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Grief and the Role of the Diabetes Educator
MK has been living with type 1 diabetes for over 52 years, most recently using an AID system. He views himself as in generally good health “for someone his age” but arrives at this annual visit reporting he recently lost his spouse of more than 46 years. For decades, they shared meals, routines, reminders, and a partnership that often supports confident diabetes self-
management. Since her death, MK’s diabetes care has understandably shifted. His eating patterns are now more irregular, medications and boluses occasionally missed, and during the visit conversation, he states, “I should’ve just canceled, I am not doing well in my diabetes.”
Beneath that statement is grief, disorientation from typical patterns and routines, the profound loss of a partner who helped make daily life with diabetes manageable, and possibly more.
How Can I Help As a Diabetes Educator?
It is tempting to jump in and explore with MK how we can help him meet targets and increase his engagement, the way he once did, but grief is a life transition that can change priorities and capacity for self-care. For MJ it altered feelings of support, his social network,
motivation, appetite, sleep, and self-efficacy. The American Diabetes Association (ADA) Standards of Care emphasize that diabetes management must be individualized and responsive to individual needs, including psychosocial. Listening and assessing changes in loneliness, social isolation, new goals and expectations, and quality of life may be “what matters most” for this visit. ¹ They also stress that treatment goals and strategies should be modified during significant life transitions, recognizing that the capacity for self-management can change over time.
Person-centered care is our clinical standard of care. Rather than centering the visit on solving assessed problems, it can focus on MK. Sitting with his grief, acknowledging the enormity of loss, and affirming that this is a transition. We can explore what success now means for MK, ensure his safety, and find new points of connection rather than isolation. This visit can support adapting diabetes management to life as it is now, not as it was.
Mental Health and Grief
In chronic grief, consideration of concurrent diagnoses such as adjustment disorders, depression, anxiety, lack of social support, and coping mechanisms is important. ² In older adults with depression, an increased risk of suicide had common factors, including recent death of a loved one, social isolation, or the perception of poor health. ³ Using validated screening tools may help identify individuals whose grief is significantly affecting daily functioning and requires additional assessments. A few examples are the Patient Health Questionnaire-2 or 9 (PHQ-2 or PHQ-9) for depression, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety, and
for emotional burden related to living with and managing diabetes, the Problem Areas in Diabetes Scale (PAID), and/or the Diabetes Distress Scale (DDS). 4 A recent article in Diabetes Spectrum 3 reported that the Center for Epidemiological Studies Depression Scale (CES-D), per systematic reviews, was found to be the best-supported tool for measuring depressive symptoms in people with diabetes. Positive screening results do not confirm a diagnosis; communication with the medical team to ensure adequate and ongoing interventions is needed. Referrals to behavioral health specialists, grief counseling, or peer and community support groups may also be recommended. As a resource, the American Diabetes Association has a directory of Mental Health Providers who specialize in supporting individuals with diabetes: https://diabetes.org/tools-resources/mental-health-directory.
Some Things to Keep In Mind
Diabetes Care and Education Specialists often take care of individuals over time; we don’t just provide medical assessments, but provide care through significant life events such as marriages, retirements, community disasters, illnesses, changes in caregiving roles, and loss. When working with individuals like MK, presence, active listening, supportive engagement, and collaborative care planning may be the most appropriate interventions. By meeting individuals where they are, rather than where they “should” be, the CDCES supports trust, connection, and access to the care they need. In doing so, we uphold the heart of diabetes care: partnering with people through all seasons of their lives.
References:
- American Diabetes Association Professional Practice Committee for Diabetes*; 13. Older Adults: Standards of Care in Diabetes—2026. Diabetes Care 1 January 2026; 49 (Supplement_1): S277–S296. https://doi.org/10.2337/dc26-S013
- American Diabetes Association Professional Practice Committee for Diabetes*; 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes—2026. Diabetes Care 1 January 2026; 49 (Supplement_1):
S61–S88. https://doi.org/10.2337/dc26-S004 - Elizabeth A. Beverly, Jeffrey S. Gonzalez; The Interconnected Complexity of Diabetes and Depression. Diabetes Spectr 14 February 2025; 38 (1):23-31. https://doi.org/10.2337/dsi24-0014
- Visit the ADA behavior health toolkit for more information and resources on validated screening tools: https://professional.diabetes.org/professional-development/behavioral-
mental-health/behavioral-health-toolkit.
Learn More With Our Upcoming Webinars
Level 2 | ADA Standards of Care Complete Review
Join us live on January 29th, 2026 at 11:30 AM PST!
Level 2 | Improving Care and Promoting Health
Join us live on February 10th, 2026 at 11:30 AM PST!
Rationale of the Week | MS keeps getting UTI’s – Best action?
For last week’s practice question, we quizzed participants on MS continuously getting UTIs, and what would be the best response. % 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
MS is a 59-year-old with type 2 diabetes who is struggling with frequent urinary tract infections. They are on metformin and empagliflozin, and their A1C is 7.3%. MS has already received several courses of antibiotics.
Which of the following actions would you recommend?
- Drink sugar-free cranberry juice a few times a week.
- Apply topical vaginal estrogen cream.
- Get A1C below 7% by adding basal insulin.
- Evaluate MS for autoimmune conditions.
Getting to the Best Answer
Answer A is incorrect: % chose this answer, “Drink sugar-free cranberry juice a few times a week.” Scientific studies have yielded mixed and inconsistent results regarding the effectiveness of cranberry juice for prevention. MS needs an intervention that will provide ongoing relief.
Answer B is correct: % chose this answer, “Apply topical vaginal estrogen cream.” Vaginal estrogen cream can help prevent recurrent urinary tract infections (UTIs) in postmenopausal women by restoring the health of vaginal and urinary tissues. Estrogen helps restore a healthy vaginal pH, increases beneficial bacteria, and improves circulation, creating an environment that is less hospitable to uropathogens. It is a non-antibiotic option recommended by medical societies and is associated with a significant reduction in rUTIs.
Answer C is incorrect: % chose this answer, “Get A1C below 7% by adding basal insulin.” Getting A1C to target can reduce risk of infections, but MS A1C is already close to target. They need an effective treatment for their frequent UTI’s.
Answer D is incorrect: % chose this answer, “Evaluate MS for autoimmune conditions.” Frequent UTIs are not usually associated with autoimmune conditions. MS needs an effective treatment for their frequent UTI’s.
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 about HRT and UTIs in our blog “Hormone Replacement Therapy (HRT) – What You Need to Know”
Learn More From Our Expert
Dr. Jill Schramm, DNP, FNP-C, BC-ADM, CDCES
Level 5 | Hot Flashes & Hyperglycemia
Recorded and Ready For Viewing!
Question of the Week | MS keeps getting UTI’s – Best action?
MS is a 59-year-old with type 2 diabetes who is struggling with frequent urinary tract infections. They are on metformin and empagliflozin, and their A1C is 7.3%. MS has already received several courses of antibiotics.
Which of the following actions would you recommend?
- Drink sugar-free cranberry juice a few times a week.
- Apply topical vaginal estrogen cream.
- Get A1C below 7% by adding basal insulin.
- Evaluate MS for autoimmune conditions.
Read our blog about Hormone Replacement Therapy (HRT) – What You Need to Know to learn more!
Learn More From Our Expert
Dr. Jill Schramm, DNP, FNP-C, BC-ADM, CDCES
Level 5 | Hot Flashes & Hyperglycemia
Recorded and Ready For Viewing!
Diabetes Tech and Distress
The world of diabetes technology is advancing at a record pace. There is no doubt that technology intends to make life with diabetes a bit easier. In the United States, over 50% of adults living with diabetes have experienced some level of diabetes distress.¹ The impact of diabetes technology on mental well-being is complicated. Diabetes technology, including insulin pumps, continuous glucose monitors (CGMs), and connected insulin pens, can either lessen or aggravate diabetes distress.
Understanding Diabetes Distress
The American Diabetes Association (ADA) defines diabetes distress as “significant negative psychological reactions related to emotional burdens and worries specific to an individual’s experience in having to manage a demanding chronic condition such as diabetes.”.² Diabetes distress is a natural reaction to the daily burden of managing diabetes. Signs of diabetes distress can include avoiding blood glucose monitoring, omitting medications, and struggling to achieve personal hemoglobin A1c targets.
The ADA recommends screening for diabetes distress at least annually. More frequent screening is recommended if clients are not meeting treatment goals, develop diabetes-related complications, and during times of life transitions.²
To access these validated diabetes distress screening tools in English and Spanish, I encourage you to visit this helpful website, DiabetesDistress.org
- Diabetes Distress Scale (DDS-17)
- Type 1 Diabetes Distress Scale (T1-DDS)
- The Type 2-Diabetes Distress Assessment System (T2-DDAS)
Can Technology Improved Diabetes Distress?
Let’s explore how diabetes technology can have a positive impact on diabetes distress.
✅ CGMs: With current CGMs, fewer fingerstick readings are needed to make treatment decisions. CGMs provide information on blood glucose trends and impending hyperglycemia or hypoglycemia, creating more peace of mind.
✅ Record Keeping: Various forms of diabetes technology can log blood glucose values, insulin doses, site changes, and total daily doses of insulin. This eliminates the need for clients to worry about detailed record-keeping.
✅ Automated Insulin Delivery: Automated insulin pumps can decrease decision fatigue by making automated adjustments to both basal and correction insulin doses. This approach to insulin delivery can also benefit individuals with an active lifestyle. Utilizing wearable insulin delivery devices and algorithms can reduce the mental burden of diabetes self-management.
✅ Connectivity: Remote data sharing supports communication with parents, caregivers, and friends to create a diabetes support team. Connectivity with healthcare providers enhances communication with the care team, allowing adjustments to treatment plans between clinic visits.
✅ Empowerment: The data trends can empower individuals living with diabetes to take control and gain confidence in making and evaluating medication and lifestyle adjustments in response to changes in glycemic control.
Can Technology Worsen Diabetes Distress?
As diabetes healthcare professionals, it is important to understand how diabetes technology can negatively impact diabetes distress.
❌ Information Overload: Diabetes technology generates an enormous amount of data. This can cause distress by constantly feeling the need to monitor glucose trends and numbers throughout the day and night, leading to feelings of anxiety and overwhelm.
❌ Alarms: Alarms on diabetes technology are rooted in safety, but for those living with these devices, this can lead to diabetes distress. Alarms can disrupt sleep or bring unwanted attention from others in public. Erroneous alarms for hyperglycemia or hypoglycemia can cause stress, frustration, and alarm fatigue.
❌ Perfectionism: Diabetes technology provides a continuous insight into glycemic control, which for some can create a need for perfection. Some clients feel like they fail when they don’t reach their time-in-range goal each day.
❌ Physical Impact: Wearable devices not only carry a psychological burden but can also cause physical distress. Skin irritation and allergic reactions to adhesives cause physical pain and embarrassment. Those who wish to keep diabetes private, wearing a CGM, insulin pump, or other wearable device that puts diabetes on display, causing distress.
❌ Technical issues: Losing connectivity with CGMs or an AID system can cause frustration and make it challenging to achieve optimal glycemic control. Insurance coverage, prior authorizations, out-of-pocket costs, and access to supplies for diabetes technology can all contribute to or worsen diabetes distress.
Diabetes Healthcare Professionals Help – Recognize and Address
The 7A’s Framework provides a useful interview tool when assessing for Diabetes Distress:
- Aware: Be aware of diabetes distress.
- Ask: Ask about diabetes distress.
- Assess: Use a validated screening tool for assessment.
- Advise: Explain diabetes distress.
- Assist: Develop an action plan.
- Assign: If you are not equipped to help, assign the client to another healthcare professional.
- Arrange: Set up follow-up as needed. 3
Here are some other actionable tips you can use to help those with diabetes distress:
- Refer clients to local or virtual diabetes support groups.
- Discuss with clients that diabetes distress is common and not a character flaw or failure
- Collaborate to choose the best technology based on their technology readiness, skill level, and comfort level.
- Set realistic goals for time-in-range and other data metrics.
- Educate clients on how to troubleshoot their devices regarding alarms or connectivity issues.
- Support a healthy relationship with diabetes tech.
References
-
-
Alexander, D.S., Saelee, R., Betsy Rodriguez, B., Koyama, A. K., Cheng, Y. J., Tang, S., Rutkowski, R. E., & Bullard, K. M. (2025). Diabetes distress among US adults with diagnosed diabetes, 2021. Preventing Chronic Disease: Public Health Research, Practice, and Policy, 22(E07), 1-7. https://www.cdc.gov/pcd/issues/2025/24_0287.htm#:~:text=Among%20US%20adults%20with%20diabetes%2C%20an%20estimated%201.6%20million%20(6.6,income%20compared%20with%20their%20counterparts.
- American Diabetes Association Professional Practice Committee. (2025). Facilitating positive health behaviors and well-being to improve health outcomes: Standards of care in diabetes—2025. Diabetes Care, 48(Supplement_1): S86–S127. https://diabetesjournals.org/care/article/48/Supplement_1/S86/157563/5-Facilitating-Positive-Health-Behaviors-and-Well?searchresult=1
- American Diabetes Association. (n.d.). Professional development: Behavioral health toolkit. https://professional.diabetes.org/professional-development/behavioral-mental-health/behavioral-health-toolkit
- Healing through Connection for Healthcare Professionals by Beverly Thomassian
-
Question of the Week | CS’s A1C Climbs After Experiencing Distress
CS is a 42-year-old with type 1 diabetes for just over 18 years. In the past year, their A1C changed from 7.4% to 9.1%, and weight increased by 20 pounds. Review of CGM data suggests missed insulin boluses more than 7 times per week, and discussion with CS reveals missed clinic visits due to feeling “burned out”. They score in the moderate range on the Diabetes Distress Scale.
Based on the ADA 2026 Standards of Care, which of the following is the most appropriate next step?
- Partner with CS to reduce missed boluses and reassess in 3 months.
- Simplify regimen to support current state of diabetes distress.
- Refer to a qualified behavioral health professional for evaluation and treatment.
- Recommend referral to MNT for a structured weight-loss program.
Level 2 | ADA Standards of Care Complete Review
Join us live on January 29th, 2026 at 11:30 AM PST!
Level 2 | Improving Care and Promoting Health
Join us live on February 10th, 2026 at 11:30 AM PST!
Rationale of the Week | How does Mifepristone Work?
For last week’s practice question, we quizzed participants on How does Mifepristone work to treat hypercortisolism? 48.73% 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 by clicking here.
A 54-year-old with type 2 diabetes and hypertension is diagnosed with hypercortisolism. Despite lifestyle interventions and maximum doses of metformin, GLP-1 RA, and an SGLT2 inhibitor, her A1C remains 9.2%. They are started on mifepristone.
Which of the following best explains how mifepristone improves glycemic control in this setting?
- It decreases cortisol synthesis in the adrenal cortex, lowering circulating cortisol levels.
- It reduces ACTH release from the pituitary, leading to decreased adrenal stimulation.
- It blocks glucocorticoid receptors, preventing cortisol from exerting metabolic effects.
- It directly enhances insulin secretion and sensitivity, independent of cortisol pathways.
Getting to the Best Answer
Answer 1 is incorrect. 25.14% chose this answer, “It decreases cortisol synthesis in the adrenal cortex, lowering circulating cortisol levels.” As tempting as this answer is, mifepristone does not inhibit cortisol synthesis.
Answer 2 is incorrect. 15.21% of you chose this answer, “It reduces ACTH release from the pituitary, leading to decreased adrenal stimulation.” This medication does not directly reduce ACTH release from the pituatary.
Answer 3 is correct. About 48.73% of respondents chose this, “It blocks glucocorticoid receptors, preventing cortisol from exerting metabolic effects.” Mifepristone is a glucocorticoid receptor antagonist. By competitively binding to glucocorticoid receptors, it prevents cortisol from exerting downstream effects, including increased hepatic gluconeogenesis, peripheral insulin resistance, and lipolysis. This mechanism is particularly useful in people with hypercortisolism and concurrent type 2 diabetes, as it improves insulin sensitivity and lowers blood glucose without lowering circulating cortisol levels.
Finally, Answer 4 is incorrect. 10.99% chose this answer, “It directly enhances insulin secretion and sensitivity, independent of cortisol pathways.” This medication does not act directly on pancreatic β-cells or insulin receptors.
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!
Invite a colleague to our DiabetesEd Seminar in San Diego and get $75 off each registration.
Use code FriendDiscountSD during check out to save.
Join us live in San Diego October 22nd – 23rd, 2025 for our upcoming
DiabetesEd Training Seminar
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Tandem Turns Up the Tech for t:slim X2 and Mobi
Tandem Diabetes has leveled up insulin pump technology with a new algorithm and expanded its continuous glucose monitor (CGM) compatibility. The new algorithm, Control IQ+, is built upon the previous Control IQ algorithm, offering several updated features. In June 2025, Tandem diabetes announced Libre 3+ is joining the family of compatible CGMs. Let’s uncover the details of this new algorithm and review the compatible CGM options.
Tandem Control IQ+
Control IQ+ introduces several new features designed to enhance glycemic control.¹ These features are available for both the Tandem t:slim X2 and Mobi insulin pumps.
✅ Age: Control IQ+ is available for ages 2 years and up.
✅ Indication: This algorithm has approval for both Type 1 Diabetes and Type 2 Diabetes.
✅ Extended Bolus: This feature allows for extended boluses for up to 8 hours.
✅ Weight Range: The new algorithm now includes extended weight ranges from 20-440 lbs.
✅ Total Daily Dose of Insulin: For those with high insulin requirements, the total daily dose of insulin is now up to 200 units per day.
✅ Temp Basal Rate: The temp basal rate feature can be used for up to 72 hours while still staying in Control IQ+. Now users don’t need to stop the automated insulin delivery mode when requiring a temp basal rate for short-term needs like illness or exercise. The algorithm will continue to adjust the basal rate and give boluses if needed based on blood glucose levels.²
CGM Compatibility
Tandem announced in June 2025 the approval of Libre 3+ to its current family of compatible CGMs. Per Tandem Diabetes Care, the Libre 3+ will be compatible with the t:slim X2 pump and is only available through an early access program, with a broader access announcement expected later this year.³ Currently, the compatible CGMs are:
🩸Dexcom G6 (For t:slim X2 and Mobi)
🩸Dexcom G7 (For t:slim X2 and Mobi)
🩸Libre 2 + (For t:slim X2 only)
The Healthcare Professional’s Perspective
Now that you know what’s new with Control IQ+ technology and the current CGM compatibility, you can confidently help clients develop a personalized approach to insulin pump management. Diabetes healthcare professionals can also help existing Tandem insulin pump users update their software to the new Control IQ+ algorithm. Individuals living with diabetes depend on your expertise to guide them through the maze of diabetes technology. During education sessions, reviewing the basics of how the algorithm works and specific features of the pump can be reassuring for individuals in our care. Additionally, assessing carbohydrate counting skills and discussing how to administer food and correction boluses along with preventing and managing hypoglycemia, can make a big difference.
Join us at our live San Diego Conference to learn more about Diabetes Technology with Diana Isaacs, PharmD CDCES, BC-ADM, FADCES. Check out the events page to see all the exciting options!
References
- Tandem Diabetes Care. Tandem Diabetes Care launches new control-IQ+ automated Insulin delivery technology in the United States [News Release]. Retrieved August 1, 2025, from https://investor.tandemdiabetes.com/news-releases/news-release-details/tandem-diabetes-care-launches-new-control-iq-automated-insulin.
- Tandem Diabetes Care. Temp rate. Retrieved August 1, 2025, from https://www.tandemdiabetes.com/support-center/pumps-and-supplies/automated-insulin-delivery/article/temp-rate#:~:text=Temp%20Rate%2C%20also%20known%20as,delivers%2060%25%20of%20that%20value.
- Tandem Diabetes Care. Tandem Diabetes Care Announces t:slim X2™ insulin pump compatibility with Abbott’s FreeStyle Libre® 3 Plus sensor in the United States [News Release]. Retrieved August 1, 2025, from https://investor.tandemdiabetes.com/news-releases/news-release-details/tandem-diabetes-care-announces-tslim-x2tm-insulin-pump.
Invite a colleague to our DiabetesEd Seminar in San Diego and get $75 off each registration.
Use code FriendDiscountSD during checkout to save
Join us live in San Diego October 22nd – 23rd, 2025 for our upcoming
DiabetesEd Training Seminar
30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Question of the Week | Grandfather Avoiding Bolus Insulin
R.S. is a 60-year-old with type 2 diabetes who was recently placed on insulin lispro at meals. He has taken insulin glargine once a day for five years. Previously, non-insulin medications have been ineffective or not tolerated. He continues to have hyperglycemia despite the addition of insulin lispro. During his diabetes education visit today, he shared that he has not been taking his mealtime insulin lispro because he does not want to inject it in front of his grandchildren, who live with him. He feels overwhelmed by these additional injections but wants to get his blood glucose levels under better control so he can have the energy to play with his grandchildren and avoid losing his eyesight like his mother did.
As the diabetes care and education specialist, which of the following would be the most appropriate first step in addressing R.S.’s concerns?
- Stress with R.S. the importance of never missing his meal time lispro to prevent diabetes-related complications.
- Using open-ended questions, explore R.S.’s routine, stressors, and support systems to understand the barriers to his insulin use.
- Recommend R.S. switch to another non-insulin medication to make his regimen easier for him to manage.
- Since it appears R.S. did not understand how to take his insulin lispro, write out step-by-step instructions on how to take the insulin.
Invite a colleague to our DiabetesEd Seminar in San Diego and get $75 off each registration.
Use code FriendDiscountSD during check to save.
Join us live in San Diego October 22nd – 23rd, 2025 for our upcoming
DiabetesEd Training Seminar
Earn 30+ CEs with Expanded Accreditation!
Join our expert team for engaging, interactive sessions that bring the ADA Standards of Care to life—covering medications, behavior change, technology, and more. Ideal for CDCES or BC-ADM exam prep, this course also includes a 4-hour Virtual Medical Nutrition Therapy Toolkit and bonus content that also meets CDCES renewal requirements.
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
Expert Faculty:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Faculty Bios & Disclosures
Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun!
Program Faculty Disclosures:
Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.
Faculy Bios & Disclosures:
Coach Beverly Thomassian RN, MPH, CDCES, BC-ADM – CEO of DiabetesEd ServicesDisclosures:
Beverly Thomassian has no financial disclosures
Bio:
Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPCES
Disclosures:
Dr. Diana Isaacs has the following relevant financial relationships:
- Consultant, advisor, and speaker for Abbot Labratories, Dexcom, Medtronic, Insulet, Lilly, Cequr, Sanofi, and Undermyfork
- Board member at Association for Diabetes Care and Education Specialists
Bio:
Diana Isaacs was awarded 2020 ADCES Diabetes Educator of the Year for her educational platform promoting the use of CGM for people with diabetes and other innovations. She serves in leadership roles for several pharmacies and diabetes organizations. She has numerous diabetes publications and research projects with a focus on medications, CGM and diabetes technology.
For the past three year, Dr. Isaacs has served as a contributing author for the 2023 ADA Standards of Care.
As the Program Coordinator and clinical pharmacist specialist in the Cleveland Clinic Diabetes Center, Dr. Isaacs brings a wealth of clinical knowledge combined with extensive research and speaking experience to this program.
Expanded Accreditation
Activity Start and End Date: 10/22/25 – 10/23/2025
Estimated time to complete the activity: 15 hours and 30 minutes
_____________________________________
Jointly provided by Partners for Advancing Clinical Education and Diabetes Education Services
Joint Accreditation Statement:
In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and Diabetes Education Services. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Education:
Partners designates this enduring material for a maximum of 15.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development:
The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 15.50 contact hours.
Pharmacy Continuing Education:
Partners designates this continuing education activity for 15.50 contact hour(s) (1.550 CEUs) of the Accreditation Council for Pharmacy Education.
(Universal Activity Number – JA4008073-9999-25-206-L01-P)
Type of Activity: Application
For Pharmacists: Upon successfully completing the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Dietitian Continuing Education:
This program offers 15.50 CPEUs for dietitians.
Interprofessional Continuing Education:
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
For additional information about the accreditation of this activity, please visit https://partnersed.com.
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
