Each year, I excitedly scan through the new ADA Standards of Care (SOC) to learn and incorporate best practices into my clinical practice and course content. Based on my initial review, here are some of the highlights I want to share with you right away, but there is a lot more info to come.

Clinical Practice Updates

Screen for hyperglycemia starting at age 35

This year, I am happy to see that the screening age for prediabetes and diabetes has dropped by a decade, from 45 years of age to 35 years of age. This new guideline provides diabetes specialists with the opportunity to reach out to our colleagues and communities to spread the word that ALL people, regardless of weight, ethnicity and other risk factors, need to be tested for glucose dysregulation starting at age 35.

New Kidney Protection Guidelines
Since diabetes is the leading cause of kidney failure, I appreciate that the ADA has created a new standard dedicated to renal protection, called Chronic Kidney Disease and Risk Management (Standard 11).

Highlights of this standard include:

• The recommendation to start SLT2 Inhibitors if the GFR is 25 or greater and the urinary albumin is 300 or greater. An abundance of data has demonstrated that SGLT2’s protect renal function, delay progression of chronic kidney disease and decrease cardiovascular events. If clinically indicated, this class of medication can be used as a first line treatment for people with type 2 diabetes.
• In addition, this standard recommends including the nonsteroidal mineralocorticoid receptor antagonist (finerenone) for treatment of diabetes kidney disease (see our Cheat Sheets for more info).

New Vaccination Information and Fatty Liver Treatment Recommendations

Standard 4 includes updated information on vaccinations.
In our clinic, we are encouraging all people to get the influenza vaccine in addition to the COVID vaccine series. Experts predict that severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) and influenza viruses will both be active in the U.S. during the 2021–2022 season.

Most people don’t know that getting the Influenza vaccine decreases risk of death.

New data is revealing that the influenza vaccine doesn’t just lower the risk of getting the flu, it also lowers risk of all cause mortality and cardiovascular events and death. This simple annual intervention is recommended for all individuals with diabetes 6 months and older.

Fatty Liver Disease – Under detected and under treated

Over 50% of people with diabetes have non-alcoholic fatty liver liver disease (NAFLD) and the percentage is even higher for those with diabetes and a BMI of 30 or greater. Yet, there is no standardized diagnostic or treatment strategy. Experts in the field are trying to raise awareness while developing a consensus statement.

Diabetes specialist can take an active discovering fatty liver disease by looking for elevated liver enzymes, especially in those with elevated BMI and other risk factors. Even without an official diagnosis, if NAFLD is suspected, we can encourage healthy eating, weight and glycemic management plus interventions for hypertension and dyslipidemia.
In addition, some studies indicate that pioglitazone, vitamin E treatment, liraglutide, and semaglutide treatment of biopsy-proven non alcoholic steatohepatitis (NASH) improves liver histology, but effects on longer-term clinical outcomes are not known. Treatment with GLP-1s and SGLT-2s has also shown promise in preliminary studies. But more research is needed!

There is so much more to explore, please join Coach Beverly on February 3rd for our Annual Standards of Care Webinar and a comprehensive review!

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Start reviewing the Standards Today with our CDCES Coach App!

Click below to download our CDCES Coach App to read the Standards today.

• CDCES Coach App for iOS devices

• CDCES Coach App – Google

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You are invited to join Coach Bev on February 3rd at 11:30 for an intensive 2-hour live webinar reviewing what Diabetes Specialists need to know about the updated standards.

Enroll in our Level 2 | ADA Standards of Care | 2.0 CEs

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2022 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for health care professionals involved in diabetes care and education.

Objectives:

1. A review of changes and updates to the 2022 ADA Standards of Medical Care
2. Identification of key elements of the position statement
3. Discussion of how diabetes educators can apply this information in their clinical setting

Intended Audience:  This course is a knowledge-based activity designed for individuals or groups of diabetes educators, 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 their patients with diabetes and other related conditions.

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator and a nationally recognized diabetes expert.

Enroll in our entire Level 2 – Standards of Care to join us for the below 2022 Live Webinar Updates. All courses air at 11:30 a.m. (PST)

• Recorded on December 15, 2021 – Hyperglycemic Crises, DKA & HHS Standards | 1.0 CE
• Recorded on December 21, 2021 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach Standards | 1.5 CEs
• February 3, 2022 – ADA Standards of Care | 2.0 CEs
• March 24, 2022 – Meds Management for Type 2 – 1.5 CEs
• March 29, 2022 – Lower Extremity Assessment 1.5 CEs
• April 26, 2022 – Microvascular Complications, Eye, Kidney Nerve Disease 1.5 CEs
• April 28, 2022 – Critical Assessment of Diabetes Patient 2.0 CEs
• May 10, 2022 – Cardiovascular Disease and Diabetes Standards 1.5 CEs
• May 12, 2022 – Older Adults and DIabetes 1.5 CEs
• May 17, 2022 – Tots to Teens – Diabetes Standards 1.5 CEs
• May 19, 2022 – Pregnancy and Diabetes 1.5 CEs
• May 26, 2022 – Hospital and Hyperglycemia 1.5 CEs
• July 21, 2022 – Setting up a Successful Diabetes Program 1.5 CEs

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.

We quizzed test takers on the new ADA 2022 Standards of Care for CGMs. 71% of respondents chose the best answer. We want to share this important updated 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 below: Answer Question

Question: In the 2022 ADA Standards, there are updated indications for use of real-time continuous glucose monitoring or intermittently scanned continuous glucose monitoring. Based on the new guidelines, which one of the following individuals needs to be offered continuous glucose monitoring to manage their diabetes?

Answer Choices:

• AL, a 54-year-old on a sulfonylurea plus metformin.
• RT, a 68-year-old on basal insulin and an SGLT-2 Inhibitor.
• ZR, a 23-year-old with diabetes secondary to HIV retroviral therapy.
• AW, an 18-year-old with prediabetes.

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

Getting to the Best Answer

Answer 1 is incorrect. 11.08% chose this answer, “AL, a 54-year-old on a sulfonylurea plus metformin.” This is a juicy answer, since AL is taking a medication that can cause hypoglycemia. This person would benefit from a glucose meter and instruction on the signs of hypoglycemia and what action to take if they have symptoms of low blood sugar. However, according to the standards, continuous glucose monitoring is not indicated for people with type 2 on orals. But knowing that insurance probably won’t cover a CGM, AL could choose to purchase (out of pocket) an intermittently scanning glucose meter to keep a close eye on their blood sugars.

Answer 2 is correct. 71.03%% of you chose this answer, “RT, a 68-year-old on basal insulin and an SGLT-2 Inhibitor.” GREAT JOB! According to the ADA Diabetes Technology Standard 7, “real-time continuous glucose monitoring or intermittently scanned continuous glucose monitoring can be used for diabetes management in adults with diabetes on basal insulin who are capable of using devices safely (either by themselves or with a caregiver). The choice of device should be made based on patient circumstances, desires, and needs.” In addition, this standard outlines that CGM should be offered during pregnancy and for youth and adults who are using insulin therapy to get glucose to target.

Answer 3 is incorrect. 14.42% of respondents chose this answer, “ZR, a 23-year-old with diabetes secondary to HIV retroviral therapy.” This answer is tempting. However, there is no indication in this answer that ZR is on insulin therapy and that is why it is not the best answer. The latest ADA Standards recommends CGM for adults on insulin therapy.

Finally, Answer 4 is incorrect. 3.47% chose this answer, “AW, an 18-year-old with prediabetes.” Good try. Currently, CGM is only recommended for people with diabetes on insulin or during pregnancy. Off the record, people with prediabetes might decide to purchase a blood glucose meter (if their insurance company doesn’t cover it) to keep an eye on their glucose levels and use the results as motivation to make lifestyle changes.

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 important learning activity!

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Want to learn more about this topic?

Join our Virtual DiabetesEd Specialist Conference
30+ CEs | April 13-15, 2022

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.

 Download Course Schedule |  Download Course Flyer

Join us LIVE for this Virtual Course and enjoy a sense of community!

Team of expert faculty includes:

• Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES – Educator of the Year, 2020
• Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
• Ashley LaBrier, MS, RD, CDCES, Diabetes Program Coordinator

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Two Registration Options

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Virtual DiabetesEd Specialist Conference Deluxe | 30+ CEs

Deluxe Option for $499: Virtual Program includes:

• Q & A Session with the instructor after each webinar.
• LIVE Presentations by our team of experts.
• State of the art review of current diabetes care and technology.
• Resources for each session.
• Access to free podcasts and video recordings within a week of each live session for one year.

Deluxe Version includes Syllabus, Standards and Swag*:

• Diabetes Educator Course 2022 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
• ADA 2022 Standards of Care Book -The ADA Standards of Medical Care in Diabetes is a key resource for healthcare professionals involved in diabetes care, education, and support.
• DiabetesEd Services highlighters, Medication PocketCard, Tote Bag and Pen

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Virtual DiabetesEd Specialist Conference Basic | 30+ CEs

Deluxe Option for $499: Virtual Program includes:

• Q & A Session with the instructor after each webinar.
• LIVE Presentations by our team of experts.
• State of the art review of current diabetes care and technology.
• Resources for each session.
• Access to free podcasts and video recordings within a week of each live session for one year.

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

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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.

• Urinary albumin creatinine ratio of 30-299 mg/g with GFR of 45.
• GFR of 60 or greater and urinary albumin creatinine ratio of 2 mg/g.
• Urinary albumin creatinine ratio less than 30 mg/g and GFR of 30-45.
• Creatinine of 1.5 and urinary albumin creatinine ratio of 300 mg/g or greater.

Click Here to Test your Knowledge

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You are invited to join Coach Bev on February 3rd at 11:30 for an intensive 2-hour live webinar reviewing what Diabetes Specialists need to know about the updated standards.

Enroll in our Level 2 | ADA Standards of Care | 2.0 CEs

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2022 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for health care professionals involved in diabetes care and education.

Enroll in our entire Level 2 – Standards of Care to join us for the below 2022 Live Webinar Updates. All courses air at 11:30 a.m. (PST)

• Recorded on December 15, 2021 – Hyperglycemic Crises, DKA & HHS Standards | 1.0 CE
• Recorded on December 21, 2021 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach Standards | 1.5 CEs
• February 3, 2022 – ADA Standards of Care | 2.0 CEs
• March 24, 2022 – Meds Management for Type 2 – 1.5 CEs
• March 29, 2022 – Lower Extremity Assessment 1.5 CEs
• April 26, 2022 – Microvascular Complications, Eye, Kidney Nerve Disease 1.5 CEs
• April 28, 2022 – Critical Assessment of Diabetes Patient 2.0 CEs
• May 10, 2022 – Cardiovascular Disease and Diabetes Standards 1.5 CEs
• May 12, 2022 – Older Adults and DIabetes 1.5 CEs
• May 17, 2022 – Tots to Teens – Diabetes Standards 1.5 CEs
• May 19, 2022 – Pregnancy and Diabetes 1.5 CEs
• May 26, 2022 – Hospital and Hyperglycemia 1.5 CEs
• July 21, 2022 – Setting up a Successful Diabetes Program 1.5 CEs

All hours earned count toward your CDCES Accreditation Information

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DiabetesEd Boot Camp | Level 3

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 BC-ADM or the CDCES certification Exam.

• February 8, 2022 – Class 1 – Diabetes – Not Just Hyperglycemia
• February 10, 2022 – Class 2 – Standards of Care & Cardiovascular Goals
• February 15, 2022 – Class 3 – Insulin Therapy – From Basal/Bolus to Pattern Management
• February 17, 2022 – Class 4 – Insulin Intensive – Monitoring, Sick Days, Lower Extremities
• February 22, 2022 – Class 5 – Meds for Type 2 – What you need to know
• February 24, 2022 – Class 6 – Exercise and Medical Nutrition Therapy
• March 1, 2022 –  Class 7 – Screening, Prevention, and Treatment of Microvascular Complications
• March 3, 2022 – Class 8 – Coping and Behavior Change 1.5 CEs
• March 8, 2022 – Class 9 – Test-Taking Coach Session (48 Questions) No CE

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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.

Are you preparing for the CDCES Exam?

Join us live on January 26th, at 11:30 am PST for our FREE Webinar

Starting your journey to becoming a CDCES? We recommend watching our FREE Preparing for CDCES Exam Webinar!

This course will transform your test anxiety into calm self-confidence and test taking readiness.

Webinar Topics

• Exam requirement updates for 2021.
• Exam eligibility and test format
• Strategies to succeed along with a review of study tips and test-taking tactics.
• We will review sample test questions and the reasoning behind choosing the right answers.
• Learn how to focus your time and prepare to take the CDCES Exam. We provide plenty of sample test questions and test-taking tips!

Can’t join us live?
Don’t worry, we will send you a link to the recorded version.

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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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Studying for the CDCES Exam?

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

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You are invited to join Coach Bev on February 3rd at 11:30 for an intensive 2-hour live webinar reviewing what Diabetes Specialists need to know about the updated standards.

Enroll in our Level 2 | ADA Standards of Care | 2.0 CEs

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2022 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for health care professionals involved in diabetes care and education.

Objectives:

1. A review of changes and updates to the 2022 ADA Standards of Medical Care
2. Identification of key elements of the position statement
3. Discussion of how diabetes educators can apply this information in their clinical setting

Intended Audience:  This course is a knowledge-based activity designed for individuals or groups of diabetes educators, 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 their patients with diabetes and other related conditions.

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator and a nationally recognized diabetes expert.

Enroll in our entire Level 2 – Standards of Care to join us for the below 2022 Live Webinar Updates. All courses air at 11:30 a.m. (PST)

• Recorded on December 15, 2021 – Hyperglycemic Crises, DKA & HHS Standards | 1.0 CE
• Recorded on December 21, 2021 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach Standards | 1.5 CEs
• February 3, 2022 – ADA Standards of Care | 2.0 CEs
• March 24, 2022 – Meds Management for Type 2 – 1.5 CEs
• March 29, 2022 – Lower Extremity Assessment 1.5 CEs
• April 26, 2022 – Microvascular Complications, Eye, Kidney Nerve Disease 1.5 CEs
• April 28, 2022 – Critical Assessment of Diabetes Patient 2.0 CEs
• May 10, 2022 – Cardiovascular Disease and Diabetes Standards 1.5 CEs
• May 12, 2022 – Older Adults and DIabetes 1.5 CEs
• May 17, 2022 – Tots to Teens – Diabetes Standards 1.5 CEs
• May 19, 2022 – Pregnancy and Diabetes 1.5 CEs
• May 26, 2022 – Hospital and Hyperglycemia 1.5 CEs
• July 21, 2022 – Setting up a Successful Diabetes Program 1.5 CEs

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!

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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.

We quizzed test takers on the new ADA 2022 Standards of Care for Hyperglycemia. 39% of respondents chose the best answer. We want to share this important updated 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 below: Answer Question

Question: Based on the 2022 ADA Standards of Care and Screening Guidelines, which one of the following people would need to be tested for hyperglycemia?

Answer Choices:

• RJ, a 36-year-old with a BMI of 23
• LS, a 32-year-old with a history of gastritis
• JM, a 33-year-old who smokes a pack a day
• KT, a 34-year-old who has bilateral pedal edema

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

Getting to the Best Answer

Answer 1 is correct. 39.80% chose this answer, “RJ, a 36-year-old with a BMI of 23.” GREAT JOB. Given the increasing incidence of prediabetes and diabetes in younger populations, the ADA has adjusted their screening threshold. The old guidelines suggest screening everyone starting at age 45. The new recommendations state that everyone aged 35 or older needs to have their blood glucose level evaluated to find undiagnosed prediabetes or diabetes.

Testing methods for prediabetes or diabetes can include:

• A1c
• Fasting Plasma Glucose (FPG) or
• Oral Glucose Tolerance Test (OGTT)

By testing for elevated glucose levels at this younger age bracket, health care professionals can provide early intervention to slow progression from prediabetes to diabetes and provide immediate care to those with newly discovered diabetes.

Answer 2 is incorrect. 15.47% of you chose this answer, “LS, a 32-year-old with a history of gastritis.” Based on the ADA Standards, we wouldn’t screen this individual for two reasons. They are younger than 35 and their BMI does not meet the threshold of 25 or greater (it isn’t even listed). Gastritis also isn’t a commonly co-associated diabetes condition*.

Answer 3 is incorrect. 22.56% of respondents chose this answer, “JM, a 33-year-old who smokes a pack a day.” Based on the ADA Standards, we wouldn’t screen this individual for two reasons. They are younger than 35 and their BMI does not meet the threshold of 25 or greater (it isn’t even listed). Smoking has been show to increase insulin resistance, but the ADA doesn’t list it as a risk factor*.

Finally, Answer 4 is incorrect. 22.17% chose this answer, “KT, a 34-year-old who has bilateral pedal edema.” They are younger than 35 and their BMI does not meet the threshold of 25 or greater (it isn’t even listed). Pedal edema can be caused for a variety of reasons, but the ADA doesn’t list pedal edema as a risk factor*.

*Coach Bev note. It is appropriate to screen for hyperglycemia, even if an individual doesn’t meet this criteria, if a health care professional is worried that based on clinical presentation, that an individual is at risk for prediabetes or diabetes.

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 important learning activity!

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Want to learn more about this topic?

Enroll in Our Standards of Care Intensive | Level 2

This bundle is specifically designed for healthcare professionals who want to learn more about the ADA Standards of Diabetes Care for their clinical practice or for those who are studying for the BC-ADM or the CDCES certification exam.

2022 Live Webinar Updates

• Recorded December 15, 2021 – Hyperglycemic Crises, DKA & HHS Standards | 1.0 CE
• Recorded December 21, 2021 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach Standards | 1.5 CEs
• February 3, 2022 – ADA Standards of Care | 2.0 CEs
• March 24, 2022 – Meds Management for Type 2 – 1.5 CEs
• March 29, 2022 – Lower Extremity Assessment 1.5 CEs
• April 26, 2022 – Microvascular Complications, Eye, Kidney Nerve Disease 1.5 CEs
• April 28, 2022 – Critical Assessment of Diabetes Patient 2.0 CEs
• May 10, 2022 – Cardiovascular Disease and Diabetes Standards 1.5 CEs
• May 12, 2022 – Older Adults and DIabetes 1.5 CEs
• May 17, 2022 – Tots to Teens – Diabetes Standards 1.5 CEs
• May 19, 2022 – Pregnancy and Diabetes 1.5 CEs
• May 26, 2022 – Hospital and Hyperglycemia 1.5 CEs
• July 21, 2022 – Setting up a Successful Diabetes Program 1.5 CEs

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

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All hours earned count toward your CDCES Accreditation Information

Intended Audience:  A great course for healthcare professionals in the field of diabetes education looking for a straightforward explanation of identification and treatment of hyperglycemic crises.

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator and a nationally recognized diabetes expert.

---

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.

• AL, a 54-year-old on a sulfonylurea plus metformin.
• RT, a 68-year-old on basal insulin and a SGLT-2 Inhibitor.
• ZR, a 23-year-old with diabetes secondary to HIV retroviral therapy.
• AW, an 18-year-old with prediabetes.

Click Here to Test your Knowledge

---

You are invited to join Coach Bev on February 3rd at 11:30 for an intensive 2-hour live webinar reviewing what Diabetes Specialists need to know about the updated standards.

Enroll in our Level 2 | ADA Standards of Care | 2.0 CEs

This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the 2022 updates to the American Diabetes Association’s Standards of Medical Care in Diabetes and provides critical teaching points and content for health care professionals involved in diabetes care and education.

Objectives:

1. A review of changes and updates to the 2022 ADA Standards of Medical Care
2. Identification of key elements of the position statement
3. Discussion of how diabetes educators can apply this information in their clinical setting

Intended Audience:  This course is a knowledge-based activity designed for individuals or groups of diabetes educators, 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 their patients with diabetes and other related conditions.

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator and a nationally recognized diabetes expert.

Enroll in our entire Level 2 – Standards of Care to join us for the below 2022 Live Webinar Updates. All courses air at 11:30 a.m. (PST)

• Recorded on December 15, 2021 – Hyperglycemic Crises, DKA & HHS Standards | 1.0 CE
• Recorded on December 21, 2021 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach Standards | 1.5 CEs
• February 3, 2022 – ADA Standards of Care | 2.0 CEs
• March 24, 2022 – Meds Management for Type 2 – 1.5 CEs
• March 29, 2022 – Lower Extremity Assessment 1.5 CEs
• April 26, 2022 – Microvascular Complications, Eye, Kidney Nerve Disease 1.5 CEs
• April 28, 2022 – Critical Assessment of Diabetes Patient 2.0 CEs
• May 10, 2022 – Cardiovascular Disease and Diabetes Standards 1.5 CEs
• May 12, 2022 – Older Adults and DIabetes 1.5 CEs
• May 17, 2022 – Tots to Teens – Diabetes Standards 1.5 CEs
• May 19, 2022 – Pregnancy and Diabetes 1.5 CEs
• May 26, 2022 – Hospital and Hyperglycemia 1.5 CEs
• July 21, 2022 – Setting up a Successful Diabetes Program 1.5 CEs

All hours earned count toward your CDCES Accreditation Information

---

Studying for the CDCES Exam?

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

---

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!

[yikes-mailchimp form=”1″]

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.

We quizzed test takers on the new ADA Standards of Care for Kidney Disease. 56% of respondents chose the best answer. We want to share this important info 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 below: Answer Question

Question: Based on the 2022 ADA Standards of Care, which of the following is the most accurate statement regarding chronic kidney disease and risk management?

Answer Choices:

• Monitor kidney function twice yearly if urinary albumin is 300 or greater and/or if GFR is 30-60.
• For people with GFR less than 60, relax glucose target to prevent hypoglycemia.
• If GFR is less than 30 in an individual with diabetes, avoid use of SGLT-2 Inhibitors.
• For individuals with GFR less than 60, refer to RD to encourage low protein diet.

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

Getting to the Best Answer

Answer 1 is correct. 55.61% chose this answer, “Monitor kidney function twice yearly if urinary albumin is 300 or greater and/or if GFR is 30-60.” YES, GREAT JOB. Most of you chose the best answer for this new recommendation. Catching renal failure early can be life saving. Two big indicators of serious renal issues include proteinuria and a diminished GFR. Early interventions (including getting BG and BP to goal) and regular monitoring can protect kidneys for the long run.

Answer 2 is incorrect. 8.51% of you chose this answer, “If GFR is less than 30 in an individual with diabetes, avoid use of SGLT-2 Inhibitors.” This is a juicy answer. The GFR cut-offs for the SGLT-2s have been changing a lot over the past year. More research is showing that, in some cases, even with a GFR less than 30 (especially in the presence of proteinuria) SGLT-2s are indicated since they have a renal protective effect. See ADA Standard 11 on Chronic Kidney Disease for more info.

Answer 3 is incorrect. 28.05% of respondents chose this answer, “People with type 2 are less likely to experience diabetes complications than those with type 1 diabetes.” According the the National Kidney Foundation, “About 30 percent of people with Type 1 diabetes and 10 to 40 percent of those with Type 2 diabetes eventually experience kidney failure.” The most important message is to encourage people with diabetes to be actively involved in their treatment plan and advocate for best medical care to protect renal function.

Finally, Answer 4 is incorrect. 7.83% chose this answer, “For individuals with GFR less than 60, refer to RD to encourage low protein diet.” This is an outdated recommendation for over the past five years. The ADA recognized that the science does not support low protein diets as a protective intervention for those with renal disease. For people with nondialysis-dependent stage 3 or higher chronic kidney disease, dietary protein intake recommendation is 0.8 g/kg body weight per day.

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 important learning activity!

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Enroll in Our Standards of Care Intensive | Level 2

This bundle is specifically designed for healthcare professionals who want to learn more about the ADA Standards of Diabetes Care for their clinical practice or for those who are studying for the BC-ADM or the CDCES certification exam.

2022 Live Webinar Updates

• Recorded December 15, 2021 – Hyperglycemic Crises, DKA & HHS Standards | 1.0 CE
• Recorded December 21, 2021 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach Standards | 1.5 CEs
• February 3, 2022 – ADA Standards of Care | 2.0 CEs
• March 24, 2022 – Meds Management for Type 2 – 1.5 CEs
• March 29, 2022 – Lower Extremity Assessment 1.5 CEs
• April 26, 2022 – Microvascular Complications, Eye, Kidney Nerve Disease 1.5 CEs
• April 28, 2022 – Critical Assessment of Diabetes Patient 2.0 CEs
• May 10, 2022 – Cardiovascular Disease and Diabetes Standards 1.5 CEs
• May 12, 2022 – Older Adults and DIabetes 1.5 CEs
• May 17, 2022 – Tots to Teens – Diabetes Standards 1.5 CEs
• May 19, 2022 – Pregnancy and Diabetes 1.5 CEs
• May 26, 2022 – Hospital and Hyperglycemia 1.5 CEs
• July 21, 2022 – Setting up a Successful Diabetes Program 1.5 CEs

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

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All hours earned count toward your CDCES Accreditation Information

Intended Audience:  A great course for healthcare professionals in the field of diabetes education looking for a straightforward explanation of identification and treatment of hyperglycemic crises.

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator and a nationally recognized diabetes expert.

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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.

Wow! This is fantastic news. I sit for the CBCDE Exam for the 7th time this year, and I am definitely going to take advantage of this remote feature! ~ Coach Beverly

The Certification Board for Diabetes Care & Education (CBDCE) is now offering the opportunity to take your Certified Diabetes Care and Education Specialist (CDCES) exam remotely!

Starting in 2022, you have the option to take your certification exam using their new Live Remote Online Proctoring (LRP) platform.

Get Familiar with the Requirements

During your exam appointment, you will be connected with a moderator who will guide you through the process and be there throughout your entire exam. You will need to share your screen and broadcast yourself during your entire exam. Your workspace should be quiet, tidy, and free of any study notes/materials.

No electronics are allowed and participants are not allowed to take a break. In addition, the moderator can request to rescan your workspace to make sure it is free of study notes and materials. After you take the exam, you will instantly get a report of your results.

To connect to the LRP platform, you will need a computer with a webcam and microphone. The CBDCE recommends that you run compatibility tests before your exam to ensure your equipment is compatible.

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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!