Join us live on August 30th, 2023, at 11:30 am PST for our NEW: Diabetes Technology Data Toolkit: Hands-on Data Interpretation Workshop with Dr. Diana Isaacs

As diabetes technology is becoming commonplace in our practice, figuring out how to make sense of all the data can seem overwhelming. Dr. Isaacs has a special knack for breaking down the essential elements of the Ambulatory Glucose Profile (AGP) and other reports to provide participants with a clear road map for data interpretation. She includes many sample practice cases utilizing CGM, connected pens, and insulin pumps. 

By attending this interactive workshop, participants will become more confident in interpreting the AGP and continuous glucose monitor (CGM) data and determining needed medication and lifestyle adjustments.

Topics include:

• Learn how to review the ambulatory glucose profile (AGP) report systematically and efficiently.
• Understand the key metrics of CGM Data and person-centered goals.
• Utilize CGM and connected data to make medication adjustments and lifestyle/behavior recommendations.
• Apply data interpretation principles to a wide variety of cases in people with type 1 and type 2 diabetes.

Instructor: Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES, was awarded ADCES Diabetes Care and Educational Specialist of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She is the Director of Education & Training in Diabetes Technology at the Cleveland Clinic. She has numerous diabetes publications and research projects focusing on medications, CGM, and diabetes technology. You won’t want to miss this hands-on workshop with an international expert in the field.

All hours earned count toward your CDCES or BC-ADM

Accreditation Information: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.* The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

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Want to learn more about Diabetes Technology?
Register now for our Virtual DiabetesEd Training Conference

Available now On-Demand!

Your team is invited to our Virtual DiabetesEd™ Training Conference! Set your team apart and prepare for diabetes certification!

Join this state-of-the-art conference taught by content experts, Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, Beverly Thomassian RN, MPH, CDCES, BC-ADM, and Ashley LaBrier who are passionate about improving diabetes care.

Group discounts are available!*

All hours earned count toward your CDCES Accreditation Information

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Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

Happy May

Last week, a disheartened individual arrived for their initial diabetes appointment. With slumped shoulders, they shared how a provider had lectured them about their elevated A1C and insisted they add an additional diabetes medication.

This person described how they had made significant progress in healthy eating and moving more, but that didn’t seem to matter to the provider. Worse, this individual just felt like giving up.

The good news is that this heartbreaking story inspired me to take action.

I penned an article on Person-Centered Coaching and then created a PDF Cheat Sheet that you can reference and share with your colleagues.

My hope is that we can all be a part of lifting people up and acknowledging even those tiny lifestyle changes that are so difficult to initiate and sustain. Through careful listening, reflection, and collaboration, we can make meaningful connections that support change in the long run and improve well-being.

We also reflect on one year of action in celebration of Earth Day. Our family is committed to making ten changes in our daily lives to give back to this incredible planet we get to inhabit. In addition, the crew at Diabetes Education Services decided to highlight the benefits of our domestic pets. They not only enhance our work day but also improve the health outcomes of people with diabetes.

Lastly, we are excited to share that people with diabetes can lower their blood sugars by changing the order of the foods consumed. You can read more about these exciting topics below, plus take a stab at our Question and Rationales of the Week.

Thanks for helping to lift people up,

Coach Beverly, Bryanna, Amanda, and Andrew

Announcements

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• Conduct a Person-Centered Interview
• 10 Actions for the Earth
• Food Order & Post-Meal Blood Sugar
• 3 Ways Pets Can Support People with Diabetes
• Question of the Week
• Rationale of the Week

Upcoming Webinars

• ReVive 5 Training Program Connect – July 19 & 26th
• Standards of Care Intensive Updates – May 11
• NEW: Tech Data Toolkit – Aug. 30th
• FREE CDCES Exam Prep Webinar – May 23rd
• Upcoming Events – See the complete calendar listing

Free Resource Catalog

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Enroll in our Level 2 | Lower Extremity Assessment | 1.5 CEs

People with diabetes are at increased risk of Lower Extremity Complications. This course reviews the steps involved in performing a detailed assessment of the lower extremities, including how to use a monofilament and tuning fork to detect neuropathy. We also discuss the significance of the Ankle Brachial Index and strategies to prevent lower extremity complications.

Objectives:

1. Describe the risk factors for lower extremity complications.
2. Discuss prevention strategies.
3. Demonstrate steps involved in a lower extremity assessment.

Intended Audience: This is a great course for healthcare professionals who want to learn the steps involved in providing a thorough lower extremity assessment.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information

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Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

For last week’s practice question, we quizzed participants on statins & the risk of dementia. 49% 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: LR is 78 years old with a new diagnosis of diabetes. Their A1C is 7.9%, LDL cholesterol is 98 mg/dL, GFR is 58 mg/g and their BP is 124/78. The provider recommends a referral to the RD and DSME program and writes a prescription for metformin XR 500mg daily and lovastatin 20mg. LR is worried about taking a statin because they heard it can cause dementia.

Based on the ADA Standards, what is the best response?

Answer Choices:

1. Based on the most recent research, statins don’t seem to cause dementia.
2. Statins are very safe and actually protect against dementia.
3. To find out more about the side effects of statins, we recommend asking your pharmacist for more information.
4. You can start with half a pill a day to evaluate for side effects.

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Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.

Answer 1 is correct. 49.45% chose this answer. “Based on the most recent research, statins don’t seem to cause dementia.” YES, is the BEST answer. According to ADA 2023 SOC 10 a recent systematic review of the U.S. Food and Drug Administration’s (FDA’s) postmarketing surveillance databases, randomized controlled trials, and cohort, case-control, and cross-sectional studies evaluating cognition in patients receiving statins found that published data do not reveal an adverse effect of statins on cognition (138). Therefore, a concern that statins or other lipid-lowering agents might cause cognitive dysfunction or dementia is not currently supported by evidence and should not deter their use in individuals with diabetes at high risk for ASCVD (138).

Answer 2 is incorrect. 26.73% of you chose this answer. “Statins are very safe and actually protect against dementia.” Although the first part of this statement is correct, statins are safe, there is no evidence presented in the ADA Standards that statins protect against dementia.

Answer 3 is incorrect. About 17.62% of respondents chose this. “To find out more about the side effects of statins, we recommend asking your pharmacist for more information.” Although pharmacists are incredibly knowledgeable about medications, diabetes specialists can relate evidence based information to the people we serve, instead of making them take additional action to get the information they need to move forward. The good news is that there is no evidence that statins or other lipid-lowering agents might cause cognitive dysfunction or dementia and their use is recommended in individuals with diabetes at high risk for ASCVD.

Finally, Answer 4 is incorrect. 6.19% chose this answer. “You can start with half a pill a day to evaluate for side effects.” This approach is tempting, but it doesn’t address the fear of the statin causing dementia. The good news is that there is no evidence that statins or other lipid-lowering agents might cause cognitive dysfunction or dementia and their use is recommended in individuals with diabetes at high risk for ASCVD.

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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Want to learn more about this question? Enroll in our

Level 2 | Older Adults & Diabetes | 1.5 CEs

 

We are living longer & more people are getting diabetes. The American Diabetes Association has updated the Older Adults Standards, with special attention to considering the reduction of medication & insulin therapy intensity. The older population has unique issues & special needs that require consideration as we provide diabetes self-management education. This online course highlights key areas of assessment, intervention, and advocacy for older clients living with diabetes.

Objectives:

1. Self-management considerations for older individuals.
2. Strategies to prevent complications & maintain optimal quality of life.
3. The role of the Diabetes Care & Education Specialist as an advocate.

Intended Audience: An important course for healthcare professionals seeking to gain an understanding of the special issues and goals for older adults.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information

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Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

 

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Want to learn more about this question? Enroll in our

Level 2 | Lower Extremity Assessment | 1.5 CEs

People with diabetes are at increased risk of Lower Extremity Complications. This course reviews the steps involved in performing a detailed assessment of the lower extremities, including how to use a monofilament and tuning fork to detect neuropathy. We also discuss the significance of the Ankle Brachial Index and strategies to prevent lower extremity complications.

Objectives:

1. Describe the risk factors for lower extremity complications.
2. Discuss prevention strategies.
3. Demonstrate steps involved in a lower extremity assessment.

Intended Audience: This is a great course for healthcare professionals who want to learn the steps involved in providing a thorough lower extremity assessment.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information

---

Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

---

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

We have two updates to announce that have been captured in our electronic Medication PocketCards.

Saxagliptin Discontinued

The DPP-IV Inhibitor Saxagliptin (Onglyza) and combination medication, Kombiglyze XR (saxagliptin/metformin extended-release tablets), have been permanently discontinued, according to manufacturer AstraZeneca.

A recent posting on the Food and Drug Administration’s (FDA) Drug Shortages tracker indicates that both products were discontinued because of a business decision and not due to safety or efficacy-related concerns.

There are three other DPP-IV inhibitors still available along with several combination versions. See our updated electronic ePocketCard that reflects this update.

Dulaglutide Approved for Peds

In late 2022, the FDA approved the use of Dulaglutide (Trulicity for Pediatrics with Type 2 diabetes ages 10-17. Currently, metformin, insulin and the following GLP-1 RA’s are approved for pediatrics with type 2 diabetes, ages 10-17 See updated ePocketCard.

GLP-1 RA list of approved medications for pediatrics.

• Exenatide XR (Bydureon)
• Liraglutide (Victoza)
• Dulaglutide (Trulicity) up to 1.5mgs

GLP-1 RAs have the benefit of not only lowering A1C, they also support weight loss and Exenatide XR and dulaglutide only need to be taken once a week. This weekly dosing can be a big advantage for busy families.

Our currently available laminated Diabetes Med PocketCards do not reflect these changes, but we will be reprinting later this year to reflect these updates.

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Download our FREE CDCES Coach App

Access to our latest pocketcards, cheat sheets, and other free resources right in your pocket. Download our CDCES Coach App!

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Starting your journey to becoming a CDCES? Our FREE Webinar

Preparing for the CDCES Exam

Airs live on Thursday, July 13th at 11:30 am PST

This course will transform your test anxiety into calm self-confidence and test-taking readiness.

Preparing for the CDCES Exam Webinar Topics

• Exam requirement updates for 2023.
• Exam eligibility and test format
• Strategies to succeed along with a review of study tips and test-taking tactics.
• We will review sample test questions and the reasoning behind choosing the right answers.
• Learn how to focus your time and prepare to take the CDCES Exam. We provide plenty of sample test questions and test-taking tips!

Can’t join us live?
Don’t worry, we will send you a link to the recorded version.

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“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, RN, MPH, CDCES, BC-ADM

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Interested in diabetes certification, but not sure where to start? Find your Study Path and Tools that are right for you based on this quick 4 question survey.

All hours earned count toward your CDCES Accreditation Information

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Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

---

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

For last week’s practice question, we quizzed participants on diabetes distress. 78% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question

Question: JR has type 1 diabetes and tells you, “My doctor just doesn’t seem to understand how to manage type 1 diabetes. Sometimes, I just skip my appointments because it feels like a waste of time.” JR’s most recent A1C was 8.7% and their time in ranges keeps decreasing with each visit.

Based on this, you realize that JR’s provider-related diabetes distress:

Answer Choices:

1. has intensified to clinical depression.
2. requires urgent referral to a mental health professional.
3. could be responsive to self-management coaching.
4. may be a sign of disordered eating.

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Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements, get rid of false answers, do any math very carefully and choose the BEST answer.

Answer 1 is incorrect. 9.58% chose this answer. “has intensified to clinical depression.” This is a tempting answer, but we don’t enough evidence to support that JR is struggling with depression. If we had JR complete the Diabetes Distress Scale, he would certainly score high on provider related distress based on this statement, “My doctor just doesn’t seem to understand how to manage type 1 diabetes. Sometimes, I just skip my appointments because it feels like a waste of time.” These comments certainly fit in the distress category. Through careful questioning and exploration, the diabetes educator could certainly help with problem solving.

Answer 2 is incorrect. 8.18% of you chose this answer. “requires urgent referral to a mental health professional.” Based on JR’s statement, “My doctor just doesn’t seem to understand how to manage type 1 diabetes. Sometimes, I just skip my appointments because it feels like a waste of time,” JR is certainly in distress. However, there is no language indicating that JR is in imminent danger of self-harm. Through careful questioning and exploration, the diabetes educator could certainly carefully assess JR’s mental health state and help with problem solving and referrals as needed.

Answer 3 is correct. About 77.84% of respondents chose this. “could be responsive to self-management coaching.” YES. This is the best answer. We could start by administering the Diabetes Distress Scale and then hone in on the high scoring areas. Then through careful questioning and exploration, the diabetes educator could certainly help with problem solving and identify if additional resources or referrals are needed.

Finally, Answer 4 is incorrect. 4.39% chose this answer. “may be a sign of disordered eating.” but we don’t enough evidence to support that JR is experiencing disordered eating. However, if we had JR complete the Diabetes Distress Scale, he would certainly score high on provider related distress based on this statement, “My doctor just doesn’t seem to understand how to manage type 1 diabetes. Sometimes, I just skip my appointments because it feels like a waste of time.”

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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Want to learn more about using the Diabetes Distress Scale and Coaching Strategies? Join our next

ReVive 5 Diabetes Training Program

Addressing diabetes distress can be tricky, even for seasoned healthcare professionals.

We invite you to attend this hands-on training program that provides the essential steps to address diabetes distress combined with an innovative approach to glucose management. Our experts offer realistic strategies to address diabetes distress that you can immediately apply to your practice setting. Plus, the ReVive 5 Program provides a breadth of tools and resources to create more meaningful connections with people with diabetes.

“ReVive 5” breathes new life into our relationship with diabetes, bringing a fresh perspective to both the person with diabetes and the provider.

Join A Team of Experts – Save $100

Team of Experts: ReVive 5 is taught by a team of 3 Interdisciplinary Experts:

• Lawrence Fisher, Ph.D., ABPP, Professor Emeritus, UCSF
• Susan Guzman, PhD
• Beverly Thomassian, RN, MPH, CDCES, BC-ADM

Accredited Training Program:

• 14.0 CEs – Includes the 7-hour Session ReVive 5 Training Program, Certificate, and 5 FREE bonus courses to supplement content.
• A comprehensive set of assessment tools, educational materials, log sheets, and resources.

Speakers Interviews – Learn more about the ReVive 5 Team

What is the Biggest Takeaway when Addressing Diabetes Distress? – Dr. Susan Guzman

Do you have to be a Mental Health Expert to Tackle Diabetes Distress? – Dr. Lawrence Fisher

Why I Transformed my Approach to Diabetes Self-Management Education- Coach Beverly

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Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information

---

Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

---

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

1. Based on the most recent research, statins don’t seem to cause dementia.
2. Statins are very safe and actually protect against dementia.
3. To find out more about the side effects of statins, we recommend asking your pharmacist for more information.
4. You can start with half a pill a day to evaluate for side effects.

Click Here to Test your Knowledge

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Want to learn more about this question? Enroll in our

Level 2 | Older Adults & Diabetes | 1.5 CEs

Join us live on May 16, 2023, at 11:30 am PST

 

We are living longer & more people are getting diabetes. The American Diabetes Association has updated the Older Adults Standards, with special attention to considering the reduction of medication & insulin therapy intensity. The older population has unique issues & special needs that require consideration as we provide diabetes self-management education. This online course highlights key areas of assessment, intervention, and advocacy for older clients living with diabetes.

Objectives:

1. Self-management considerations for older individuals.
2. Strategies to prevent complications & maintain optimal quality of life.
3. The role of the Diabetes Care & Education Specialist as an advocate.

Intended Audience: An important course for healthcare professionals seeking to gain an understanding of the special issues and goals for older adults.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information

---

Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

---

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

Last year, we came up with a list of 10 Simple Steps to improve planetary health. Me and my family committed to making all 10 of these changes and I wanted to report on how we fared for the year. We weren’t perfect, but we definitely made some good progress! Check out our report below!

10 Earth Actions We Took

1. Grow plants native to our area.

We are transforming our yard, plant by plant, with native species. The effort is paying off. The diversity of our bird and butterfly population has dramatically increased, along with a new host of amphibious friends.
By choosing plants that originated from your geographic area, you help support your regional ecosystem and offer pollinators, birds, butterflies, and other healthy critters needed food, pollen, and building materials for their survival.

Read more on our blog, Earth Day Secrets to Improving Planet Health

2. Compost kitchen scraps and cut down on waste

This year, we purchased a Lomi Composter from Pela Earth, and we love it. All of our food scraps go into the Lomi and from this food waste, nutrient-rich compost is created, and serves as the BEST fertilizer, ever. My house and outdoor plants have never looked so good!

3. Eat more sustainable veggies, fruits, and grains and less meat, and processed foods.

My husband, a committed meat eater, recently discovered that his cholesterol was elevated. Overnight, he reached back in time and started cooking the vegetarian dishes of his Armenian grandparents. My kitchen has never smelled so good and the flavors coupled with joy, make each dish extra special. Plus, our fiber intake has dramatically increased and we are all learning more about traditional Armenian foods (so delicious).

4. Drive less and walk more, especially in nature

In addition to walking out day outside with our furry friends, we needed a new car and decided to go completely electric. I can’t tell you how GREAT it feels to drive without creating emissions (and it’s so quiet). In addition, we have enough solar panels to charge our cars and rarely need to go to a charging station.

5. Think of 3 ways to use less water

My husband and I have decreased our frequency of showering and have replaced the emitters in our yard to prevent water waste. Most of our plants are drought-tolerant too.

6. Use cold water to wash, and hang clothes to dry.

Cold water in the washer works as well as warm or hot water for most items. If the weather is bad, we toss wet clothes over chairs and over the headboard. We don’t hang everything to dry, but we are approaching 50%.

7. Turn appliances, lights, and computers off when not in use.

This is an ongoing goal that we keep working on. Our computers are on sleep at night, but we keep forgetting to turn them off.

8. Purchase used items and re-use everything you can. Swap and trade instead of buying new.

As a family, we try to purchase used items and clothes whenever possible. In addition, we work on maintaining our appliances and other household gadgets to extend their life and avoid putting them into landfill.

9. Try to use fewer plastics

Plastic is everywhere and is so hard to avoid. We first committed to no longer buying plastic water bottles and are trying to use refillable soaps, lotions, and other items. When shopping, we bring our reusable bags to the store. The next goal is to avoid buying fresh foods packaged in plastic.

10. Trade out filament light bulbs for new LED bulbs.

We are at 50% of this goal. Since the new LED bulbs last so long, it has decreased the hassle of changing the bulbs and we love the wonderful light color choices too.

Please send us your stories too at info@diabetesed.net. We want to hear from you!

For all the earth has given me and I want to give back to this beautiful blue planet. Each intention and action matters.

Each action, no matter how small, matters. We can do this!

With wishes for improved planetary health,

Beverly, Chris, Jackson, Robert and Choochi, and Maverick

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Free Resources Catalog

• Diabetes Cheat Sheets
• Diabetes Blog Bytes
• Medication PocketCards
• 10 Steps to Succeed
• CDCES Coach App
• Free Webinars hosted by Coach Beverly
• Question of the Week
• Free Diabetes Article Library

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Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.