Join us for our final 2022 Standards of Care Intensive Update!

 Hospitals & Hyperglycemia | Level 2 | $29 for 1.5 CEs

Join us live Thursday, May 26 at 11:30 am PST

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 and outlines practical strategies to achieve targets in the inpatient setting.  We incorporate the latest ADA Standards and provide links to resources and inpatient management templates.

Objectives:

1. The impact of hyperglycemia in the hospital setting
2. The importance of inpatient glucose control
3. Three strategies to get glucose to goal in the hospital setting

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Studying for the CDCES Exam?

Enroll in CDCES Online Prep Bundle + 5th Ed ADCES Review Guide Book | 47 CEs

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What is a Certified Diabetes Care and Education Specialist?

Read More: What is a CDCES?

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Why become a CDCES?
Three Reasons from Coach Beverly

Read More: 3 Reasons to Become a CDCES

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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.

The injectable GLP-1 semaglutide (Ozempic) can now be dosed up to 2.0mg a week. This higher maximum dose provides greater reductions in body weight (6.9kgs vs 6.0kgs) and A1c (2.2 vs 1.9% ) when compared to 1.0 semaglutide dose. There was a comparable safety profile with both doses. However, more people experienced negative gastrointestinal side effects when receiving the higher dose (34% compared to 30.8%).

This is good news for people with type 2 diabetes who would like to benefit from both A1C and weight reduction. Plus, semaglutide lowers the risk of cardiovascular events.

Without insurance coverage, this medication costs about $1000 for a month’s supply. However, since semaglutide (Ozempic) is an established diabetes medication covered by many insurance plans, we are hopeful that people who would benefit from this therapy will have access to this higher dose.

The SUSTAIN FORTE trial lasted for 40-weeks and enrolled 961 patients with type 2 diabetes with an A1C of 8.0-10.0%. All patients in the trial initiated treatment with a 0.25 mg dose of semaglutide that was doubled every 4 weeks until the target dose was achieved.

In addition to reduction in A1C and body weight, the semaglutide 2.0 mg arm of the trial saw a greater proportion of patients achieve an A1C less than 7% (67.6% vs 57.5% [OR, 1.60; 95% CI, 1.21-2.13; P=.001]) or a body weight reduction greater than 5% (59.2% vs 51.3% [OR, 1.41; 95% CI, 1.08-1.84]) than the semaglutide 1.0 mg arm.

We have updated our Diabetes Medication PocketCard with this higher maximum dose or our website, CDCES Coach App, and printed PocketCards.

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Studying for the CDCES Exam?

Enroll in CDCES Online Prep Bundle + 5th Ed ADCES Review Guide Book | 47 CEs

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What is a Certified Diabetes Care and Education Specialist?

Read More: What is a CDCES?

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Why become a CDCES?
Three Reasons from Coach Beverly

Read More: 3 Reasons to Become a CDCES

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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 test takers on if insulin is safe for older adults. 78% of respondents chose the best answer. We want to 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: For older adults with diabetes using insulin therapy, which of the following is the most accurate statement?

Answer Choices:

1. Due to cognitive decline, continuous glucose monitoring is not recommended for older adults.
2. Older adults are at greater risk of hypoglycemia than younger adults.
3. Divide basal insulin into two separate doses to enhance absorption.
4. Give insulin after meals to prevent hypoglycemia.

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As shown above, the most common choice was option 2, the second most common answer was option 4, then option 3, and finally 1.

Getting to the Best Answer

Answer 1 is incorrect. 4.40% chose this answer, “Due to cognitive decline, continuous glucose monitoring is not recommended for older adults.” Many older adults on intensive insulin therapy with a history of hypoglycemia can benefit from CGM technology to prevent low blood sugars and fine tune carb intake and insulin dosing. Each older adult needs a individualized assessment to determine if a CGM is right for them. The rate of cognitive decline is complex and is a result of genetics, other chronic conditions and overall health combined with aging.

Answer 2 is correct. 78.20% of you chose this answer, “Older adults are at greater risk of hypoglycemia than younger adults. GREAT JOB, almost 80% of you chose this best answer. As people with diabetes age, they are at higher risk for low blood sugars for many reasons, especially if they are taking insulin or a secretagogue. Older individuals may have diminished renal function, which increases the duration of the action of insulin and secretagogues. Some can experience lower calorie intake due to decreasing appetite, trouble chewing, lack of resources, forgetfulness or depression and feelings of isolation. Others may have difficulty administering their insulin or medications accurately or may forget to eat after injections. For this reason, the ADA Standards recommends that older adults are assessed for hypoglycemia risk at each visit coupled with problem solving as needed.

Answer 3 is incorrect. 7.55% of respondents chose this answer, “Divide basal insulin into two separate doses to enhance absorption.” This is a juicy answer. For older adults at risk for hypoglycemia, the ADA does recommend scheduling the basal insulin for the morning instead of evening.

Finally, Answer 4 is incorrect. 9.85% chose this answer, “Give insulin after meals to prevent hypoglycemia.” Another juicy answer. This answer implies that all older people should take their insulin after meals. Some individuals might benefit from post-meal insulin, especially if they are not sure how much they are going to eat and they have a history of hypoglycemia. However, insulin works best when given before the meal so it peaks at the same time the post meal glucose is peaking.

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Studying for the CDCES Exam?

Enroll in CDCES Online Prep Bundle + 5th Ed ADCES Review Guide Book | 47 CEs

---

What is a Certified Diabetes Care and Education Specialist?

Read More: What is a CDCES?

---

Why become a CDCES?
Three Reasons from Coach Beverly

Read More: 3 Reasons to Become a CDCES

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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.

1. Add bolus insulin to get A1C less than 6.5%.
2. Increase the semaglutide (Ozempic) to 2.0mg weekly.
3. Add a SGLT-2 Inhibitor to get glucose to target.
4. Instruct AR to stop the semaglutide (Ozempic).

Click Here to Test your Knowledge

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Want to learn more about this question? Join us for our webinar

Pregnancy & Diabetes Standards | Level 2 | $29 for 1.5 CEs

Recorded & Ready to Watch!

Pregnancy with diabetes is confronted with a variety of issues that require special attention, education, and understanding. This course reviews those special needs while focusing on Gestational Diabetes and Pre-Existing Diabetes. Included are the most recent diagnostic criteria, management goals, and prevention of complications during pregnancy. A helpful review for the CDCES Exam and for those who want more information on people who are pregnant and live with Diabetes.

Objectives:

1. Three issues that affect pregnancy with diabetes
2. The unique attributes of pre-existing diabetes in pregnancy and gestational diabetes
3. Diagnostic criteria and management goals for gestational diabetes
4. Potential short term and long term complications of fetal exposure to hypoglycemia
5. Prevention measures to keep parent and baby healthy

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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.

Join us for our Standards of Care Intensive Updates!

From Tots to Teens | Level 2 | $29 for 1.5 CEs

Join us live Tuesday, May 17 at 11:30 am PST

This course includes updated goals and 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 and their families. We discuss the clinical presentation of diabetes, goals of care, and normal growth and development through the early years through adolescence. Strategies to prevent acute and long term complications are included with an emphasis on positive coping for family and child with diabetes.

Objectives:

1. Discuss the goals of care for Type 1 and Type 2 Kids with Diabetes
2. State Strategies to prevent acute and chronic complications
3. Discuss the importance of positive psychosocial adjustment and resources

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Pregnancy & Diabetes Standards | Level 2 | $29 for 1.5 CEs

Join us live Thursday, May 19 at 11:30 am PST

Pregnancy with diabetes is confronted with a variety of issues that require special attention, education, and understanding. This course reviews those special needs while focusing on Gestational Diabetes and Pre-Existing Diabetes. Included are the most recent diagnostic criteria, management goals, and prevention of complications during pregnancy. A helpful review for the CDCES Exam and for those who want more information on people who are pregnant and live with Diabetes.

Objectives:

1. Three issues that affect pregnancy with diabetes
2. The unique attributes of pre-existing diabetes in pregnancy and gestational diabetes
3. Diagnostic criteria and management goals for gestational diabetes
4. Potential short term and long term complications of fetal exposure to hypoglycemia
5. Prevention measures to keep parent and baby healthy

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DiabetesEd Free Resources

Please enjoy these FREE resources that we have put together for you:

• Diabetes Cheat Sheets
• Diabetes Blog Bytes
• Medication PocketCards
• 10 Steps to Succeed
• CDCES Coach App
• Free Webinars hosted by Coach Beverly
• Question of the Week
• Free Diabetes Article Library

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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.

There are so many amazing and dedicated people and organizations working to revitalize our planet. To make it easy to explore these opportunities, Bryanna and I put together this list with the hope that you find inspiration for action. Thank you.

Sustainable Eating

• Sustainable Eating article by the Academy of Nutrition and Dietetics
• Food Dates Lead to Waste- Taste Before Tossing
• 5 tips for Sustainable Eating article by Harvard School of Public Health
• Sustainable Eating Resource Hub by Food Print
• Meatless Monday’s Campaign
• Produce from Purchase to Plate – Steps to Reduce Food Waste article by the Academy of Nutrition and Dietetics
• Local Farmer’s Market Finder by Local Harvest

Gardening & Water Saving

• 20 Common Types of Native Plants to the US article by Audubon
• Native Plant Finder by National Wildlife Federation
• Native Plant Nursery Finder
• Water-Saving Tips by the US Environmental Protection Agency

Reduce Plastic Usage & Composting

• A Complete Guide To Alternatives For Plastic by EcoMastery Project
• Mushroom Packaging
• 19 Companies Who Are Ditching Plastic Packaging article by Food Tank
• Compostable Products Checker by Biodegradable Products Institute
• Find a Composter Near You
• Composting Tipsheet by USDA

Reduce Carbon Footprint

• Home Energy Saver Calculator by the US Department of Energy
• Ecological Footprint Calculator by the Global Footprint Network
• Individual Greenhouse Gas Emissions Calculator by the US Environmental Protection Agency
• Energy-Efficient Household Products Finder by Energy Star
• Cars Evaluated Against Climate Targets Graph by Carbon Counter
• Offset Flight Admissions Calculator by MyClimate

Sustainable Living

• Supporting a Healthy Planet podcast by the CDC
• Project Regeneration

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DiabetesEd Free Resources

Please enjoy these FREE resources that we have put together for you:

• Diabetes Cheat Sheets
• Diabetes Blog Bytes
• Medication PocketCards
• 10 Steps to Succeed
• CDCES Coach App
• Free Webinars hosted by Coach Beverly
• Question of the Week
• Free Diabetes Article Library

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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.

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.

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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.

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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

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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 test takers on how diabetes and earth health are interconnected. 78% of respondents chose the best answer, GREAT JOB. We want to share this important information, so you can pass it on to people living with diabetes and your colleagues. We can all take action to protect the earth and prepare for extreme climate events.

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: According to a NIH systematic literature review, there is clear evidence that diabetes and climate change are interconnected. Which of the following situations are due to the impact of a changing climate?

Answer Choices:

1. Lack of healthy food supply due to disrupted agricultural production.
2. Shortages of medications, insulin and other diabetes supplies.
3. Increased risk of cardiovascular events and death in people with diabetes due to extreme heat.
4. All of the above

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As shown above, the most common choice was option 4, the second most common answer was option 1, then option 3, and finally 2.

Getting to the Best Answer

Answer one – 15.05% chose this answer, and it is accurate “Lack of healthy food supply due to disrupted agricultural production.” It is true that extreme weather can result in agricultural production disruptions. In our community, many fields that were once green with trees and crops, now are brown and barren. There is not enough water to keep crops alive and growing. When the healthy food supply is limited, people living with diabetes may turn to lower-cost, processed foods which are environmentally unfriendly and low in nutrients.

Answer two – 1.46% of you chose this answer and it is accurate, “Shortages of medications, insulin, and other diabetes supplies.” It is true that with recent climate disasters, like the Camp Fire, Hurricane Katrina in 2005, and Hurricane Harvey in 2017, resulted in people not being able to access, afford or safely store their medications, including insulin. In addition, we are experiencing supply chain disruptions in D50 (25 grams of glucose in a 50 ml prefilled syringe (50% glucose)) to treat hypoglycemia and certain intravenous fluids are in short supply. Other diabetes products and medications could be impacted in the future.

Answer three – 6.07% of respondents chose this answer and it is accurate, “Increased risk of cardiovascular events and death in people with diabetes due to extreme heat.” It is true that people with diabetes are at greater risk of experiencing dehydration and cardiovascular events during periods of extreme heat. With the increasing frequency of extreme heat episodes, there is an associated increased risk of heat-related death and cardiovascular events for people living with diabetes. Several studies reveal that people with diabetes have a higher risk of death on hot days, and are more likely to need emergency care and those with a history of heart disease are most vulnerable.

Finally, Answer four – 77.43% chose this answer, “All of the above.” YES. Great job, all of the answers are true, there is clear evidence that diabetes and climate changes are interconnected. As Diabetes Specialists, I believe we can make a difference by leaning into our unique blend of behavior change skills, advocacy, and scientific knowledge.
We can take a two-fold approach:

1. Take action to help slow and reverse climate change – Read our blog on actions we can start taking today.
2. Help people with diabetes to be prepared for natural disasters. Read our blog on How to Get Ready

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Studying for the CDCES Exam?

Enroll in CDCES Online Prep Bundle + 5th Ed ADCES Review Guide Book | 47 CEs

---

What is a Certified Diabetes Care and Education Specialist?

Read More: What is a CDCES?

---

Why become a CDCES?
Three Reasons from Coach Beverly

Read More: 3 Reasons to Become a CDCES

---

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.