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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: 

  1. Aware: Be aware of diabetes distress.
  2. Ask: Ask about diabetes distress. 
  3. Assess: Use a validated screening tool for assessment.
  4. Advise: Explain diabetes distress.
  5. Assist: Develop an action plan.
  6. Assign: If you are not equipped to help, assign the client to another healthcare professional. 
  7. 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

    1. 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.

    2. 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
    3. American Diabetes Association. (n.d.). Professional development: Behavioral health toolkit. https://professional.diabetes.org/professional-development/behavioral-mental-health/behavioral-health-toolkit
    4. Healing through Connection for Healthcare Professionals by Beverly Thomassian

Question of the Week | MS keeps getting UTI’s – Best action?

Question of the Week Diabetes Education Services

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?

  1. Drink sugar-free cranberry juice a few times a week.
  2. Apply topical vaginal estrogen cream.
  3. Get A1C below 7% by adding basal insulin.
  4. 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!

Question of the Week | What Does J.C.’s Family History & Lab Work Reveal?

Question of the Week Diabetes Education Services

J.C. is a ten-year-old female with a family history of type 1 diabetes. Her 7-year-old brother was diagnosed with type 1 diabetes two years ago. J.C. has no complaints and reports feeling well. She enjoys playing sports, including basketball and soccer. Her current BMI is 22.1 (93rd percentile for age). She denies any polydipsia, polyuria, or polyphagia. Her lab work demonstrates a fasting blood sugar of 71 mg/dL, an A1c of 5.0%, normal kidney function, and normal electrolytes. Her diabetes autoantibody panel shows positive glutamic acid decarboxylase (GAD) and islet antigen 2 (IA-2) antibodies, negative zinc transporter 8 (ZnT8) antibodies, and negative insulin antibodies.

What does her lab work reveal?

  1. Stage 1 Type 1 diabetes
  2. Stage 2 Type 1 diabetes
  3. Stage 3 Type 1 diabetes
  4. Type 2 diabetes

Learn More About Type 1 Staging & Stds

CDCES Boot Camp - Includes Levels 1-3

Get ready to lead the charge to implement best care practices while preparing for certification. This course reviews the glucose goals of care from pediatrics, through pregnancy, during middle age, & for seasoned citizens. We also take a close look at the goals for CV care & strategies to reduce the risk of experiencing CV events. Resources for hypertension & lipid medications are provided.

If you’re preparing for the CDCES or BC-ADM exam, this conference, paired with a handful of free bonus courses, serves as the ideal study companion! Plus, this content counts toward the ADA Standards requirements for CDCES Renewal.

With interactive co-teaching, we keep sessions engaging, relevant, and fun. 

Let’s learn and grow together!

Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!

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.

Lightbulb and text: Rationale of the Week

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?

  1. It decreases cortisol synthesis in the adrenal cortex, lowering circulating cortisol levels.
  2. It reduces ACTH release from the pituitary, leading to decreased adrenal stimulation.
  3. It blocks glucocorticoid receptors, preventing cortisol from exerting metabolic effects.
  4. It directly enhances insulin secretion and sensitivity, independent of cortisol pathways.

Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose 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

Smiling woman in white blazer and lavender blouse

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 Services

Disclosures: 

Beverly Thomassian has no financial disclosures

Bio:

Author, Nurse, Educator, Clinician, and Innovator, Beverly has specialized in diabetes management for over twenty years. As president and founder of Diabetes Education Services, Beverly is dedicated to providing compassionate and evidence based diabetes education and improving the lives of those with diabetes.

PicsArt_04 03 11Diana 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. 

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

  1. 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
  2. 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.
  3. 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

Smiling woman in white blazer and lavender blouse

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

Question of the Week Diabetes Education Services

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?

  1. Stress with R.S. the importance of never missing his meal time lispro to prevent diabetes-related complications.
  2. Using open-ended questions, explore R.S.’s routine, stressors, and support systems to understand the barriers to his insulin use.
  3. Recommend R.S. switch to another non-insulin medication to make his regimen easier for him to manage.
  4. 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

Smiling woman in white blazer and lavender blouse

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 Services

Disclosures: 

Beverly Thomassian has no financial disclosures

Bio:

Author, Nurse, Educator, Clinician, and Innovator, Beverly has specialized in diabetes management for over twenty years. As president and founder of Diabetes Education Services, Beverly is dedicated to providing compassionate and evidence based diabetes education and improving the lives of those with diabetes.

PicsArt_04 03 11Diana 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. 

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.

Shining A Spotlight on Our Scholarship Winners!

We are delighted to celebrate our “Bridge Scholarships” for CDCES Prep Boot Camp and the Live Seminar Scholarships!

Celebrating Our Diabetes Education Scholarship Recipients

We are incredibly grateful for the overwhelming response to our Bridge Scholarships for both the CDCES Prep Boot Camp and Live Seminar Scholarships. Your passion, dedication, and commitment to advancing in diabetes care truly inspired us.

Each application we received was a powerful reminder of the incredible work being done across our healthcare community. Our panel of judges faced the challenging task of selecting recipients, carefully evaluating each application based on several important criteria: financial need, person-centered language, inclusivity, impact, volunteerism, and readiness to sit for the CDCES exam.

After thoughtful consideration, we are thrilled to announce the recipients of this round of scholarships! 🎉

These individuals represent the very best of what our community stands for—dedication, empathy, service, and the drive to grow professionally and personally. The scholarships they’ve received will not only recognize their hard work and achievements but also provide the support they need as they take the next step in their journey toward becoming Certified Diabetes Care and Education Specialists.

Please join us in congratulating our scholars! Their commitment to improving diabetes care and education will undoubtedly have a lasting impact on the communities they serve.

To our scholarship recipients: Congratulations! And to our entire community of healthcare professionals: Thank you for your continued passion, perseverance, and support. Together, we are building a stronger, more inclusive future in diabetes care.

San Diego Live Seminar Bridge Recipients

JJunick_Photo

Jessika Junick

FNP-C
Roswell, NM

IMG_2789

Christy Walowit

MS, RDN
Sacramento, CA

Jue Lia Fong

BS, MSN, PHN
Los Angeles, CA

Shelagh Cooley

ADN, BA in Public Policy, Master's in International Development
South Hero, VT

Erica Otieno

Bachelor of Science in Dietetics - Registered Dietitian
Houston, TX

IMG_3498

Alaina Hernandez

ARPN, FNP-C
Texarkana, TX

Lynsi Beers

Bachelor of Science in Foods & Nutrition, RDN, LDN
Pinehurst, NC

IMG_0240

Eglazia Brown

Registered Nurse, BSN
Charleston, SC

Maribel_Medina_photo

Maribel Medina

RN
Chicago, IL

Emily D'Angelo

MS, RD, HWC
Hartford, CA

TMurray_10-2020_headshot

Trudee Murray

MS, BSN, CCRN-Pediatric, CPHQ
Sacramento, CA

IMG_7921

Nicki Li

RDN
Lodi, CA

Jovanna Orozco

MS, RDN, LDN
Charlotte, NC

Tina Guadan Fogall

MS, RDN, CD
Bellevue, WA

Jacqueline Lee

AGACNP, CNP, RN, CCRN
Minneapolis, MN

Gina Duncan

FNP- BC
Brooklyn. NY

Cinthia Reyez

BSN, RN
Kansas City, MO

Oliver Thompson

MPH
Gooding, ID

Thendral Srinivasan

BSN
Cary, NC

Nayelie Benitez Santos

MS in Nursing, FNP
Corona, CA

Live in San Diego
DiabetesEd Training Seminar

Join us live October 22nd – 23rd, 2025!

30+ CEs with Expanded Accreditation!

More than a course, an experience.

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

Smiling woman in white blazer and lavender blouse

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.

Rationale of the Week | Time Restricted Eating – Best Approach

For last week’s practice question, we quizzed participants on Time Restricted Eating- Best Approach. 86% 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

Lightbulb and text: Rationale of the Week

MJ is a 56-year-old with type 2 diabetes (A1C 7.3%), HTN, and dyslipidemia. Current medications include metformin 1,000 mg twice daily, lisinopril, and atorvastatin. Activity includes walking 20–30 minutes most evenings. At their most recent visit, MJ is inquiring about using at 16:8 time-restricted eating plan and plans eating from 11 a.m. to 7 p.m. and will include coffee/unsweetened beverages outside that window. MJ checks their blood glucose once daily and there is no reported history of severe hypoglycemia.

What response would you provide MJ regarding the safety and effectiveness of an intermittent fasting, time-restrictive eating plan?

  1. Individuals with type 2 diabetes should include regular meals throughout the day to support stabilize blood sugars and prevent hypoglycemia.
  2. Review with MJ his motivations for the time-restricted eating plan and assess plan for dietary intake within the eating window.
  3. Encourage a time-restricted eating plan, evidence indicates it is more effective than calorie reduction alone for weight loss and A1c reduction.
  4. Recommend starting Incretin therapy, such as Ozempic or Mounjaro, to ensure effectiveness of time-restricted eating plan.

Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.

Answer 1 is incorrect. 9% chose this answer, “Individuals with type 2 diabetes should include regular meals throughout the day to support stabilize blood sugars and prevent hypoglycemia.” Random control trials have indicated that time-restricted eating is a safe and practical dietary approach for individuals with type 1 and type 2 diabetes. While assessment and prevention of hypoglycemia is a priority, MJ’s current medication regimen is of low risk. Even with higher risk medications, such as insulin or sulfonylureas modifications of medication, timing or dose can be made to support safety.

Answer 2 is correct. 86% of you chose this answer, “Review with MJ his motivations for the time-restricted eating plan and assess plan for dietary intake within the eating window.” Great Job! Time-restricted eating can be a safe and effective strategy for MJ. Reviewing motivation and current eating patterns may improve the ability to apply balanced meals within the eating window.

Answer 3 is incorrect. About 3% of respondents chose this, “Encourage a time-restricted eating plan, evidence indicates it is more effective than calorie reduction alone for weight loss and A1c reduction.” While time restricted eating may be a practical strategy, it has not been shown to be superior to continuous energy restricted dietary intake for weight loss and A1c outcomes.

Finally, Answer 4 is incorrect. About 2% chose this answer, “Recommend starting Incretin therapy, such as Ozempic or Mounjaro, to ensure effectiveness of time-restricted eating plan.” While we may consider addition of an incretin therapy to support A1c, weight and cardiovascular risk reduction, time-restricted eating does not require the addition of these medications to be effective.

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!

Live in San Diego
DiabetesEd Training Seminar

Join us live October 22nd – 23rd, 2025!

30+ CEs with Expanded Accreditation!

More than a course, an experience.

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

Smiling woman in white blazer and lavender blouse

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 Services

Disclosures: 

Beverly Thomassian has no financial disclosures

Bio:

Author, Nurse, Educator, Clinician, and Innovator, Beverly has specialized in diabetes management for over twenty years. As president and founder of Diabetes Education Services, Beverly is dedicated to providing compassionate and evidence based diabetes education and improving the lives of those with diabetes.

PicsArt_04 03 11Diana 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. 

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.