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You’re Invited | Type 2 Intensive Workshop & CDCES Prep Webinar
Type 2 Intensive Workshop | Earn 2.0 CEs
This course provides a detailed overview of the pathophysiology of type 2 diabetes, prevention strategies, and cardiovascular risk reduction. In addition, we highlight type 2 treatment approaches including nutrition, activity, oral and injectables medications plus screening and treatment guidelines for micro and macrovascular disease. Through case studies and discussion, we highlight strategies to focus on a person-centered approach along with attention to psychosocial care for people living with diabetes.
Objectives:
- Discuss the current epidemiology of type 2 diabetes.
- Describe the classification, terminology & diagnostic criteria for diabetes.
- Identify the eight pathophysiologic defects associated with the ominous octet.
- Describe evidence and strategies to prevent type 2 diabetes.
- State strategies to implement a person-centered approach to those with diabetes and more…
Learn the Steps to Become a CDCES!
Prep for CDCES FREE Webinar – Sept 22nd
Starting your journey? 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.
Preparing for the CDCES Exam Webinar Topics
- Exam requirement updates for 2022.
- 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!
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.
Question of Week | Best action before starting tirzepatide (Mounjaro)?
AR is 36 years old with type 2 diabetes and a BMI of over 40. Current A1C 7.9%, UACR less than 30, and GFR more than 60. Current diabetes medications include metformin, sitagliptin, and empagliflozin at maximum doses. AR is prescribed the new dual incretin tirzepatide (Mounjaro) to help improve glucose levels and support weight loss.
Before starting tirzepatide (Mounjaro), what action do you recommend to the provider?
- Repeat the UACR and GFR to verify kidney function.
- Stop the sitagliptin.
- Decrease metformin dose to prevent hypoglycemia.
- Evaluate thyroid function.
Click Here to Test your Knowledge
New Injectable – “TwinCretin” on Printed PocketCards
We have just added this novel, first in class, dual incretin hormone therapy, Tirzepatide (Mounjaro), to our printed version of our Diabetes Medication PocketCard.
This new twin therapy includes not only a GLP-1 Receptor Agonist, but also a Glucose-dependent insulinotropic polypeptide (GIP), which magnifies the therapeutic effectiveness. The SURPASS studies indicate that study participants experienced an A1C drop of up to 2.5% and weight loss of up to 10kg or more.
Want to learn more about Diabetes Medications?
Virtual DiabetesEd Training Conference | 30+ CEs
Airs October 12-14th, 2022
Join us LIVE for this Virtual Training Conference and enjoy a sense of community!
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.
Download Course Flyer | Download Schedule
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.
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
Two Registration Options
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
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.
Certification Help – 2 FREE Webinars to Prep for CDCES or BC-ADM
Coach Beverly and Bryanna are here to Help
If you are considering taking the CDCES or BC-ADM Exam, we have great news. We are offering 2 different webinars that provide you with the study prep information and tools you need to propel across the finish line.
As health care professionals, we value your limited study time by offering evidence-based content carefully crafted for exam success with direct application to your clinical practice. Please let us know if we can be of any help on your journey!
Warmly, Coach Beverly and Bryanna
Preparing for BC-ADM FREE Webinar
September 20th at 11:30am PST
Register for BC-ADM Webinar | September 20, 2022
BC-ADM 2022 Note Taking Handout
We hope you can join us live. But, if not, no worries.
We will send you a link to the recorded version within 24 hours of airing.
Preparing for the CDCES Exam FREE Webinar
September 22 at 11:30am PST
This course will transform your test anxiety into calm self-confidence and test-taking readiness.
Join Coach Bev Live – September 22, 2022 at 11:30am
2022 PowerPoint Note-Taking Handouts
We hope you can join us live. But, if not, no worries.
We will send you a link to the recorded version within 24 hours of airing.
Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator who has passed her CDCES Exam 6 times and first earned her BC-ADM credential 20 years ago. She is a nationally recognized diabetes expert for over 25 years.
Virtual and Online Certification Education Options
3 Day Intensive: Virtual DiabetesEd Specialist Conference |Oct. 12-14th
This Virtual Training Conference streams LIVE in October. Invite your friends to enjoy a group discount. Plus, save on travel costs and enjoy conference interactivity through demonstrations, games and Q&A sessions. Our Deluxe Conference Package includes a 100+ page printed syllabus, Med PocketCards, ADA Standards and swag. This advanced level course features 3 expert speakers who translate the ADA Standards, Meds, Technology, Complications, Nutrition Therapy and more. Join us to get recharged or to prepare for certification.
Self-Study Online Certification Bundles:
- CDCES Exam Prep Bundle
- BC-ADM Exam Prep Bundle
These courses are designed to walk participants through the knowledge needed to succeed at either the CDCES or BC-ADM certification exams. Viewed at your convenience and pace, each module contains poll questions, case studies and real life situations that prepare participants for clinical situations as well as the exams. Students consistently state that our online courses not only helped them achieve certification, they also provided valuable insights into providing effective diabetes care. See more info below.
All hours earned count toward your CDCES Accreditation Information
Free Certification Resources
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.
Rationale of the Week | Ambulatory Glucose Profile Confusion
For last week’s practice question, we quizzed test takers on ambulatory glucose profile confusion. Only 62% of respondents chose the best answer, which indicates that there was some uncertainty. 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:
LS is 72 years old with type 2 diabetes and injects insulin 4 times a day. They were started on a CGM device last month and you are looking at the Ambulatory Glucose Profile (AGP) together. You notice their time in range is 60%, their time above range is 38%, in low range is 2% and their coefficient of variation is less than 36%.
What is the best response?
Answer Choices:
- We still need to improve your coefficient of variation.
- Based on these results, let’s decrease your insulin by 20%.
- Time in range should be 70% or greater for your age group.
- This information is going to help with problem solving.
Getting to the Best Answer
Answer 1 is incorrect. 11.89% chose this answer, “We still need to improve your coefficient of variation.” This is a juicy answer, but not the best one. If you refer to the Ambulatory Glucose Profile (AGP) below, you will see that the goal for Coefficient of Variation is less than 36%. In this question, LS has coefficient of variation is less than 36%, so they are meeting the target. This measure of glucose variability is important since it informs us of the intensity and duration of glucose levels fluctuations.
Answer 2 is incorrect. 5.26% of you chose this answer, “Based on these results, let’s decrease your insulin by 20%.” This is not the best answer either. Since their time in range of 60% is a little below target and 38% of the time they are above target, LS might actually need some more insulin. Of course, safety is always first, but their low blood sugar range is only 2%, well below the 5% target.
Answer 3 is incorrect. 20.91% of respondents chose this answer, “Time in range should be 70% or greater for your age group.” Another juicy answer, but just like A1C goals, time in range targets are based on the individual and other factors. For a 72 year old on multiple daily injections, 70% time in range may be too aggressive and put them at risk for hypoglycemia. The target time in range is not a “one size fits all” and needs to be customized to the individual. In addition, this statement uses the “should” word, which can evoke feelings of embarrassment or shame. Instead we might say, “Great job tracking your blood sugars. How are you feeling about your progress?
Finally, Answer 4 is correct. 61.94% chose this answer, “This information is going to help with problem solving.” YES, GREAT JOB, this is the best answer. It is person centered, acknowledges their effort and engages LS in participating in problem solving. This comment will definitely increase their feelings of mastery and empowerment.
Want to learn more about this topic?
Dr. Diana Isaacs is providing a fantastic technology update.
Coach Beverly will highlight diabetes language that is empowering.
Virtual DiabetesEd Training Conference | 30+ CEs
Airs October 12-14th, 2022
Join us LIVE for this Virtual Training Conference and enjoy a sense of community!
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.
Download Course Flyer | Download Schedule
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.
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
Two Registration Options
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
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.
Ambitious Action Plan to Help Americans Eat Healthier | Free White House Conference
The Standard American Diet (SAD) is not known for optimizing health and improving longevity. Almost half of U.S. deaths from heart disease are linked to unhealthy food choices. People who have lower incomes have even worse health-related outcomes. “It is clear that the challenges of food insecurity, diet-related diseases, and health inequities intersect with and exacerbate each other, and that radical systemic changes across multiple sectors are needed to adequately address them.” (Task Force)
“We’re really in a nutrition crisis in this country.”
says Dariush Mozaffarian, a cardiologist and dean of the Friedman School of Nutrition Science and Policy at Tufts University.
Nutrition Task Force Recommendations
The good news is that there is growing momentum to address this problem. A newly convened Task Force on Hunger has put together a comprehensive plan to improve the nutrition of Americans.
The Task Force members have an unwavering belief in the “importance of taking decisive action to achieve transformative change to end food insecurity and hunger, improve nutrition, and reduce diet-related diseases.”
White House Conference Sept 28th
The Biden administration will hold the White House Conference on Hunger, Nutrition, and Health on September 28th with the agenda driven by the Task Force Recommendations.
Afterward, they will announce a new national strategy to improve access to healthier foods based on these tenets.
Seven Big Ideas Recommended by Task Force on Hunger, Nutrition and Health
1. Treat Food as Medicine
There is growing momentum to integrate food and nutrition into regular health care through innovative strategies. Providing prescriptions for healthy groceries coupled with nutrition education is an idea that is being piloted around the country. In this model, health care systems or insurers pay for groceries to help people make significant changes to their eating habits.
2. Focus on the Quality of Calories, not just the Quantity
Historically, federal food assistance programs have helped to address hunger. Policies and programs have historically focused on improving access to sufficient quantities of food. Now there is momentum to modernize this approach and focus on the quality of food and make sure people have adequate access to enough nutritious food.
3. Expand Access to Dietary and Lifestyle Counseling
The task force recommends more preventive behavioral lifestyle coaching by providers as a part of usual care. They also recommend that Congress expand Medicare and Medicaid coverage for medical nutrition therapy for people with hypertension, prediabetes, celiac disease, HIV/AIDS, cancer and other diet-related conditions. There is also a call for expanded coverage of cooking classes and nutrition assistance, as well as coverage of the Diabetes Prevention Programs delivered by telehealth.
4. Support Food Entrepreneurs
By supporting individuals who start food businesses, they can help nourish communities and create jobs. The task force calls on the federal government to pass policies that boost new healthy food enterprises, including providing new loans and grants to food and nutrition-related companies centered on health, equity, and sustainability. The idea is to focus especially on businesses owned by people of color and other marginalized groups.
5. Increase the number of new farmers growing healthy foods using regenerative farming techniques
The U.S. has invested heavily in monoculture with a focus on producing corn and soybeans on most cropland. Now, there’s growing recognition of the need for more specialty crops – including fruits, vegetables, and nuts. To promote crop diversity, the task force proposed providing new farmers with paid internships and apprenticeships to learn about sustainable farming and funding to cover a living wage and housing. Read more here Beginning Farmers and Ranchers Development Program.
6. Make school meals free for all students
Many families who are eligible for free or reduced-priced meals may not receive them, sometimes due to the paperwork, bureaucracy or stigma of participating or enrolling. Amid the pandemic, school meals have been offered for free to all students. Now, the task force says this should be a permanent change.
7. Establish a Federal Agency and National Director of Food and Nutrition.
To initiate and formulate these bold and common sense changes, the task force recommends the creation of a new role in the federal government; a National Director of Food and Nutrition. This department could evaluate the success of programs, make adjustments and expand and fund programs that work.
Click here to access the Full report and dive into the details
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.
Question of Week | What explains JR’s sudden DKA?
JR, a 67-year-old with type 2 diabetes for seven years and an A1C of 9.7% was started on empagliflozin 10mg two weeks ago. Other labs include a GFR of 49 and a UACR of 34 mg/g. Other diabetes medications include glucotrol 10mg twice daily and sitagliptin 100mg daily. JR sometimes has a few shot’s of whiskey before bed, especially if they had a stressful day. JR’s partner calls you in a panic and says JR is admitted to the hospital in DKA.
What is the most likely explanation?
- Excess alcohol intake leading to starvation ketosis
- Potential side effect of SGLT-2 Inhibitors
- Low GFR and elevated UACR increase hyperglycemic risk
- JR is misdiagnosed and likely has type 1 diabetes
Click Here to Test your Knowledge
Want to learn more about Diabetes Medications and Side Effects? Dr. Diana Isaacs will be sorting fact from fiction in our
Virtual DiabetesEd Training Conference | 30+ CEs
Airs October 12-14th, 2022
Join us LIVE for this Virtual Training Conference and enjoy a sense of community!
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.
Download Course Flyer | Download Schedule
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.
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
Two Registration Options
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
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.
Uvalde T-Shirt Installation Connects Art to Heart
After the Uvalde shooting, a group of mothers who belonged to a monthly book club, decided not to talk about their book of the month. Instead they dedicated their gathering to sharing their deep grief and feelings of powerlessness about the senseless loss of 19 beautiful children in Uvalde, Texas. Children, just like their own, who were excited to learn, hang out with friends and wrap up school for the summer.
I am one of the book club mothers.
We committed to shine a light on this tragedy and connect to our common humanity through art. We are often afraid to talk about gun violence because it is such a fraught conversation. However, we know one thing we all have in common regardless of our political affiliation or upbringing.
We all want our school aged children to be safe and free of death from gun violence in their schools, homes and communities.
Let’s start our conversation with this belief in mind.
To express our grief and touch the hearts of others, we created an art installation featuring 21 orange t-shirts of different sizes, with the hand-painted names of the children and teachers who died that day in May. We call it the “Uvalde T-shirt Clothesline”.
The Uvalde T-Shirt Clothesline speaks of the empty shirts left behind: shirts that will never be played in, worn to school, or hugged at night.
We displayed this at our local Farmer’s Market where many people stopped, looked up and reflected on the loss. It now it hangs at the entrance of the museum of northern california, monca.
Uvalde T-Shirt Clothesline Story
On May 24, 2022, in the small town of Uvalde, Texas, nineteen innocent children and two teachers were gunned down at school by an 18-year-old with an automatic weapon. Out of our grief and dismay over this tragic loss of life arose this installation of 21 orange t-shirts, hand-painted with the names of the children and teachers who died that day.
The Uvalde T-Shirt Clothesline speaks of the empty shirts left behind: shirts that will never be played in, worn to school, or hugged at night. Shirts whose young owners will never reach their full potential. We chose orange shirts since orange is the commemorative color of gun violence prevention.
Empty orange shirts on a clothesline serves as a metaphor for the ordinary act of hanging our family’s clothes to dry, a commonplace fixture of household routine. It connects to the tragic reminder that gun violence in our schools is also becoming routine.
Firearms are the leading cause of death for children in the United States. Every two and a half-hours, a child loses their life due to firearm violence, accidents, or suicide. We hope this display touches hearts and shines a light on the senseless loss of these beautiful souls. Through connection and conversation, we can make a difference.
Please share any questions or comments regarding this blog with [email protected]. Thank you.
T-Shirt Clothesline Tribute makes local paper front page.
Maybe other communities could create their own clothesline? Read Enterprise Record Article here.
Resources
Download a List of Gun Violence Prevention Organizations
Nurses Union Addresses Gun Violence
Art Displays
Uvalde mural honors Robb Elementary School shooting
September 2022 eNews | Boosting Nutrition Health & Jumping for Joy
September 2022 eNews | Boosting Nutrition Health & Jumping for Joy
September Greetings
We are experiencing a food crisis. Ten percent of Americans in every state, across rural and urban households, experienced food insecurity at least some time during 2020. With food prices on the rise, how do we help people with prediabetes and diabetes make healthy food choices within their means? There is good news! A national nutrition task force has unveiled its findings and ambitious strategies to improve nutrition access and reduce diet-related diseases. These thought leaders and food experts have outlined an innovative plan to address the food crisis by increasing nutrition education and access, including funding cooking classes and more.
Good news in diabetes tech. The first ever tubeless integrated insulin delivery system was just FDA approved for toddlers 2 years old and up. Parents and providers alike are celebrating this latest advance in insulin delivery technology for kids and adults alike.
We all know that exercise is good for you, but does it elicit feelings of joy? A researcher has identified a series of one-minute movements that not only improve coordination, balance, and strength but also bring a smile to your face. Give it a try and invite your friends and family to join you in Jumping for Joy.
In preparation for our 25th year anniversary, we are adopting a higher tech Online University Learning Platform. This means easier navigation and more bells and whistles for our subscribers. We plan to make the switch in early Fall, so keep your eyes open for more info as we get closer to the date.
Finally, we are thrilled to announce two Flower Scholars for our October Virtual DiabetesEd Course. They are making a big difference in their communities, and we are overjoyed to celebrate both of them.
You and your colleagues are invited to join our three FREE Webinars this month. If you feel like a challenge, take a moment to check out our Question and Rationale of the Week.
Thank you in advance for your actions and advocacy on behalf of people living with diabetes.
Beverly, Bryanna, Robert, and Amanda
Click here to read our full September 2022 newsletter.
Featured Articles
- Task Force aims to Help Americans Eat Healthier
- New Tubeless Insulin Delivery for Toddlers
- Can Movement Increase Feelings of Joy?
- DiabetesEd University Launches New Platform
- Question of the Week
- Rationale of Week
- Flower Scholarship Recipients
Upcoming Webinars
- Virtual DiabetesEd Specialist Conference | Oct. 12-14th
- What We Say | Sept 13th
- BC-ADM Prep | Sept 20th
- CDCES Exam Prep | Sept 22
- ADCES Book Bundle
- Free Resources
Upcoming FREE Webinar
What We Say Matters: Language that Respects the Individual and Imparts Hope| Airs September 13th
What we say matters.
As educators, advocates, spouses, friends, and providers, our use of language can deeply affect the self-view of people living with diabetes every day.
Intentional communication is a powerful tool that can uncover trauma, identify barriers, and move both the provider and person with diabetes toward a greater understanding of the issues involved.
The language used in the health care setting is immensely important in determining trust, mutual respect, and meaningful long-term relationships.
Many people with diabetes have experienced injustice, trauma, and marginalization, and are often struggling with feelings of shame and blame.
- Let’s lift people through our commitment to careful listening.
- Let’s choose a language that is person-centered and free from judgment.
- Let’s empower our interactions by identifying and addressing trauma and the impact of social determinants.
FREE Webinar – Lifting People Up
Topics covered include:
- Learn phrases, words, and approaches that can be left behind.
- Describe diabetes language that is respectful, inclusive, person-centered, and imparts hope.
- Discuss how to evaluate for ACE and provide trauma-informed care
- Practice communicating about diabetes using phrases free from judgment with a focus on a strength-based approach.
This mini-webinar is free, and no CEs are provided, but there is lots of great info!
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″]Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
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.
