For some people with diabetes, the thought of “exercise” can seem downright terrifying. We can help lift that fear by encouraging them to start with baby steps and substitute the term “activity” for “exercise”. Reassuring people that “any movement is better than no movement” allows them to shift their perspective and give themselves credit for something as simple as walking to the mailbox. 

With spring in the air, it’s a perfect time to take a fresh approach to encourage activity.

The majority of people with diabetes are aware that regular activity is integral to diabetes self-care. With thoughtful coaching, we can support them to meet the target of 150 minutes of walking (or other activity) a week coupled with strength training.

Coach Beverly has outlined five strategies that she has found helpful in encouraging people to move more.

Everything off the Couch Counts

The goal is to accumulate about thirty minutes of activity a day, so taking a 10-minute walk after breakfast means they are one-third of the way there. Other activities that count include; gardening, housework, yard work, shopping, chasing kids, and those dance moves people do when no one is looking,

Keep it Practical and Fun

Starting and keeping new habits is challenging. By integrating activity into everyday life, people are likelier to keep it up. If the movement brings them joy, that is an added benefit. An excellent starting strategy is asking them what activities they like. Then explore if they can add it to their typical day. For example, taking a walk during a lunch break or hitting the gym before heading home. What about lifting weights with the kids or helping with after-dinner cleanup instead of relaxing in that favorite comfy chair? Joining an organized sport or dance class is also an option.

Activity Quips that Help Reignite the Passion

These simple sentences capture people’s attention and help them take that first step toward more movement. Please feel free to borrow and use these sayings in your practice!

• Even a ten-minute bout of activity can lower blood sugars for up to 24 hours.
•  Each minute of activity lowers blood sugar by about one point.
•  Walking for even 10 minutes after meals can help lower post-meal blood sugar levels.
•  Even without weight loss, getting active can reduce A1C levels by 0.6%.
•  Regular activity improves people’s mood, sex life, and balance. 
•  Keeping active helps people maintain their independence.

Prepare and PLAN for setbacks

Even the best-made plans may go differently than envisioned. Being ready for setbacks early on helps people set realistic expectations. As diabetes specialists, we can prepare people for obstacles and setbacks and remind them that a falter does not equal failure. According to Sylvia Gonsahn-Bollie, MD, assisting individuals to prepare for barriers with a PLAN helps for a quicker recovery. 

PLAN stands for:

•  Ponder what happened; 
•  Learn from it; 
•  Adjust the original goal; 
•  Now get back on track.  

Encourage people to avoid black-and-white thinking, like, “Well, I missed my planned workout, so I might as well just give up.” Getting back on track as soon as possible keeps the momentum and prevents muscle deconditioning.

Exercise is medicine. 

Regular physical activity can help prevent disease and improve well-being. Although exercise statistics are disheartening, improvement is possible. As health advocates, we can encourage systemic changes in health care and environmental changes in our neighborhoods to increase activity on a population level.

While waiting for more extensive changes, we have the power to equip individuals with personalized, actionable tools for improving and maintaining physical activity.

Our belief in people’s ability to get active is contagious. A person-centered collaborative approach can help people get moving, one step at a time.

 

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Join our NEW

ReVive 5 Diabetes Training Program

Whether you are a novice or an expert in providing diabetes care, we invite you to attend this exciting training program that provides the essential steps to address diabetes distress combined with an innovative approach to glucose management that will revolutionize your practice.

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

Join A Team of Experts – Save $100

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

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

Accredited Training Program:

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

Speakers Interviews – Learn more about the ReVive 5 Team

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

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

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

 

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

All hours earned count toward your CDCES Accreditation Information

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

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

 

 

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

Click Here to Test your Knowledge

 

For last week’s practice question, we quizzed participants on being at risk for NASH. 63% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!

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

Question: JR is 46 years old with type 2 diabetes and a BMI of 33. In addition, JR has hypertension and hyperlipidemia, with elevated liver enzymes (ALT and AST).

According to the latest ADA Standards, which of the following would best help determine if JR is at risk for liver fibrosis and cirrhosis?

Answer Choices:

1. UACR
2. FIB-4
3. GAD or ICA
4. Weight in (kg) divided by the square of height in meters (m2)

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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. 14.51% chose this answer. “UACR.” This is a juicy answer, however the Urinary Albumin Creatinine Ratio (UACR) evaluates kidney function and doesn’t provide any hepatic insights. Instead we would recommend the Fibrosis-4 Index for Liver Fibrosis helps determine risk of hepatic cirrhosis and inflammation (see answer 2).

Answer 2 is correct. 62.53% of you chose this answer. “FIB-4.” GREAT JOB. The Fibrosis-4 Index for Liver Fibrosis helps determine risk of hepatic cirrhosis and inflammation. By entering the person’s age, AST, ALT and Platelet count using the FIB-4 calculator, a risk level is calculated (see slide below). The hope is that by screening for hepatic issues early, we can take action to protect the liver and improve outcomes.

Answer 3 is incorrect. About 11.69% of respondents chose this. “GAD or ICA.” Although this answer is familiar, it does not match the intent of the question. GAD and ICA are blood tests to determine if someone has autoimmune mediated type 1 diabetes. Instead we would recommend the Fibrosis-4 Index for Liver Fibrosis helps determine risk of hepatic cirrhosis and inflammation (see answer 2).

Finally, Answer 4 is incorrect. 11.27% chose this answer. “Weight in (kg) divided by the square of height in meters (m2).” This answer is also familiar since it is the formula to determine a person’s body mass index (BMI). Instead we would recommend the Fibrosis-4 Index for Liver Fibrosis helps determine risk of hepatic cirrhosis and inflammation (see answer 2).

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! Learn more by attending our Virtual Conference plus save $100 through April 18, 2023.

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Register now for our Virtual DiabetesEd Training Conference

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

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

Group discounts are available!*

All hours earned count toward your CDCES Accreditation Information

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

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

1. 2 vials
2. 4 pens
3. 6 pens
4. 3 pens

Click Here to Test your Knowledge

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Register now for our Virtual DiabetesEd Training Conference

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

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

Group discounts are available!*

All hours earned count toward your CDCES Accreditation Information

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

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

You’re invited! Join us on April 11th & April 13th for our upcoming Standards of Care Intensive Updates!

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Our Microvascular Complications, Prevention & Treatment | Eye, Kidney, Nerve Disease | Level 2 Webinar airs live on April 11th at 11:30 am PST

This course provides the need-to-know information regarding the microvascular complications of diabetes. It includes a brief overview of the pathophysiology & clinical manifestations along with prevention strategies & screening guidelines. This straightforward program will provide participants with the information they can use in a clinical setting & also provides critical content for certification exams.

Objectives:

1. List the main factors contributing to eye, kidney, & nerve disease.
2. Describe modifiable & non-modifiable risk factors for diabetes complications.
3. State screening guidelines & prevention strategies.

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Our Cardiovascular Disease & Diabetes | Level 2 Webinar airs live on April 13th at 11:30 am PST

This course takes a close look at insulin resistance syndrome & vascular complications. We discuss the impact of vessel disease from the heart to the toes. Included is a discussion of identifying & preventing vascular disease & a comprehensive review of the latest American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes for heart disease.

Objectives:

1. The impact of insulin resistance & hyperglycemia on vessel disease.
2. State the complications & factors associated with vascular disease.
3. List management goals to reduce the risk of vascular disease.
4. Discuss strategies to promote health.

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Virtual DiabetesEd Training Conference

Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.

If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.

Group discounts are available!*

Download Course Flyer | Download Schedule

All hours earned count toward your CDCES Accreditation Information

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

---

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

For last week’s practice question, we quizzed participants on having their cake and eating it too. A whopping 94% of respondents chose the best answer. We want to celebrate your success and give you all a shout out for a job well done.

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: AJ is a 9-year-old with type 1 diabetes, A1c of 7.2%, and uses an insulin pump and CGM. They ask you how to include a piece of birthday cake for an upcoming birthday celebration.

What is the best advice?

Answer Choices:

1. Accept the cake but don’t actually eat it.
2. Increase their daytime basal insulin to prevent hyperglycemia.
3. Take additional bolus insulin to cover the extra carbs.
4. Encourage AJ to have a piece of fruit instead.

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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 Person-Centered answer.

Answer 1 is incorrect. 1.53% chose this answer. “Accept the cake but don’t actually eat it.” Since this doesn’t honor AJ’s choice to accept and enjoy the cake, it is not the best answer. People with diabetes can absolutely enjoy special treats by adjusting their bolus insulin dose to account for the extra carbs to prevent post cake hyperglycemia.

Answer 2 is incorrect. 2.3% of you chose this answer. “Increase their daytime basal insulin to prevent hyperglycemia.” People with diabetes can absolutely enjoy special treats by adjusting their bolus insulin dose to account for the extra carbs to prevent post cake hyperglycemia.

Answer 3 is correct. About 94.12% of respondents chose this. “Take additional bolus insulin to cover the extra carbs.” YAY! This person centered approach is the BEST guilt free answer since it recognizes and respects AJ’s choice to enjoy a piece of birthday cake while still managing blood sugars with extra bolus insulin.

Finally, Answer 4 is incorrect. 2.05% chose this answer. “Encourage AJ to have a piece of fruit instead.” Since this doesn’t honor AJ’s choice to accept and enjoy the cake, it is not the best answer. People with diabetes can absolutely enjoy special treats by adjusting their bolus insulin dose to account for the extra carbs to prevent post cake hyperglycemia.

We hope you appreciate this week’s person-centered rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

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Want to learn more about Medical Nutrition Therapy?

You are invited to join our Virtual Conference  with our Nutrition expert speaker, Ashley LaBrier, MS, RD, CDCES, who will be providing a half-day presentation on this important topic!

Ashley LaBrier, MS, RD, CDES, is an innovator in the field of diabetes, nutrition, and technology. Ashley is a consultant and the Diabetes Education Program Coordinator at the Salinas Valley Medical Clinic’s Diabetes & Endocrine Center. 

Ms. LaBrier is passionate about providing person-centered education to empower those who live with diabetes. Having been diagnosed with type 1 diabetes herself nearly 20 years ago, she combines her professional knowledge with personal experience and understanding. 

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Virtual DiabetesEd Training Conference

Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.

If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.

Group discounts are available!*

Download Course Flyer | Download Schedule

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.