
JR has newly discovered type 2 diabetes and is admitted to the hospital with heart failure. Their A1C is 7.9% with negative ketones and a GFR greater than 90 mg/g.
According to the 2024 ADA Standards of Care, which of the following is a recommended intervention during JR’s hospital stay?
Click Here to Test your Knowledge

Objectives:
Intended Audience: This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
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.
“What Year ADA Standards Should I Study?”
This popular question warrants careful consideration. Coach Beverly’s first response is from her exam experience, and then we will provide the official statement from CBDCE regarding this question.
Coach Beverly’s suggested approach and insights.

Being familiar with the ADA Standards of Care is an essential strategy for exam success. More importantly, this evidence-based guidebook is crucial for providing the best clinical and person-centered care.
Taking CDCES in January or February 2024?
If you are taking the exam in January or February 2024 and you have already read the 2023 ADA Standards cover-to-cover, you should be fine. It takes at least a year for the exam writers to include new questions culled from the ADA Standards. Having said that, if there are any critical new guidelines that impact clinical care, education, or treatment of diabetes, that content can be included in the exam that same year. One important caveat: if you are relying on last year’s standards, make sure to read through the Summary of Revisions section included in the Standard of Care.
Taking the Exam in 2024 Sometime?
On the other hand, if you are taking the exam in 2024 and haven’t reviewed the ADA Standards in the past, I recommend a thorough review of this clinical guidebook.
Short on Time?
In case of emergency, there is a shorter version of the ADA Standards called the Abridged version for Primary Care Providers that highlights critical clinical content. The abridged version can also be used as a quick review after you have read the entire document. Again, after successfully passing the exam seven times, my advice is to be familiar with the ADA Standards of Care in its entirety.
Study Strategies from Coach Beverly
Here is official statement on “Testing of Advancements” from the CBDCE
CBDCE recognizes that advances in the treatment of diabetes continue to be made. It is also recognized that the dissemination of this information may not occur at the same rate in different areas of the United States. In consideration, CBDCE has developed the following policies:
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

For last week’s practice question, we quizzed participants on best approach to treat hypoglycemia according to 2024 ADA Standards. 51% 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: The 2024 ADA Standards of Care includes expanded content on the prevention and treatment of hypoglycemia.
Based on the updated guidelines for the treatment of hypoglycemia, which of the following is true?
Answer Choices:

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 incorrect. 23.44% chose this answer. “If blood glucose is less than 70 mg/dL, treat with a combination of fast acting glucose and protein to sustain blood glucose levels.” Part of this answer is correct. We need to treat a blood glucose of less than 70 with mg/dL with 15gms of carbohydrate. However, there is no recommendation to add protein to the carbohydrate treatment. As a matter of fact, adding protein (which if often combined with fat) can slow the absorption of the carbohydrate and delay glucose improvement. In addition, for people with beta cell function, the ingestion of protein can stimulate insulin production.
Answer 2 is incorrect. 9.31% of you chose this answer. “Avoid use of glucagon emergency treatment for those with type 2 diabetes to prevent rebound hyperglycemia.” The new standards recommend that all people using insulin therapy have access and training on glucagon rescue medications. See our Glucagon Pocketcards.
Answer 3 is incorrect. 16.61% of respondents chose this. “In community settings, check blood sugar to verify hypoglycemia before providing glucagon emergency treatment.” In the community or home setting, there may be limited access to glucose monitors and the public may not know how to check blood sugars, which could lead to delayed treatment for this emergency situation. For this reason, if a person has diabetes and is experiencing an episode of severe hypoglycemia, it is recommended to provide a glucagon rescue medication and activate the emergency response system if warranted. See our Glucagon Pocketcards.
Finally, Answer 4 is correct. 50.65% chose this answer. “If individual has one or more episode of clinically significant hypoglycemia, consider short-term relaxation of glucose goals.” YES, this is the BEST answer. If a person has an episode of clinically significant hypoglycemia, it is an indication that they may be taking too much insulin or diabetes medication. In addition, experiencing hypoglycemia puts individuals at a higher risk for another episode of significant hypoglycemia. Relaxing glucose goals and up-adjusting them can help the person re-set their “glucose thermostat” in a safer range with the ultimate goal of preventing future hypoglycemia.
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!
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

JR is 47 years old and who just got lab results from their annual physical. Their fasting plasma glucose result was 129 mg/dL. The provider is worried that JR might have diabetes and sent them to back to the lab to check their A1C, which came back 6.4%.
According to the 2024 ADA Standards, to most accurately assess if JR has diabetes, which of the following follow-up actions is recommended?
Click Here to Test your Knowledge

Objectives:
Intended Audience: This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

We are thrilled to welcome our newest member of the Diabetes Education Services faculty and blog team. Winner of the 2023 Impact on Diabetes Award, Christine Craig, MS, RD, CDCES is a leader in the field of nutrition, technology, and diabetes care. Her years of expertise combined with her person-centered approach and work ethic, make her a perfect fit for our company. In addition to writing a monthly blog and question of the week, Christine will also be providing nutrition lectures as part of Diabetes Fundamentals and Boot Camp. We are excited to integrate her fresh perspective and breadth of knowledge into our courses and blog offerings.
On a personal note, Christine loves to adventure. Travel, hiking, and snow skiing are her favorite pastimes. For Christine, having a moment to take in the landscape and beauty around us can re-energize and fuel a busy life.
Learn more about Christine’s approach to diabetes and nutrition education in this brief interview and you can read more about Christine here. Welcome, Christine!
What advances in nutrition therapy are you excited to explore?
Nutrition is a constantly evolving field that is both a science and an art; we know there is no one-size-fits-all approach. In the science of nutrition, I am excited by the emerging field of precision nutrition, which may give us better insight into an individual’s needs. Precision nutrition uses the complexity of genetics, metabolic profiles, individual microbiomes, wearables, lifestyle, and environmental exposures to better predict an individual’s nutrition needs. This science is still in the very early stages, but the ability to integrate precision nutrition with the art of nutrition has the potential to transform our approach to medical nutrition therapy.
How do you integrate social determinants of health when developing a diabetes management plan?
Developing a diabetes management plan involves finding out about the individual, asking questions, and not making assumptions that you know what is best for the person living with diabetes at that time. Life is complex and managing health can be complex. As a healthcare provider, we can’t always solve structural obstacles, which can feel overwhelming at times. We can, however, through shared decision-making, constant learning, and linking to community resources, develop a collaborative self-care plan that considers the individual’s social determinants of health.
What communication strategies do you find most effective when providing nutrition therapy?
As a dietitian and diabetes educator, I have worked across modalities of care including in-person visits, telehealth, chat-based message communication, and group classes. Like nutrition therapy, there is no one-size-fits-all approach; each person can respond differently to different style types. For me, what has always been effective is using non-judgmental language and open-ended questions. People want to feel heard; this opens the doors to trust and developing an effective nutrition plan.
What do you love most about being a diabetes nutrition specialist?
I love that diabetes care supports health throughout the lifespan, we care for individuals with diabetes over time and at different transition points in their lives. I love that we can walk into work each day and present a breadth of options to support the person living with diabetes or our care teams. I love that I can talk diabetes tech in one moment, nutrition meal planning in the next, and then end my day reviewing coping strategies. This profession is never boring and I love bringing the latest research into my daily practice.
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Be a part of our diabetes community while learning about the latest in diabetes care. Plus, Coach Beverly provides an interactive question and answer session at the end of each live webinar.

Topics:
This course reviews the latest national nutrition guidelines and provides strategies to translate this information to individuals. We delve into the recent exercise recommendations and provide realistic strategies to help keep individuals active and engaged.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.

Topics:
This course is an introduction to the abundance of medications available to treat type 2 diabetes. We explore the different classes of diabetes medications including action, considerations & side effects. Case studies help students with problem solving & immediate application of this complex topic.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.

Topics:
This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the annual updates to the American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provides critical teaching points & content for healthcare professionals involved in diabetes care & education.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

For last week’s practice question, we quizzed participants on 2024 ADA Standards. 44% 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:
The new ADA 2024 Standards of Care include dozens of updates to diabetes clinical practice.
Which of the following statements has actually been added to the ADA 2024 Standards of Care?
Answer Choices:

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 incorrect. 23.05% chose this answer. “Evaluate B12 levels for Individuals on long-term metformin therapy at least yearly.” This juicy answer is very tempting. It is true the metformin can be associated with lower B12 levels. However, the ADA does not recommend checking B12 levels annually for people taking this biguanide. Instead, they suggest regularly monitoring B12 levels in people on metformin therapy who have signs of B12 deficiency such as neuropathy or anemia.
Answer 2 is correct. 44.04% of you chose this answer. “Screen people with diabetes, caregivers, and family for diabetes distress at least annually.” Yes, this is the BEST answer! Many individuals with diabetes experience unrecognized and undertreated diabetes distress, which can lead to decreased engagement in self-management activities and worsen outcomes. We address diabetes distress and discuss strategies to address this common emotional response to diabetes in our ReVive 5 Training Program.
Answer 3 is incorrect. About 16.27% of respondents chose this. “Provide COVID 19 immunizations annually to people with diabetes starting at age 18.” The ADA recommends starting COVID 19 immunizations in people with diabetes starting at 6 months and follow-up with boosters as recommended,
Finally, Answer 4 is incorrect. 16.63% chose this answer. “Test for type 1 autoimmunity annually starting at age 5 for those with family history of autoimmune conditions.” Autoimmune testing is recommended for those with immediate family members with type 1 diabetes and other risk factors. There is no age cut-off nor is there a recommendation for annual testing.
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!

Objectives:
Intended Audience: This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
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.
If your New Year’s resolution includes getting ready for diabetes certification exams, keep reading!

The Certification Board for Diabetes Care and Education Specialists (CBDCE) has posted a few critical updates on its website regarding CDCES testing blackout dates and an extension of COVID-19 pandemic professional practice requirements. This information will help as you plan your exam dates and work toward acquiring professional practice hours.
Blackout Periods for Application Submission, Scheduling, and CDCES Testing
According to the CBDCE website, to improve the candidate experience, they will be moving to a new application platform in early 2024. Due to this change, there will be specified periods where no applications are accepted, and testing will be closed.
Blackout period for exam application
To accomplish the transition to a new platform, there will be a two-week blackout period from February 9, 2024, to February 27, 2024, when individuals cannot apply for the CDCES exam.
Blackout period for exam application AND testing
In addition, there will be a blackout period where scheduling or testing is unavailable from February 19, 2024, to February 27, 2024.
Please consider this important information as part of your plan to apply, schedule, and take your CDCES exam. We will keep you updated and let you know if any changes occur.
Professional Practice Experience Updates
Starting in 2021, the CBDCE increased the period of time allowed to accumulate professional practice hours from 4 years to 5 years. This additional time allotment addressed the impact of the COVID-19 pandemic on the ability of health professionals to accrue practice experience in diabetes care and education (DCE). The CBDCE also decreased by half the number of diabetes care and education hours required within 12 months prior to taking the application.
The good news is that the CBDCE Board of Directors approved making these initial temporary changes to the professional practice requirement for initial certification to a permanent state (see table below).
According to the CBDCE Website, Professional Practice Experience Requirement Changes are identified
below:

Learn more about changes in the Pandemic Impact Certification Statement or visit CBDCE website.
Plus, you can join our FREE webinar coming up soon (see below)

Starting your journey to becoming a CDCES? You won’t want to miss our FREE Preparing for CDCES Exam Webinar! This course will transform your test anxiety into calm self-confidence and test-taking readiness. Coach Beverly has taken (and passed) the CDCES exam 7 times and loves sharing her insights on exam success. She will include the latest exam updates with her clear spoken and engaging approach.
A perfect way to kick off your New Year and it’s FREE!
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!
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.