
For last week’s practice question, we quizzed participants on who is most at risk of diabetes based on the new ADA Standards. 45% 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:
The clinic where JR works as a Diabetes Specialist wants to set up a screening program to identify people with undiagnosed prediabetes or diabetes based on risk status. According to the 2023 ADA Standards of Care, which of the following indicates that an individual is at increased risk of having prediabetes and diabetes and needs further testing?
Answer Choices:

Answer 1 is correct. 44.91% chose the BEST answer, “A 29-year-old newly started on antiretroviral therapy.” GREAT JOB. A potential side effect of antiretroviral therapy, used to treat HIV, is the destruction of beta cells and resultant hyperglycemia. The ADA guidelines recommend screening blood sugars before starting antiretroviral therapy, during treatment and yearly. Of course, it is also important to alert the individual on antiretroviral therapy of the signs of hyperglycemia and ask them to report any signs right away. Please refer to our Diabetes Diagnosis and Screening Cheat Sheet for more information.
Answer 2 is incorrect. 34.23% of you chose this answer, “A 24-year-old who leads a sedentary lifestyle and father has history of heart disease.” Screening for prediabetes or diabetes starts at the age of 35 for everyone or for younger individuals with an elevated BMI and an additional risk factor. Since this person is under the age of 35 and we don’t know their weight, they wouldn’t meet the criteria for a high risk individual based on the information provided and the ADA Guidelines. Please refer to our Diabetes Diagnosis and Screening Cheat Sheet for more information.
Answer 3 is incorrect. 12.69% of respondents chose this answer, “A 14-year-old whose cousin with type 1 diabetes.” The ADA guidelines suggest screening individuals with a first-degree family members with type 1 diabetes. Since cousins aren’t considered first-degree relatives, this is not the best answer. However, JDRF has a Type 1 Screening Resource Page for those who are interested in being screened for type 1 diabetes. Please refer to our Diabetes Diagnosis and Screening Cheat Sheet for more information.
Finally, Answer 4 is incorrect. 8.18% chose this answer, “A 26-year-old who just delivered a baby three weeks early.” This answer is tempting, but does not match the ADA risk factors. A person who had gestational diabetes has a higher risk of future diabetes, but in this answer, there is no indication that the person had GDM or any blood sugar elevations. Delivering a baby early is not associated with increased diabetes risk. Please refer to our Diabetes Diagnosis and Screening Cheat Sheet for more information.

Thank you so much for reading this “Rationale of the Week”.
Please refer to our Diabetes Diagnosis and Screening Cheat Sheet for more information.
We also invite you to join our Online Courses for more information (see info below)
Hope you can join our ADA Standards of Care Webinar Update in February.

This bundle is specifically designed for healthcare professionals who want to learn more about diabetes fundamentals for their clinical practice or for those who are studying for the Certified Diabetes Care and Education Specialist (CDCES) exam.
Intended Audience: This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with diabetes and preparing for the CDCES Certification Exam.
All hours earned count toward your CDCES Accreditation Information
Join us live on February 2, 2023, at 11:30 am PST for our

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2023 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for healthcare professionals involved in diabetes care and education.
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.

JR is 42 years old with type 2 diabetes and has worked up to brisk walking for 30 minutes on most days. JR has an A1C of 6.7% and takes an SGLT-2, metformin, and lovastatin along with trying to eat healthfully. JR decided to check blood sugars an hour after exercise and was surprised to see post-exercise blood glucose in the 180’s on two different days. JR asks you why their blood glucose actually rises after exercise.
What is the diabetes specialist’s best response?
Click Here to Test your Knowledge

Can’t join all the sessions live? No problem. Your registration guarantees you access to the recorded lectures for a full year.
This bundle is specifically designed for healthcare professionals who want to learn more about diabetes fundamentals for their clinical practice or for those who are studying for the Certified Diabetes Care and Education Specialist (CDCES) exam.
Intended Audience: This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with diabetes and preparing for the CDCES Certification Exam.
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.

This bundle is specifically designed for healthcare professionals who want to learn more about diabetes fundamentals for their clinical practice or for those who are studying for the Certified Diabetes Care and Education Specialist (CDCES) exam.
Intended Audience: This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with diabetes and preparing for the CDCES Certification Exam.
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.

Every year, Coach Beverly excitedly waits for the release of the new ADA Standards of Care. She loves scanning through the pages of content to discover updates and advances that lead to improved diabetes care. She then translates this new information into her presentations, updates her Cheat Sheets, and refreshes web content to reflect the latest guidelines.
Coach Beverly has discovered three real gems that she is excited to share with all of you.
In this first newsletter of 2023, we feature the new blood pressure and lipid guidelines based on ADA Standard 10. Plus, we explore changes to the Medication Algorithm for Type 2 Diabetes as featured in Standard 9, with a discussion on starting insulin versus an incretin mimetic.
We have updated our images for Question and Rationale of the Week and we invite you to test your knowledge below and review the rationale for the best answer.
Our Cheat Sheets are updated to reflect the 2023 Standards, so you can download these helpful references and study tools. The ever-popular Medications and Glucagon 2023 PocketCards are back from the printer and ready for purchase.
January marks the month we kick off our Level 1 Series. In February, we present our annual ADA Standards of Care update webinar and Level 3 Boot Camp Course Series.
For our 25-year celebration, we have several special events planned that we will be rolling out in the Spring. Stay tuned for an exciting 2023.
With gratitude for our amazing community,
Coach Beverly and Bryanna
Featured Articles
Upcoming Webinars

This bundle is specifically designed for healthcare professionals who want to learn more about diabetes fundamentals for their clinical practice or for those who are studying for the Certified Diabetes Care and Education Specialist (CDCES) exam.
Intended Audience: This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with diabetes and preparing for the CDCES Certification Exam.
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.

For last week’s practice question, we quizzed participants on insulin storage guidelines. 55% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question
Question:
JR has a bunch of insulin pens at home and is wondering if they are still good to use. Most of the unopened insulin pens are stored in the fridge, but JR has 2 degludec (Tresiba) pens that they left out of the refrigerator by accident. They ask you if they are still good. What is the most accurate response for the shelf life of degludec (Tresiba) pens stored at room temperature of up to 86 degrees Fahrenheit?
Answer Choices:

Practical Clinical Pointers: Of course, these are general storage guidelines and if people using insulin notice blood sugars climbing despite adequate insulin dosing, it can be a sign the insulin has lost its potency. Sometimes, people on a budget might decide to keep using insulin past the expiration date. In either case, we can advise individuals to switch to a new insulin vial or pen right away if they notice blood sugars unexplainably trending up.
Thank you so much for reading this “Rationale of the Week”.
Please refer to our Insulin Storage Guidelines or package inserts for more information. We also invite you to join our Online Courses for more information (see info below)
Hope you can join our ADA Standards of Care Webinar Update in February.
See below for info.

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2023 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for healthcare professionals involved in diabetes care and education.
Objectives:
Intended Audience: This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with prediabetes, diabetes and other related conditions.
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
This bundle includes our CDCES Online Prep Bundle (featured above) plus the ADCES Review Guide – 5th Edition-Revised. The online bundle includes Level 1, Level 2, and Level 3 (Boot Camp), plus two bonus courses. The ADCES Review Guide offers over 480+ practice questions and is a fantastic independent study tool and comprehensive resource for the Diabetes Care and Education Specialist Exam.
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.
If you are taking the CDCES or BC-ADM exam in 2023, these new blood pressure target recommendations and treatment interventions are important to know.
For all of us who serve people with diabetes, research suggests that these more intensive blood pressure targets will save lives and decrease CV and microvascular disease. By sharing this information with our colleagues and teams, we can be a part of improving outcomes and quality of life.
The following content summarizes the 2023 updated ADA guidelines as outlined in Standard 10 – Cardiovascular Disease and Risk Management.

Randomized clinical trials have unequivocally demonstrated that getting blood pressure to target saves lives and reduces risk of cardiovascular and microvascular complications.
The recommendation to support a blood pressure goal of <130/80 in people with diabetes is consistent with guidelines from the American College of Cardiology and American Heart Association (20), the International Society of Hypertension (21), and the European Society of Cardiology (22).

Keeping track of medications for hypertension and cholesterol can seem daunting. We have put together a Hypertension and Lipid Medication Cheat Sheet along with summary information for each class that is important to know for certification exams and is very useful in clinical practice.
Together, we can improve the quality of life and outcomes for people living with diabetes. Getting blood pressure to target is one of the most important interventions we can take to maintain health. Thank you for reading this article and advocating for the best evidence-based care.

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2023 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for healthcare professionals involved in diabetes care and education.
Objectives:
Intended Audience: This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with prediabetes, diabetes and other related conditions.
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
This bundle includes our CDCES Online Prep Bundle (featured above) plus the ADCES Review Guide – 5th Edition-Revised. The online bundle includes Level 1, Level 2, and Level 3 (Boot Camp), plus two bonus courses. The ADCES Review Guide offers over 480+ practice questions and is a fantastic independent study tool and comprehensive resource for the Diabetes Care and Education Specialist Exam.
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.
Welcome to our first 2023 Question of the Week. We decided to freshen up some of our images and are excited to share our new purple light bulb graphic for Question of the Week. Thanks for joining us and Happy New Year.

The clinic where JR works as a Diabetes Specialist wants to set up a screening program to identify people with undiagnosed prediabetes or diabetes based on risk status. According to the 2023 ADA Standards of Care, which of the following indicates that an individual is at increased risk of having prediabetes and diabetes and needs further testing?
Click Here to Test your Knowledge

This bundle is specifically designed for healthcare professionals who want to learn more about diabetes fundamentals for their clinical practice or for those who are studying for the Certified Diabetes Care and Education Specialist (CDCES) exam.
Intended Audience: This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with diabetes and preparing for the CDCES Certification Exam.
All hours earned count toward your CDCES Accreditation Information
Join us live on February 2, 2023, at 11:30 am PST for our

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2023 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for healthcare professionals involved in diabetes care and education.
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.

The new ADA 2024 Standards of Care include dozens of updates to diabetes clinical practice.
Which of the following statements has actually been added to the ADA 2024 Standards of Care?
Click Here to Test your Knowledge

Topics:
Intended Audience: This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions.
Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.
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.