1. Evaluate transglutaminase levels.
2. Encourage small, frequent, low fiber meals.
3. Suggest a consult for a gastric pacemaker.
4. Recommend they try avoiding foods with gluten for a few weeks to see if they feel better.

Click Here to Test your Knowledge

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Want to learn more about this practice question?
Join us LIVE in San Diego for our DiabetesEd Training Conference with 4 Hours of Medical Nutrition Therapy
October 11-13th, 2023

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Two Registration Options

Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego. 

You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.    

Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy! 

Bring your colleagues and enjoy our friend discount.

Our team expertly translates the complex science of diabetes into understandable terms while keeping it real, practical, and fun. 

Team of expert faculty includes:

• Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES – Educator of the Year, 2020
• Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
• Ashley LaBrier, MS, RD, CDCES, Diabetes Program Coordinator 

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!

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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.

You passed the CDCES Exam (yay)! Now five years have flown by, you are up for renewal. How do you maintain this hard-earned certification?

This year, the CBDCE published new rules to renew certification which you might have missed. To make sure there are no surprises during your renewal process, here are key considerations from the CBDCE Website that we hope you find helpful!

2025 CDCES Renewal Updates

To promote quality and inclusive diabetes care and education, the CBDCE Board changed the continuing education (CE) content requirements. Certificants will still need to complete 75 CE units over a five-year period. However, to make sure CDCES’s stay abreast of the latest standards and promote inclusive care, the Board is now requiring participation in CE courses that provide updates on the ADA Standards of Care at least twice during the individual’s renewal cycle.

This means that starting in 2023, certificants will need to start acquiring these more specific CEs in preparation for 2025 renewal.

1. Required CE Activities now include ADA Standards Update

According to the CBDCE, to successfully renew their CDCES, applicants must participate in CE activities that are focused on the American Diabetes Association’s Standards of Care for Diabetes* two separate times during your renewal cycle.

2. In addition, the following CE Activities are encouraged:

If you are renewing your CDCES in 2025 or later by completing 75 CE units over the five-year period, the CBDCE requires that you demonstrate completion of the following type of CE Activities (you can immediately start accumulating these needed CEs). The CBDCE encourages the following CE activities at least once during your renewal cycle:

• education principals/teaching strategies
• diabetes-related technology;
• leadership/strategy (e.g., CQI, change agent, program development);
• population health; or
• diversity, equity, inclusion, and accessibility (e.g., social determinants of health, cultural competency).

Diabetes Education Services Online University is Here to Help

*Since Diabetes Education Services is Accredited by the Commission on Dietetic Registration (CDR), all of our courses can be applied toward your CDCES Renewal.

Our content incorporates the ADA Standards and Content Requirements
Our Level 2 ADA Standards of Care series, CDCES Basic Prep Bundle, and our new “Everything” Bundle are perfect options for those working toward CDCES renewal requirements. Plus, we update our entire library of content yearly to reflect the latest ADA Guidelines.

In addition, our DiabetesEd Training Programs cover the ADA Standards of Care with clarity and intention by a trio of experts, including Diana Issacs, PharmD, BC-ADM, CDCES, and FADCES a contributing author to the ADA Standards.

Plus, all of our content incorporates education principles and teaching strategies, with a special emphasis on population health, equity, diversity, and inclusion.

We are here to help you succeed. Whether you are starting your journey or working toward recertification, our Standards of Care Intensive, CDCES Basic Prep Bundle, and our new “Everything” Bundle or DiabetesEd Training Conferences are perfect options to meet your goals.

For more information, visit CBDCE Renewal Webpage and/or the current Renewal Handbook for details on the requirements.

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Is it Worth all this Work? – YES!

Achieving my CDCES is one of the best and most meaningful investments in professional career! ~ Coach Beverly

---

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 diabetes certification exams. CBDCE & ADCES does not endorse any preparatory or review materials for the certification exams, except for those published by CBDCE & ADCES.

**To satisfy the requirement for renewal of certification by continuing education for the Certification Board for Diabetes Care & Education (CBDCE), continuing education activities must be applicable to diabetes and approved by a provider on the CBDCE List of Recognized Providers (www.ncbde.org). CBDCE does not approve continuing education. Diabetes Education Services is accredited/approved by the Commission of Dietetic Registration which is on the list of CBDCE Recognized Providers.

For last week’s practice question, over 1,900 participants submitted their answers for how LR could improve glucose while preparing for pregnancy. 37% 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 29 years old, has newly discovered diabetes and polycystic ovary syndrome (PCOS) and is trying to get pregnant. In addition to treating the diabetes and PCOS, LR would like to lose weight. LR was referred to the RD/RDN and encouraged to increase activity level. To treat PCOS and diabetes, LR was started on metformin ER 500mg BID.  After a month of treatment, LR’s A1C was still above 8%.

 According to ADA Standards, besides increasing the metformin dose, what additional therapy could be added to get LR’s glucose to goal?

Answer Choices:

1. GLP-1 Receptor Agonist
2. SGLT-2 Inhibitor
3. Either A or B
4. None of the above

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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 incorrect. 25.41% chose this answer. “GLP-1 Receptor Agonist.” Given that LR has elevated blood glucose and wants to lose weight, starting a GLP-1 seems like a reasonable idea. However, GLP-1’s are not FDA approved for use during pregnancy. Since LR is trying to get pregnant, this class of medication would not be recommended.

Answer 2 is incorrect. 13.35% of you chose this answer. “SGLT-2 Inhibitor.” Given that LR has elevated blood glucose and wants to lose weight, starting a SGLT-2i seems like a reasonable idea. However, SGLT-2i’s are not FDA approved for use during pregnancy. Since LR is trying to get pregnant, this class of medication would not be recommended.

Answer 3 is incorrect. About 24.51% of respondents chose this. “Either A or B.” Given that LR has elevated blood glucose and wants to lose weight, starting either a SGLT-2i or a GLP-1 seems like a reasonable idea. However, SGLT-2i’s and GLP-1’s are not FDA approved for use during pregnancy. Since LR is trying to get pregnant, neither class of medication would not be recommended.

Finally, Answer 4 is correct. 36.73% chose this answer. “None of the above.” YES, This is the Best Answer. Metformin is the only non-insulin diabetes medication the ADA recommends for the first trimester of pregnancy. Many people with PCOS are treated with metformin to decrease insulin resistance and ovulation can resume, resulting in pregnancy. The ADA recommends stopping metformin after the first trimester and starting insulin if blood glucose levels remain above target.

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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Celebrating 25 Years Sale!!!

Save $100 on our Most Popular Online Programs! Sale ends July 31st!

Prepare for Certification and Earn CEs

---

ReVive 5 Diabetes Training Program

“ReVive 5 Program is the best program I have ever attended – should be required for all diabetes educators! Thank you so much for translating this research into practical approaches!!” – Sarah F.

Save $100! Enroll now to watch the webinar on-demand

Addressing diabetes distress can be challenging, 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.

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:

• 15.0 CEs – Includes the 7-hour 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.

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

---

CDCES Basic Prep Bundle

30+ Online Courses | 50+ CEs

---

BC-ADM Deluxe Prep Bundle

35 online courses | 50+ CEs

---

NEW: Everything Bundle

40+ online courses | 85+ CEs

The first person who purchases our Everything Bundle wins our last copy of the Diabetes Review Guide 5^th Ed. 

The next edition of the Review Guide will be released in August. We will be preselling as soon as we get the thumbs up.

The first person who purchases our Everything Bundle wins our last copy of the Diabetes Review Guide 5^th Ed. 

All hours earned count toward your CDCES Accreditation Information

---

ADCES Art & Science Desk Reference
5th Edition

ADCES will be releasing an updated edition of the Art & Science Desk reference in August 2023

---

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. Consistently decrease portion size and increase vegetable intake.
2. Ask AR if they can increase bike riding to daily.
3. Explore addition of twice weekly strength training.
4. Encourage AR to reconsider increasing empagliflozin dose.

Click Here to Test your Knowledge

---

Celebrating 25 Years Sale!!!

Save $100 on our Most Popular Online Programs! Sale ends July 31st!

Prepare for Certification and Earn CEs

---

ReVive 5 Diabetes Training Program

Save $100! Enroll now to watch the webinar on-demand

Addressing diabetes distress can be challenging, 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.

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:

• 15.0 CEs – Includes the 7-hour 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.

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

---

CDCES Basic Prep Bundle

30+ Online Courses | 50+ CEs

---

BC-ADM Deluxe Prep Bundle

35 online courses | 50+ CEs

---

NEW: Everything Bundle

40+ online courses | 85+ CEs

The first person who purchases our Everything Bundle wins our last copy of the Diabetes Review Guide 5^th Ed. 

The next edition of the Review Guide will be released in August. We will be preselling as soon as we get the thumbs up.

The first person who purchases our Everything Bundle wins our last copy of the Diabetes Review Guide 5^th Ed. 

All hours earned count toward your CDCES Accreditation Information

---

ADCES Art & Science Desk Reference
5th Edition

ADCES will be releasing an updated edition of the Art & Science Desk reference in August 2023

---

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.

Like many seasoned diabetes educators, I used to worry that I wasn’t “teaching” enough during my initial one-hour individual assessment. Over time, I realized that listening to and acknowledging the persons’ feelings about diabetes distress and their living situation was the most critical part of this interview process. This initial meeting provides a vital opportunity to make a meaningful connection and start the long-term collaborative problem-solving process.

In addition, according to researchers on the seven sources of distress, the most significant are feelings of powerlessness, followed by management, hypoglycemia, and eating distress.

Good news! The findings from the EMBARK Trial presented at the American Diabetes Scientific Session in June validated the effectiveness of this whole-person approach. The EMBARK study results demonstrated that providing education, combined with careful listening and attunement to the emotional side of diabetes, significantly decreased diabetes distress.

Coach Beverly Participated in EMBARK Trial 

I was asked to participate in the EMBARK Trial as a diabetes educator. My role was to provide a three-hour informational online program for a cohort of people with type 1 diabetes. In addition, I provided six to eight 20-minute individual sessions with this same cohort over the next few months. In this study, my role was not to answer clinical questions or make insulin adjustments. Instead, I provided “coaching” to help the individuals discover their own best answers to make needed adjustments.

Participating in this study opened my eyes to a new approach to diabetes education and gave me permission not to know all the answers. The truth is that individuals with diabetes hold the solution in themselves. Our most important job is to help them with the process of self-discovery. The EMBARK Trial provided guidelines and tools for diabetes educators, so we had a clear framework for providing effective coaching.

ReVive 5 Program Shares Strategies that worked in EMBARK

After we completed the study, the lead researchers on this trial, Dr. Lawrence Fisher and Dr. Susan Guzman, reached out to see if we could take the information learned from the EMBARK Trial and create a comprehensive CE program for healthcare professionals. One year later, we launched the ReVive 5 Program to share the steps involved in providing whole-person education and increasing comfort and confidence in addressing emotions. Our next ReVive 5 program starts July 19th, and we would love to have you join us.

More About the EMBARK Trial

The EMBARK study was a randomized controlled trial that compared three diabetes distress interventions: Streamline, which was a diabetes educator-led program focused on education and management; TunedIn, which was a psychologist-led program focusing exclusively on the emotional side of diabetes; and FixIt, which integrated elements from the Streamline and TunedIn programs. All sessions were held virtually in groups of eight to 12 adults and occurred over 3 to 4 months. Sessions included initial workshops, one-on-one phone calls, and follow-up group meetings.

There were reductions in diabetes distress with all three interventions, with Streamline participants having a reduction in score of 0.48 points, TunedIn participants reporting a 0.59-point decrease and FixIt participants having a 0.88-point decrease. The reduction in diabetes distress for FixIt participants was greater than what was observed in Streamline (P = .005).

According to lead researcher, Danielle Hessler Jones, PhD, “We feel that these findings suggest that these distress reductions are greatest when interventions integrate education alongside a focus on the emotional side of diabetes.”

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ReVive 5 Diabetes Training Program

“ReVive 5 Program is the best program I have ever attended – should be required for all diabetes educators! Thank you so much for translating this research into practical approaches!!” – Sarah F.

Save $100! Enroll now to watch the webinar on-demand

---

ReViVE 5 Diabetes Training Program: 
Unlocking Hidden Barriers to Diabetes Management
Enroll Now and Save $100! 

Recorded & Ready to Watch

---

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.

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:

• 15.0 CEs – Includes the 7-hour 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.

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

---

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 diabetes certification exams. CBDCE & ADCES does not endorse any preparatory or review materials for the certification exams, except for those published by CBDCE & ADCES.

For last week’s practice question, we quizzed participants on person-centered care. 55% 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: MR has an A1C of 9.6% and is deciding whether or not to start another diabetes medication to help lower their glucose. MR’s parent had diabetes and severe complications due to chronic hyperglycemia. 

What would best describe the application of the Health Belief Model in this situation?

Answer Choices:

1. MR’s perception of the benefit and cost associated with preventing diabetes complications.
2. MR’s level of readiness to add an additional diabetes medication to their regimen.
3. MR is more likely to start this medication if they know someone taking the same medication.
4. MR’s feelings of empowerment impact their decision whether or not to start the medication.

---

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. 54.67% chose this answer. “MR’s perception of the benefit and cost associated with preventing diabetes complications.” GREAT JOB. The Health Belief Model (HBM) focuses on individual beliefs and perceptions about health-related behavior change. It suggests that behavior change is influenced by an individual’s perception of the severity of a health problem, their susceptibility to it, the benefits of behavior change, and the barriers or cues to action. In other words it looks at the cost-benefit of a given situation.

Answer 2 is incorrect. 18.28% of you chose this answer. “MR’s level of readiness to add an additional diabetes medication to their regimen.” This answer actually refers the Stages of Change (transtheoretical) Model: This model proposes that individuals go through a series of stages when changing behavior: precontemplation, contemplation, preparation, action, and maintenance. It suggests that people move through these stages in a cyclical manner and that interventions should be tailored to each stage.

Answer 3 is incorrect. About 5.88% of respondents chose this. “MR is more likely to start this medication if they know someone taking the same medication.” This answer reflects the Social Cognitive Theory (SCT): This theory emphasizes the reciprocal interaction between personal factors (such as cognition and self-efficacy), environmental factors, and behavior. It suggests that behavior change is influenced by observing others (social modeling), self-regulation, and the belief that one can successfully perform the behavior (self-efficacy).

Finally, Answer 4 is incorrect. 21.18% chose this answer. “MR’s feelings of empowerment impact their decision whether or not to start the medication.” This answer refers to the empowerment model which is a theoretical framework that focuses on empowering individuals or communities to take control of their own lives and make informed decisions. It emphasizes the importance of promoting autonomy, self-efficacy, and participation in decision-making processes. The empowerment model is often applied in various fields, including social work, community development, healthcare, and education.

Behavior Change Theories Explained – LIVE FREE Webinar
August 23rd, @ 11:30 am PST

Learning behavior change theories and getting to the best answer for certification exams can be tricky. To say thanks for 25 years, Coach Beverly is going to host a FREE Webinar where she dissects common learning theories that are not only helpful for your clinical practice, but also for exam preparation.

Join her August 23rd at 11:30 am PT. For live webinars, Coach Beverly stays after class to answer any lingering questions you may have on the topic.

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!

---

ReVive 5 Diabetes Training Program

“ReVive 5 Program is the best program I have ever attended – should be required for all diabetes educators! Thank you so much for translating this research into practical approaches!!” – Sarah F.

Save $100! Enroll now to watch the webinar on-demand

---

ReViVE 5 Diabetes Training Program: 
Unlocking Hidden Barriers to Diabetes Management
Enroll Now and Save $100! 

Recorded & Ready to Watch

---

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.

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:

• 15.0 CEs – Includes the 7-hour 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.

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

---

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 diabetes certification exams. CBDCE & ADCES does not endorse any preparatory or review materials for the certification exams, except for those published by CBDCE & ADCES.

1. GLP-1 Receptor Agonist
2. SGLT-2 Inhibitor
3. Either A or B
4. None of the above

Click Here to Test your Knowledge

---

Celebrating 25 Years Sale!!!

Save $100 on our Most Popular Online Programs! Sale ends July 31st!

Prepare for Certification and Earn CEs

---

ReVive 5 Diabetes Training Program

“ReVive 5 Program is the best program I have ever attended – should be required for all diabetes educators! Thank you so much for translating this research into practical approaches!!” – Sarah F.

Save $100! Enroll now to watch the webinar on-demand

---

ReViVE 5 Diabetes Training Program: 
Unlocking Hidden Barriers to Diabetes Management
Enroll Now and Save $100! 

Recorded & Ready to Watch

---

Addressing diabetes distress can be challenging, 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.

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:

• 15.0 CEs – Includes the 7-hour 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.

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

---

CDCES Basic Prep Bundle

30+ Online Courses | 50+ CEs

---

BC-ADM Deluxe Prep Bundle

35 online courses | 50+ CEs

---

NEW: Everything Bundle

40+ online courses | 85+ CEs

The first person who purchases our Everything Bundle wins our last copy of the Diabetes Review Guide 5^th Ed. 

The next edition of the Review Guide will be released in August. We will be preselling as soon as we get the thumbs up.

The first person who purchases our Everything Bundle wins our last copy of the Diabetes Review Guide 5^th Ed. 

All hours earned count toward your CDCES Accreditation Information

---

ADCES Art & Science Desk Reference
5th Edition

ADCES will be releasing an updated edition of the Art & Science Desk reference in August 2023

---

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 ADA recommendations for meal planning with diabetes. 41% 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: Which of the following diabetes meal planning recommendations is accurate according to ADA Standards of Care?

Answer Choices:

1. Decrease intake of starchy vegetables.
2. Limit carbs to 45 grams per meal.
3. Eat 25 gms of fiber for every 1000 calories consumed.
4. Avoid all concentrated sweets.

---

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. 41.24% chose this answer. “Decrease intake of starchy vegetables.” YES, this is the BEST answer. According to ADA Standard 5, “Reducing overall carbohydrate intake for individuals with diabetes has demonstrated evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences. Eating plans should emphasize nonstarchy vegetables, fruits, legumes, and whole grains, as well as dairy products, with minimal added sugars. However, “macronutrient distribution should be based on an individualized assessment of current eating patterns, preferences, and metabolic goals.”

Answer 2 is incorrect. 16.79% of you chose this answer. “Limit carbs to 45 grams per meal.” This is a juicy answer, but is an older approach that is no longer recommended. According to ADA Standard 5, “Evidence suggests that there is not an ideal percentage of calories from carbohydrate, protein, and fat for people with diabetes. However, macronutrient distribution should be based on an individualized assessment of current eating patterns, preferences, and metabolic goals.”

Answer 3 is incorrect. About 23.15% of respondents chose this. “Eat 25 gms of fiber for every 1000 calories consumed.” WOW, that would be a LOT of fiber. This is a great number to know for certification exams. According to ADA Standard 5, “People with diabetes and those at risk for diabetes are encouraged to consume a minimum of 14 g of fiber/1,000 kcal, with at least half of grain consumption being whole, intact grains, according to the Dietary Guidelines for Americans.”

Finally, Answer 4 is incorrect. 18.81% chose this answer. “Avoid all concentrated sweets.” Even if you are not sure what the best answer is at first, this answer has two red flags, the word “avoid” and the word “all”. Since the ADA recommends flexibility and tailoring to the individual, this would not be the best person-centered answer. According to ADA Standard 5, “Dietary guidance should emphasize the importance of a healthy dietary pattern as a whole rather than focusing on individual nutrients, foods, or food groups, given that individuals rarely eat foods in isolation.”

We hope you appreciate this week’s rationale! For more info on ADA Standard 5, click here. 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 practice question?
Join us LIVE in San Diego for our DiabetesEd Training Conference
October 11-13th, 2023

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Two Registration Options

Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego. 

You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.    

Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy! 

Bring your colleagues and enjoy our friend discount.

Our team expertly translates the complex science of diabetes into understandable terms while keeping it real, practical, and fun. 

Team of expert faculty includes:

• Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES – Educator of the Year, 2020
• Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
• Ashley LaBrier, MS, RD, CDCES, Diabetes Program Coordinator 

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.