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Rationale of the Week | Pregnancy & Diabetes Medication
For last week’s practice question, we quizzed participants on gestational diabetes & medication. A whopping 70% of respondents chose the best answer – great job. 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: AR has PCOS and type 2 diabetes and is in shock because they just discovered they are 6 weeks pregnant. AR takes metformin 1000mg BID plus empagliflozin (Jardiance) 25 mg and their most recent A1C is 8.6%.
Which of the following actions do you recommend?
Answer Choices:
- Stop empagliflozin
- Stop metformin, keep empagliflozin
- Stop metformin and empagliflozin, start insulin.
- Stop empagliflozin, start a GLP-1 inhibitor
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. 20.16% chose this answer. “Stop empagliflozin.” It is true that empagliflozin and all SGLT-2’s are not indicated during pregnancy. However, there is a better answer given that her A1C of 8.6% is above the pregnancy target of less than 6.5%.
Answer 2 is incorrect. 2.58% of you chose this answer. “Stop metformin, keep empagliflozin.” Empagliflozin and all SGLT-2’s are contraindicated during pregnancy, so this answer is not the best choice.
Answer 3 is correct. About 70% of respondents chose this. “Stop metformin and empagliflozin, start insulin.” GREAT JOB. Given that her A1C of 8.6% is above the pregnancy target of less than 6.5%, insulin absolutely needs to be started to get glucose to goal. According to the ADA Standards, the provider may opt to continue the metformin treatment for PCOS for the first trimester But given the urgent need to get blood glucose to target, this individual will be most effectively managed with a combination of nutrition therapy and insulin.
Finally, Answer 4 is incorrect. 7.26% chose this answer. “Stop empagliflozin, start a GLP-1 inhibitor.” Yes, we need to stop empagliflozin since all SGLT-2’s are contraindicated during pregnancy. However, GLP-1 Inhibitors are also contraindicated during pregnancy, so this answer is incorrect.
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!
Want to learn more about this question? Enroll in our
Level 2 | Pregnancy & Diabetes | 1.5 CEs
Pregnancy with diabetes is confronted with a variety of issues that require special attention, education, & understanding. This course reviews those special needs while focusing on Gestational Diabetes & Pre-Existing Diabetes. Included are the most recent diagnostic criteria, management goals, & prevention of complications during pregnancy. This is a helpful review for Certification Exams & those who want more information on people who are pregnant & live with diabetes.
Objectives:
- List three issues that affect pregnancy with diabetes.
- Describe the unique attributes of pre-existing diabetes in pregnancy & gestational diabetes.
- State the diagnostic criteria & management goals for gestational diabetes.
- Potential short-term & long-term complications of fetal exposure to hypoglycemia.
- Prevention measures to keep mother & baby healthy.
Intended Audience: A great course for healthcare professionals seeking to enhance their knowledge of the issues surrounding pregnancy and diabetes and appropriate care to improve outcomes.
Level 2 | Hospitals & Hyperglycemia | 1.5 CEs
Research clearly demonstrates the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge. This course reviews the evidence that supports inpatient glucose control & outlines practical strategies to achieve targets in the inpatient setting. We incorporate the latest American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provide links to resources & inpatient management templates.
Objectives:
- Describe the impact of hyperglycemia in the hospital setting.
- Discuss the importance of inpatient glucose control.
- List three strategies to get glucose to goal in the hospital setting.
Intended Audience: A great course for healthcare professionals seeking strategies to manage and improve inpatient diabetes care.
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Question of the Week | Diabetes & Hospital Standards
JR was admitted to the hospital with an infection and newly discovered diabetes. To get glucose to ADA target range for hospitalized individuals, JR was started on 12 units of basal insulin plus bolus insulin with meals. JR experienced a morning BG of 87 mg/dL, so the provider decreased the basal insulin to 9 units. JR’s morning blood sugar the next day was 157 mg/dL.
What is the best action?
- Increase basal insulin by 10- 20%.
- Intensify correction scale.
- Continue with same basal dose.
- Ask MS if they are snacking during the night before making adjustments.
Click Here to Test your Knowledge
Want to learn more about this question? Enroll in our
Level 2 | Hospitals & Hyperglycemia | 1.5 CEs
Research clearly demonstrates the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge. This course reviews the evidence that supports inpatient glucose control & outlines practical strategies to achieve targets in the inpatient setting. We incorporate the latest American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provide links to resources & inpatient management templates.
Objectives:
- Describe the impact of hyperglycemia in the hospital setting.
- Discuss the importance of inpatient glucose control.
- List three strategies to get glucose to goal in the hospital setting.
Intended Audience: A great course for healthcare professionals seeking strategies to manage and improve inpatient diabetes care.
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Rationale of the Week | AR is pregnant and Worried
For last week’s practice question, we quizzed participants on gestational diabetes & pregnancy complications. 68% 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: AR has PCOS type 2 diabetes and worried because they just discovered they are 6 weeks pregnant. AR takes metformin 1000mg BID plus empagliflozin (Jardiance) 25 mg and their most recent A1C is 8.6%.
Which of the following is a potential complication associated with hyperglycemia during the first 10 weeks of pregnancy?
Answer Choices:
- Intrauterine hypoglycemia
- Macrosomia and post-natal jaundice
- Neonatal respiratory distress
- Diabetic embryopathy
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. 10.53% chose this answer. “Intrauterine hypoglycemia.” Although this answer is tempting, it is not accurate. If the fetus experienced elevated blood sugars (from mom) during gestation, this stimulates increased fetal production of insulin. After delivery, baby’s who were exposed to intrauterine hyperglycemia are at higher risk of post-delivery hypoglycemia (not intrauterine hypoglycemia).
Answer 2 is incorrect. 14.56% of you chose this answer. “Macrosomia and post-natal jaundice.” Although this answer is tempting, it is not accurate. If the fetus experienced elevated blood sugars (from mom) during their first 10 weeks of gestation, this stimulates increased fetal production of insulin and can stimulate extra fat stores later in pregnancy leading to larger babies and higher risk for post delivery jaundice. However, the question is asking, what complications can elevated blood sugars cause during their first 10 weeks of pregnancy when the organs are developing?
Answer 3 is kind of incorrect. About 7.37% of respondents chose this. “Neonatal respiratory distress.” The question is asking, if the fetus experienced elevated blood sugars (from mom) during the first 10 weeks of gestation, what complications can elevated blood sugars cause during the first trimester pregnancy when the organs are developing? The lungs can be affected by first trimester hyperglycemia, causing the newborn to struggle with respiratory distress.
Finally, Answer 4 is correct. 67.54% chose this answer. “Diabetic embryopathy.” GREAT JOB. This is the best answer. If the fetus experienced elevated blood sugars (from mom) during the first 10 weeks of gestation, embryonic complications result from elevated blood sugars during the first trimester pregnancy when the organs are developing. These can include, congenital heart disease, renal anomalies and caudal regression.
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!
Want to learn more about this question? Enroll in our
Level 2 | Pregnancy & Diabetes | 1.5 CEs
Pregnancy with diabetes is confronted with a variety of issues that require special attention, education, & understanding. This course reviews those special needs while focusing on Gestational Diabetes & Pre-Existing Diabetes. Included are the most recent diagnostic criteria, management goals, & prevention of complications during pregnancy. This is a helpful review for Certification Exams & those who want more information on people who are pregnant & live with diabetes.
Objectives:
- List three issues that affect pregnancy with diabetes.
- Describe the unique attributes of pre-existing diabetes in pregnancy & gestational diabetes.
- State the diagnostic criteria & management goals for gestational diabetes.
- Potential short-term & long-term complications of fetal exposure to hypoglycemia.
- Prevention measures to keep mother & baby healthy.
Intended Audience: A great course for healthcare professionals seeking to enhance their knowledge of the issues surrounding pregnancy and diabetes and appropriate care to improve outcomes.
Level 2 | Hospitals & Hyperglycemia | 1.5 CEs
Research clearly demonstrates the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge. This course reviews the evidence that supports inpatient glucose control & outlines practical strategies to achieve targets in the inpatient setting. We incorporate the latest American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provide links to resources & inpatient management templates.
Objectives:
- Describe the impact of hyperglycemia in the hospital setting.
- Discuss the importance of inpatient glucose control.
- List three strategies to get glucose to goal in the hospital setting.
Intended Audience: A great course for healthcare professionals seeking strategies to manage and improve inpatient diabetes care.
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Question of the Week | Pregnancy & Diabetes Medication
AR is 6 weeks pregnant, what action is recommended?
AR has PCOS and type 2 diabetes and is in shock because they just discovered they are 6 weeks pregnant. AR takes metformin 1000mg BID plus empagliflozin (Jardiance) 25 mg and their most recent A1C is 8.6%.
Which of the following actions do you recommend?
- Stop empagliflozin
- Stop metformin, keep empagliflozin
- Stop metformin and empagliflozin, start insulin.
- Stop empagliflozin, start a GLP-1 inhibitor.
Click Here to Test your Knowledge
Want to learn more about this question? Enroll in our
Level 2 | Pregnancy & Diabetes | 1.5 CEs
Pregnancy with diabetes is confronted with a variety of issues that require special attention, education, & understanding. This course reviews those special needs while focusing on Gestational Diabetes & Pre-Existing Diabetes. Included are the most recent diagnostic criteria, management goals, & prevention of complications during pregnancy. This is a helpful review for Certification Exams & those who want more information on people who are pregnant & live with diabetes.
Objectives:
- List three issues that affect pregnancy with diabetes.
- Describe the unique attributes of pre-existing diabetes in pregnancy & gestational diabetes.
- State the diagnostic criteria & management goals for gestational diabetes.
- Potential short-term & long-term complications of fetal exposure to hypoglycemia.
- Prevention measures to keep mother & baby healthy.
Intended Audience: A great course for healthcare professionals seeking to enhance their knowledge of the issues surrounding pregnancy and diabetes and appropriate care to improve outcomes.
Level 2 | Hospitals & Hyperglycemia | 1.5 CEs
Research clearly demonstrates the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge. This course reviews the evidence that supports inpatient glucose control & outlines practical strategies to achieve targets in the inpatient setting. We incorporate the latest American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provide links to resources & inpatient management templates.
Objectives:
- Describe the impact of hyperglycemia in the hospital setting.
- Discuss the importance of inpatient glucose control.
- List three strategies to get glucose to goal in the hospital setting.
Intended Audience: A great course for healthcare professionals seeking strategies to manage and improve inpatient diabetes care.
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
You’re invited – FREE Prep for CDCES Webinar on May 23rd
Starting your journey to becoming a CDCES? Our FREE Webinar
Preparing for the CDCES Exam
Airs live on Tuesday, May 23rd at 11:30 am PST
This course will transform your test anxiety into calm self-confidence and test-taking readiness.
Preparing for the CDCES Exam Webinar Topics
- Exam requirement updates for 2023.
- Exam eligibility and test format
- Strategies to succeed along with a review of study tips and test-taking tactics.
- We will review sample test questions and the reasoning behind choosing the right answers.
- Learn how to focus your time and prepare to take the CDCES Exam. We provide plenty of sample test questions and test-taking tips!
Can’t join us live?
Don’t worry, we will send you a link to the recorded version.
“Becoming a Certified Diabetes Care and Education Specialist (CDCES) is one of the best professional and personal decisions I have ever made.” – Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
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.
Question of the Week | AR is pregnant and Worried
AR has PCOS type 2 diabetes and worried because they just discovered they are 6 weeks pregnant. AR takes metformin 1000mg BID plus empagliflozin (Jardiance) 25 mg and their most recent A1C is 8.6%.
Which of the following is a potential complication associated with hyperglycemia during the first 10 weeks of pregnancy?
- Intrauterine hypoglycemia
- Macrosomia and post-natal jaundice
- Neonatal respiratory distress
- Diabetic embryopathy
Click Here to Test your Knowledge
Want to learn more about this question? Enroll in our
Level 2 | Pregnancy & Diabetes | 1.5 CEs
Pregnancy with diabetes is confronted with a variety of issues that require special attention, education, & understanding. This course reviews those special needs while focusing on Gestational Diabetes & Pre-Existing Diabetes. Included are the most recent diagnostic criteria, management goals, & prevention of complications during pregnancy. This is a helpful review for Certification Exams & those who want more information on people who are pregnant & live with diabetes.
Objectives:
- List three issues that affect pregnancy with diabetes.
- Describe the unique attributes of pre-existing diabetes in pregnancy & gestational diabetes.
- State the diagnostic criteria & management goals for gestational diabetes.
- Potential short-term & long-term complications of fetal exposure to hypoglycemia.
- Prevention measures to keep mother & baby healthy.
Intended Audience: A great course for healthcare professionals seeking to enhance their knowledge of the issues surrounding pregnancy and diabetes and appropriate care to improve outcomes.
Level 2 | Hospitals & Hyperglycemia | 1.5 CEs
Research clearly demonstrates the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge. This course reviews the evidence that supports inpatient glucose control & outlines practical strategies to achieve targets in the inpatient setting. We incorporate the latest American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provide links to resources & inpatient management templates.
Objectives:
- Describe the impact of hyperglycemia in the hospital setting.
- Discuss the importance of inpatient glucose control.
- List three strategies to get glucose to goal in the hospital setting.
Intended Audience: A great course for healthcare professionals seeking strategies to manage and improve inpatient diabetes care.
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Older Adults & Tots to Teens Webinars | Airs Live May 16th & May 18th
Getting ready for certification exams and feeling overwhelmed by the Standards of Care?
Join us live this week to dissect the Older Adults & Children to Adolescents ADA Standards.
Tuesday, May 16th at 11:30 am PST
Level 2 | Older Adults & Diabetes | 1.5 CEs
We are living longer & more people are getting diabetes. The American Diabetes Association has updated the Older Adults Standards, with special attention to considering the reduction of medication & insulin therapy intensity. The older population has unique issues & special needs that require consideration as we provide diabetes self-management education. This online course highlights key areas of assessment, intervention, and advocacy for older clients living with diabetes.
Objectives:
- Self-management considerations for older individuals.
- Strategies to prevent complications & maintain optimal quality of life.
- The role of the Diabetes Care & Education Specialist as an advocate.
Intended Audience: An important course for healthcare professionals seeking to gain an understanding of the special issues and goals for older adults.
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Thursday, May 18, 2023, at 11:30 am PST
Level 2 | From Tots to Teens | Diabetes Standards | 1.5 CEs
This course includes updated goals & guidelines for children living with type 1 or type 2 diabetes. This course discusses the special issues diabetes educators need to be aware of when working with children with diabetes & their families. We discuss the clinical presentation of diabetes, goals of care, & normal growth & development through the early years through adolescence. Strategies to prevent acute & long-term complications are included with an emphasis on positive coping for families & children with diabetes.
Objectives:
- Discuss the goals of care for Type 1 and Type 2 Kids with Diabetes.
- State Strategies to prevent acute and chronic complications.
- Discuss the importance of positive psychosocial adjustment & resources.
Intended Audience: A great course for healthcare professionals seeking information about providing care for children with diabetes and their families.
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Happy International Nurses Day – 5 Ways to say Thank You
When I was considering college, my dad offered me some simple advice, “Why don’t you become a nurse?” Four years later, I stood proudly with my white cap and nursing pin securely fastened as an RN graduate.
As I reflect on my years in this noble profession, I have witnessed the most unselfish acts of love and pure heroism by my nursing colleagues. I have highlighted some top qualities that represent my gratitude, but this thank you list could encompass an entire page.
Like the founder of nursing, Florence Nightingale, you are all “Holding the Lamp” and shining it in dark places that are often scary and unknown to provide comfort to those with the greatest need.
This week is a perfect time to let our nursing colleagues, mentors, professors, and friends know how much they are appreciated.
Coach Beverly thanks each nurse who has cared for me, held my hand, and reassured me that I am going to be okay.
5 Ways to Thank a Nurse
- Send them a handwritten note sharing how they helped you when you needed it most.
- A bundle of colorful flowers with a special note
- A basket of fruit or healthy snacks with a few sweet treats too!
- Sharing a heartfelt story on social media about how a nurse made an impact on your life.
- Letting their supervisor know how they provided you with care and comfort.
- Let a nurse mentor or teacher know how they impacted your life.
These are just a few ideas to get started. As you think of that special moment of gratitude, maybe you will come up with the perfect idea for that one special nurse.
With gratitude,
Coach Beverly
Level 2 | Older Adults & Diabetes | 1.5 CEs
We are living longer & more people are getting diabetes. The American Diabetes Association has updated the Older Adults Standards, with special attention to considering the reduction of medication & insulin therapy intensity. The older population has unique issues & special needs that require consideration as we provide diabetes self-management education. This online course highlights key areas of assessment, intervention, and advocacy for older clients living with diabetes.
Objectives:
- Self-management considerations for older individuals.
- Strategies to prevent complications & maintain optimal quality of life.
- The role of the Diabetes Care & Education Specialist as an advocate.
Intended Audience: An important course for healthcare professionals seeking to gain an understanding of the special issues and goals for older adults.
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
