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For those of us working in diabetes care and education, it often feels more like a calling than a job. The relationships we build and the role we play in supporting behavior change make this deeply meaningful work.
At the same time, the field is evolving. Workforce shifts, changing care models, and growing demand are shaping what practice looks like today and where it is headed. The 2025 Association of Diabetes Care & Education Specialists National Practice Survey offers a timely snapshot of these trends, highlighting current roles, areas where clinicians need more support, and perspectives on the future of the profession.
As you think about your own career path, important questions emerge. What will job opportunities look like in the coming years? How might your clinical role evolve? Let’s explore key themes from the survey, including a few findings that may surprise you, and what they could mean for the future of diabetes care and education.
The 2025 National Practice Survey conducted by the Association of Diabetes Care & Education Specialists was a national, quantitative survey designed to better understand the current diabetes care and education workforce.
Distributed online through ADCES and the Certification Board for Diabetes Care and Education, the survey assessed workforce characteristics, roles, practice settings, and evolving responsibilities, while also capturing perspectives on challenges, training needs, and the future direction of the profession.
The need for diabetes care and education specialists continues to rise alongside increasing rates of diabetes and prediabetes. At the same time, rapid advancements in technology, like CGM and AID systems, are reshaping care delivery. There is a growing need for clinicians who can interpret data and guide both patients and the healthcare team through increasingly complex treatment decisions.
While DSMES remains the core of the role, the scope of practice has expanded. Many diabetes care and education specialists are now involved in medication management, technology training, behavioral health support, and care coordination.
Future roles will likely require not only strong DSMES education skills, but also comfort with data, devices, and clinical decision-making, creating more diverse and specialized career pathways within the field.
Diabetes care and education specialists are increasingly seen as the go-to resource for diabetes technology, yet adoption is not consistent. While many are guiding patients on CGM, pumps, and data interpretation, fewer are using broader digital tools such as telehealth platforms, remote patient monitoring, or social media in practice.
This gap highlights a key opportunity. Clinicians who build skills in digital health, remote monitoring, and data-driven care will be well positioned for future job opportunities.
One of the most encouraging findings is that job satisfaction remains high, with the majority of respondents reporting they are satisfied in their roles. At the same time, time constraints, work-life balance, and keeping up with evolving technology were among the most commonly reported challenges.
This dual reality reflects a field that is deeply rewarding, but also demanding. Establishing a sustainable practice within a supportive environment will be key to long-term career success.
Another notable finding was the aging of the workforce and the number of professionals nearing retirement. A significant portion of the field has more than 20 years of experience, while relatively few are early in their careers. Nearly one-third of respondents plan to retire within five years, signaling a potential workforce gap on the horizon
While this suggests strong job opportunities for those entering the field, it also highlights a broader need for stronger career pipelines, mentorship, and greater visibility of the role within the profession.
The survey also highlights areas of future growth, including entrepreneurship, expanded clinical roles, and integration into broader cardiometabolic care. There is increasing emphasis on addressing social determinants of health, as well as providing behavioral and mental health support and integrating emerging tools like AI.
The field of diabetes care and education is expanding in both scope and impact. Clinicians who will thrive are those who are adaptable, curious, and willing to grow alongside the evolving needs of patients and healthcare systems.
Whether you are early in your career or more established, this is a moment of opportunity. The work remains deeply meaningful, but the way we deliver it is evolving. And if you are in this field, you likely know this is more than “just a job”.
You can read the full practice survey in The Science of Diabetes Self-Management and Care here:
https://journals.sagepub.com/doi/10.1177/26350106251401514
Sarah Hormachea, MS, RD, CDCES, BC-ADM
Owner & Consultant, Sarah Hormachea: Diabetes Care and Education, LLC
Sarah Hormachea is listed as a co-author on the 2025 ADCES National Practice Survey publication referenced in this article. She also serves as an elected member of the Board of Directors for the Association of Diabetes Care & Education Specialists.
1. Brackney DE, Cantazaro M, Duker P, et al. The Diabetes Education Arena: Results of the 2025 ADCES National Practice Survey of Diabetes Care and Education Specialists. The Science of Diabetes Self-Management and Care. 2026;52(1):12-24. doi:10.1177/26350106251401514
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.
Are you a healthcare professional providing diabetes care in an under-resourced community? Are you working toward earning your certification in diabetes education (CDCES or BC-ADM?)
If yes, please consider applying for our Bridge Scholarship, which covers the registration cost for the DiabetesEd Training Conference in San Diego, Oct 22-23, 2026 (value of $559). This program will provide you with the content needed to prepare for mastery-level diabetes certification and beyond!
Recipients will be awarded the Training Conference reg fee, including the live program, printed syllabus, 30+ CE’s, plus access to the online bonus courses for one year! Applications Due on July 20th, 2026
🌟Updated Schedule: ADA Boot Camp, Tech, MNT & More
Live in Beautiful San Diego – Oct 22-23, 2026
Re-Ignite your Passion & Prepare for Diabetes Certification Exams
🎓 Earn 30+ CEs: AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
📅
2-Day Conference
Oct 22–23, 2026
⏱️
15.5 Live CEs
+ 17 bonus CEs
🏅
CDCES & BC-ADM
Exam Prep + Renewal
📍
San Diego, CA
1.7 mi from airport
The field of diabetes care is expanding and evolving rapidly. This unique training conference will keep you on the cutting edge plus prepare you for certification exams. It also fulfills the Standards of Care renewal requirement. Join us for two days of intensive education that is fun and inspiring. Add on the optional Day 3 (Engaging the Disengaged), to complete your conference exeperience.
Coach Beverly and Diana Isaacs, PharmD, BC-ADM, CDCES co-lead an exciting day that brings the ADA and AACE Standards to life. Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. After attending, you will be empowered to share the latest in diabetes care with your colleagues and the people in your care.
Take your knowledge to the next level with this intensive deep-dive into insulin therapy, dosing and pattern management with Dr. Diana Isaacs. Next, stay for the diabetes tech show-and-tell as Diana demonstrates the specs of the latest pumps and sensors. After lunch, nutrition whiz Christine Craig, MS, RDN, CDCES expertly details the latest in MNT and provides real strategies on translating this content to your clinical practice. You will have a chance to put it all together as Coach Beverly leads you through a series of case studies that integrates content from Day 1 and Day 2.
On Saturday, join this exceptional day-long program led by William H. Polonsky, PhD, CDCES & Susan Guzman, PhD (Behavioral Diabetes Institute) that reveals psychosocial forces behind diabetes self-management — tools to break through resistance and inspire change.
Read more below
📜 Essentials
Registration
+ Printed Syllabus
$559.00
🌟 Deluxe
Essentials
+ ADA Standards Book
$589.00
🏆 Complete – Best Value!
Deluxe
+ ADCES Review Guide e-Book
$669.00
Transform how you engage patients with diabetes — master behavior change, reduce distress, and overcome medication hesitancy.
Why do so many patients know what they should do — but still struggle to do it?
The answer lies in the psychology of diabetes.
In this transformative full-day course, world-renowned experts William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, from the Behavioral Diabetes Institute reveal the hidden psychosocial forces that drive — or derail — diabetes self-management.
You’ll walk away with a completely new toolkit for breaking through patient resistance, dissolving medication hesitancy, and creating clinical encounters that actually inspire change!
A diabetes care professional is evaluating a new program that includes group education visits, CGM data sharing, and team-based care coordination for adults with type 2 diabetes.
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.
Level 4 | Advanced Level | 14+ CEs
Advance your expertise in complex diabetes care!
Level 4 is designed for experienced healthcare professionals who want to deepen their knowledge of advanced diabetes topics or are preparing for BC-ADM certification. This 12-course series covers complex clinical scenarios, insulin calculations, pattern management, cardiorenal risk reduction, and person-centered care strategies—perfect for advancing your clinical practice and professional growth.
Join us for our first Level 4 course of the year
Type 2 Diabetes Intensive | 2.25 CEs
Master the pathophysiology, prevention, and person-centered management of type 2 diabetes.
This course provides a detailed overview of the pathophysiology of type 2 diabetes, prevention strategies, and cardiovascular risk reduction. Through case studies and discussion, we highlight strategies to focus on a person-centered approach along with attention to psychosocial care for people living with diabetes
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.
✔ 1-year Access
You know how many hours along with blood, sweat and tears that go into preparing for this incredibly challenging diabetes certification exam. We are dedicating space in each month’s newsletter to celebrate this hard-earned success and let folks share their journeys with you.
Are you a healthcare professional providing diabetes care in an under-resourced community? Are you working toward earning your certification in diabetes education (CDCES or BC-ADM?)
If yes, please consider applying for our Bridge Scholarship, which covers the registration cost for the DiabetesEd Training Conference in San Diego, Oct 22-23, 2026 (value of $559). This program will provide you with the content needed to prepare for mastery-level diabetes certification and beyond!
Recipients will be awarded the Training Conference reg fee, including the live program, printed syllabus, 30+ CE’s, plus access to the online bonus courses for one year! Applications Due on July 20th, 2026
🌟Updated Schedule: ADA Boot Camp, Tech, MNT & More
Live in Beautiful San Diego – Oct 22-23, 2026
Re-Ignite your Passion & Prepare for Diabetes Certification Exams
🎓 Earn 30+ CEs: AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
📅
2-Day Conference
Oct 22–23, 2026
⏱️
15.5 Live CEs
+ 17 bonus CEs
🏅
CDCES & BC-ADM
Exam Prep + Renewal
📍
San Diego, CA
1.7 mi from airport
The field of diabetes care is expanding and evolving rapidly. This unique training conference will keep you on the cutting edge plus prepare you for certification exams. It also fulfills the Standards of Care renewal requirement. Join us for two days of intensive education that is fun and inspiring. Add on the optional Day 3 (Engaging the Disengaged), to complete your conference exeperience.
Coach Beverly and Diana Isaacs, PharmD, BC-ADM, CDCES co-lead an exciting day that brings the ADA and AACE Standards to life. Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. After attending, you will be empowered to share the latest in diabetes care with your colleagues and the people in your care.
Take your knowledge to the next level with this intensive deep-dive into insulin therapy, dosing and pattern management with Dr. Diana Isaacs. Next, stay for the diabetes tech show-and-tell as Diana demonstrates the specs of the latest pumps and sensors. After lunch, nutrition whiz Christine Craig, MS, RDN, CDCES expertly details the latest in MNT and provides real strategies on translating this content to your clinical practice. You will have a chance to put it all together as Coach Beverly leads you through a series of case studies that integrates content from Day 1 and Day 2.
On Saturday, join this exceptional day-long program led by William H. Polonsky, PhD, CDCES & Susan Guzman, PhD (Behavioral Diabetes Institute) that reveals psychosocial forces behind diabetes self-management — tools to break through resistance and inspire change.
Read more below
📜 Essentials
Registration
+ Printed Syllabus
$559.00
🌟 Deluxe
Essentials
+ ADA Standards Book
$589.00
🏆 Complete – Best Value!
Deluxe
+ ADCES Review Guide e-Book
$669.00
Transform how you engage patients with diabetes — master behavior change, reduce distress, and overcome medication hesitancy.
Why do so many patients know what they should do — but still struggle to do it?
The answer lies in the psychology of diabetes.
In this transformative full-day course, world-renowned experts William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, from the Behavioral Diabetes Institute reveal the hidden psychosocial forces that drive — or derail — diabetes self-management.
You’ll walk away with a completely new toolkit for breaking through patient resistance, dissolving medication hesitancy, and creating clinical encounters that actually inspire change!
For last week’s practice question, we quizzed participants on ADCES 7 Self-Care Behaviors. 71% 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.
When providing Diabetes Self-Management Education (DSME), which of the following list includes the ADCES 7 Self-Care Behaviors?
Answer A is incorrect. 8.94% chose this answer, “Healthy Eating, Being Active, Insulin Adjustment.” This answer is so close. The 7 ADCES Self-Care Behaviors include Healthy Coping, Healthy Eating, Being Active, Taking Medication, Monitoring, Reducing Risk, Problem Solving. Insulin Adjustment is just one component of Taking Medication.
Answer B is correct. 71.95% of you chose this answer, “Monitoring, Problem Solving, Healthy Coping.” Great JOB! This answer is the best answer. The 7 ADCES Self-Care Behaviors include Healthy Coping, Healthy Eating, Being Active, Taking Medication, Monitoring, Reducing Risk, Problem Solving. This great info to be familiar with for any upcoming certification exam in your future!
Answer C is incorrect. About 10.57% of respondents chose this: “Reducing Risks, Being Active, Social Support.” This answer is so close. The 7 ADCES Self-Care Behaviors include Healthy Coping, Healthy Eating, Being Active, Taking Medication, Monitoring, Reducing Risk, Problem Solving. Social Support falls under the category of Healthy Coping and is not it’s own category.
Finally, Answer D is incorrect. 8.54% chose this answer, “Problem Solving, Reducing Risk, Positive Self-Attitude.” Another juicy answer. The 7 ADCES Self-Care Behaviors include Healthy Coping, Healthy Eating, Being Active, Taking Medication, Monitoring, Reducing Risk, Problem Solving. Positive Self-Attitude might fall under the category of Healthy Coping, but is not it’s own category.
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.
✔ 1-year Access
Every year, National Nurses Week invites us to pause and honor a profession rooted in compassion, resilience, and an unwavering commitment to care.
This Nurses Week, I encourage you to take a moment to appreciate a nursing colleague, friend or family member. Let them know how their care and compassion has made a difference in your life!
As I reflect on my 40 years as a nurse, I feel both humbled and energized by the extraordinary legacy we carry forward. Nursing is not just a career—it is a calling shaped by human connection, scientific curiosity, and the courage to show up, again and again, for people in their most vulnerable moments.
The history of nursing is rich with pioneers who transformed care through both innovation and heart. Florence Nightingale is often recognized as the founder of modern nursing, bringing sanitation and data-driven care to the forefront. But beyond her statistics and systems, she modeled something deeper—the importance of presence. That legacy continues today in every nurse who sits at the bedside, listens without judgment, and advocates fiercely for those in their care.
The observance recognizes the critical role of nurses in patient care, research, leadership, and education. It raises public awareness of the challenges nurses face, such as staffing shortages and workplace stress – and promotes professional pride and public gratitude. The ANA and partner bodies like the American Association of Critical-Care Nurses host webinars, award ceremonies, and advocacy events to spotlight the profession’s impact
Today, nurses represent the largest group of healthcare professionals specializing in diabetes. Nearly half (46%) of those who hold a CDCES credential are nurses. That’s not just a statistic—it’s a reflection of the profound impact nurses have in shaping how diabetes care is delivered, understood, and experienced every day.
In the world of diabetes care, nurses have been at the center of transformation. From the early days of checking urine glucose to administering pork and beef insulin to today’s advanced technologies, nurses have led the way. As early adopters of continuous glucose monitoring and automated insulin delivery systems, nurses have bridged the gap between complex science and real-life application. We are educators, coaches, and translators—helping people make sense of numbers, medications, and daily decisions that can feel overwhelming.
What makes diabetes nursing uniquely powerful, is the ongoing contact nurses often maintain with individuals over a lifetime. Diabetes doesn’t take a day off, and neither does the emotional weight that often accompanies it. In my work, I’ve learned that the most meaningful breakthroughs don’t come from adjusting a medication or starting a CGM, they come from creating a space where someone feels seen, heard, and supported.
Over the decades, I’ve witnessed incredible advancements in diabetes care—new medications, smarter devices, and more personalized approaches. Nurses, along with their colleagues, are often the steady thread in a fragmented healthcare system. We are the ones who notice subtle changes, ask deeper questions, and advocate when something doesn’t feel right. In diabetes care, this might mean recognizing patterns in glucose trends, addressing social determinants of health, or simply acknowledging the burnout a person feels after years of self-management. These moments matter more than we often realize.
As I reflect on my journey, from bedside nursing to education, from rural clinics to national stages – I am continually reminded that our greatest impact comes not from having all the answers, but from presence. The simple act of sitting with someone, validating their experience, and walking alongside them can be profoundly healing – for them and for us. This mutual growth is at the heart of sustainable, meaningful care.
In hospitals, clinics, schools, and beyond – you show up at every hour of the day and night, bringing skill, compassion, and unwavering dedication. You give of yourselves in ways both seen and unseen, helping others heal, receive comfort, and feel cared for in their most vulnerable moments.
National Nurses Week offers us a moment to pause and honor your service and a profession grounded in compassion, resilience, and an unwavering commitment to showing up for others. Thank YOU!
Coach Beverly, RN and author of Healing through Connection for Healthcare Professionals!
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.
✔ 1-year Access
A 45 year old man with type 2 diabetes is referred to a CDCES with a persistently elevated A1c (9.4%). He has missed multiple follow-up appointments and reports inconsistent medication use.
During the visit, he shares that he recently lost his job, is staying intermittently with friends, and often skips meals due to limited food access. He reports feeling “constantly stressed” and “burned out” with diabetes management.
A Diabetes Distress Scale (DDS) score indicates moderate distress, and a PHQ-9 score is 4 (minimal depressive symptoms). He denies suicidal ideation.
Which of the following is the most appropriate next step for the CDCES?
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.
✔ 1-year Access
For last week’s practice question, we quizzed participants on how much protein is recommended. 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.
AR is a 63-year-old with type 1 diabetes and mild hypertension. Their GFR is 41 mL/min/1.73m² and UACR is 312 mg/g and their BMI is 24. The provider asks you to instruct AR on a low-protein diet, since AR is in stage 3 CKD. What is your best response?
Answer A is incorrect. 16.88% chose this answer, “Agree to provide education for AR low protein (0.6 -0.8 g/kg/day) to slow kidney disease progression.” This answer is incorrect. Very low-protein diets (<0.6 g/kg/day) have not consistently shown additional renal benefit and may increase the risk of malnutrition, sarcopenia, and frailty, especially in older adults like AR (age 63).
Answer B is correct. 73.05% of you chose this answer, “Reframe and suggest protein intake of about 0.8 g/kg/day as supported by ADA guidelines.” This answer is correct. GREAT Job! People with stage 3 CKD need adequate plant-based or animal protein intake to maintain muscle mass and optimize health and well-being.
Answer C is incorrect. About 2.52% of respondents chose this: “Suggest AR eliminates most protein sources and focus primarily on fiber, carbohydrates and fats.” This answer is incorrect. Since people with diabetes need to consume adequate amounts of either plant-based on animal protein (~0.8 g/kg/day) to maintain muscle mass and optimize health.
Finally, Answer D is incorrect. 7.56% chose this answer, “Reinforce that a protein intake of 1.3 g/kg/day is warranted to prevent sarcopenia and maintain muscle mass.” This answer is incorrect. Higher protein intake (>1.3 g/kg/day) may increase intraglomerular pressure and albuminuria, potentially accelerating kidney decline.
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!
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.
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.
Christine Craig, MS, RDN, CDCES
Founder: Nutrition for Daily Living
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.
