into practical, personalized strategies to support heart health.
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Walk away with tools you can apply immediately in clinical practice or while preparing for CDCES or BC-ADM exams. From insulin dosing protocols to behavior change strategies that work in the real world—this content bridges theory and practice.
That future is no longer theoretical.
With the FDA approval of insulin icodec (Awiqli) for people with type 2 diabetes, we are entering a new era of diabetes care—one that prioritizes simplicity, adherence, and person-centered innovation.
Insulin icodec (brand name Awiqli®) is the first once-weekly basal insulin analog designed to provide steady glucose control over 7 days with a single injection.
Unlike traditional basal insulins, icodec is engineered to:
This innovation reduces injections from 365 per year to just 52, a meaningful shift for many people living with diabetes.
Insulin icodec represents a significant pharmacologic advancement as a once-weekly, ultra–long-acting basal insulin formulated at U-700 concentration (700 units/mL).
This high-concentration formulation allows delivery of a full week’s basal insulin in a single injection while maintaining a manageable injection volume.
Structurally, icodec is designed with strong, reversible albumin binding, creating a circulating depot that slowly releases insulin over approximately 7 days. It has a half-life of about one week, reaching steady state after several weekly doses, which supports consistent basal coverage with minimal peak-to-trough variability.
Because of this prolonged action, dose adjustments must be made thoughtfully, as changes take longer to fully manifest. Understanding this pharmacokinetic profile is essential to safely initiating, titrating, and educating patients about this novel therapy.
The ONWARDS Phase 3 clinical program (≈4,000 participants with type 2 diabetes) demonstrated:
For clinicians, this means:
👉 Similar outcomes
👉 With fewer injections
👉 And potentially happier patients
Download FREE Insulin PocketCard
The following recommendations based on kidney function are suggested.
The following recommendations for missed doses are suggested:
Icodec insulin is available in 3 different pen sizes and has a 12 week shelf life at room temperature. Pens can be dialed in 10 unit increments with a maximum dose of 700 units.
Download our FREE Insulin Storage and Dispensing Info Cheat Sheet below as a helpful reference.
Insulin icodec may be especially valuable for:
This is where your role as a healthcare professional becomes even more powerful—matching the right therapy to the right person.
Insulin icodec represents a transformational step forward in diabetes management. While ongoing evaluation is needed—especially regarding safety and real-world use—this therapy has the potential to reshape how we approach basal insulin. Novo Nordisk plans to launch and release the prefilled icodec (Awiqli) FlexTouch® pens in the US in the second half of 2026.
As healthcare professionals, staying current with these advancements allows us to:
Join us as we break down the latest in diabetes care, guidelines, and emerging therapies— you can bring confidence, clarity, and compassion to your clinical practice by joining our
Virtual DiabetesEd Training Conference.
Join national experts including Dr. Diana Isaacs (Cleveland Clinic), Beverly Thomassian (30+ years of experience), and Christine Craig for high-impact, virtual learning—no travel required.
✔ Learn from National Experts — Anywhere
Get the same expert-level instruction you’d receive in person, delivered live to your home or office.
✔ Interactive & Flexible
Get exam-ready with confidence.
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Full accreditation details are available on the registration page
Our CDCES Boot Camp Online Prep Bundle is a comprehensive, high-impact program built specifically for healthcare professionals preparing for the Certified Diabetes Care and Education Specialist (CDCES) exam who want to level up their clinical knowledge and skills.
This evidence-based study bundle is a comprehensive BC-ADM Boot Camp designed for advanced-level healthcare professionals preparing for the Board Certified in Advanced Diabetes Management (BC-ADM) exam and will also provide you with state-of-the-art information to level up your clinical practice.