Rationale of the Week | How do they calculate UACR?
We quizzed test takers on the urinary albumin creatinine ratio. 59% 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: What best describes how to measure urinary albumin creatinine ratio?
Answer Choices:
- Divide blood creatinine results with urinary albumin secretion rate.
- Collect 24-hour urine sample and add alkaline solution to determine albumin ratio quantity.
- Draw a fasting blood sample to determine ratio of creatinine in grams to albumin in milligrams.
- Divide urinary albumin concentration in milligrams by creatinine concentration in grams.
As shown above, the most common choice was option 4, the second most common answer was option 1, then option 3, and then finally option 2.
Getting to the Best Answer
Answer 1 is incorrect. 16.57% chose this answer, “Divide blood creatinine results with urinary albumin secretion rate.” This is a juicy answer! To calculate UACR, the lab uses albumin and creatinine results from the urine only. And since it is a ratio, they divide the urine albumin levels by the urine creatinine to get the result. Please see our blog From Dipsticks to GFR – How to Evaluate Kidney Function for a detailed explanation.
Answer 2 is incorrect. 12.00%% of you chose this answer, “Collect 24-hour urine sample and add alkaline solution to determine albumin ratio quantity.” In the old days, we would collect a 24 urine samples to evaluate kidney health. However, since the spot urine albumin /creatinine ratio is so accurate, we don’t need to do the cumbersome 24-hour collection to determine UACR. Now we can evaluate UACR using a spot collection (dipstick) or lab evaluation of urine. Please see our blog From Dipsticks to GFR – How to Evaluate Kidney Function for a detailed explanation.
Answer 3 is incorrect. 12.43% of respondents chose this answer, “Draw a fasting blood sample to determine the ratio of creatinine in grams to albumin in milligrams.” To calculate UACR, the lab uses albumin and creatinine results from the urine only. And since it is a ratio, they divide the urine albumin levels by the urine creatinine to get the result. No fasting is required for this test. Please see our blog From Dipsticks to GFR – How to Evaluate Kidney Function for a detailed explanation.
Finally, Answer 4 is correct. 59.00% chose this answer, “Divide urinary albumin concentration in milligrams by creatinine concentration in grams.” GREAT JOB. You chose the best answer. Urinary Albumin Creatinine Ratio (UACR) is the ratio of urine albumin to urine creatinine. The UACR is usually already calculated on the lab report,
To determine the UACR, you divide urine albumin by creatinine, then convert it to mg/g. The reason this value is reported as a ratio as opposed to just urine albumin is to account for the concentration and hydration status of the individual which improves accuracy.
UACR is an important measure of kidney health and the goal is to measure it yearly and if elevated, more frequently.
Testing for UACR is fairly easy. The ADA has approved using a urine dipstick or a urine sample to calculate the UACR, However, according to the standards, two of three tests need to be positive to confirm diagnosis within a 3 to 6 month period before confirming a diagnosis of moderate or severe albuminuria. Exercise within 24 h, infection, fever, congestive heart failure, marked hyperglycemia, menstruation, and marked hypertension may elevate UACR independently of kidney damage. Please see our blog From Dipsticks to GFR – How to Evaluate Kidney Function for a detailed explanation.
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!
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
Two Registration Options
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
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.
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.
Rationale of the Week | Healthy Kidney Labs?
We quizzed test takers on kidney function. 81.64% 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: Evaluating kidney function is important to determine the most beneficial treatment interventions. Which of the following measurements would indicate that JR has healthy kidney function?
Answer Choices:
- 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.
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. 6.52% chose this answer, “Urinary albumin creatinine ratio of 30-299 mg/g with GFR of 45.” There are two major indicators of kidney health for people with diabetes, Glomerular Filtration Rate (GFR) and Urinary Albumin Creatinine Ratio (UACR). According to the ADA Standards, to have a healthy kidney function, JR would need a GFR of 60 or greater and a UACR less than 30 mg/g. Give that JR’s UACR is elevated at 30 mg/g or greater and the GFR is sluggish at 45, this is not the best answer.
Answer 2 is correct. 81.64%% of you chose this answer, “GFR of 60 or greater and urinary albumin creatinine ratio of 2 mg/g.” YES, GREAT JOB choosing the BEST answer. There are two major indicators of kidney health for people with diabetes, Glomerular Filtration Rate (GFR) and Urinary Albumin Creatinine Ratio (UACR). According to the ADA Standards, to have a healthy kidney function, JR would need a GFR of 60 or greater and a UACR less than 30 mg/g. Since JR meets both of these criteria, we can rest well knowing JR’s kidneys are healthy and flowing.
Answer 3 is incorrect. 7.25% of respondents chose this answer, “Urinary albumin creatinine ratio less than 30 mg/g and GFR of 30-45.” There are two major indicators of kidney health for people with diabetes, Glomerular Filtration Rate (GFR) and Urinary Albumin Creatinine Ratio (UACR). According to the ADA Standards, to have a healthy kidney function, JR would need a GFR of 60 or greater and a UACR less than 30 mg/g. Even though JR’s UACR is less than 30mg/g, the GFR is sluggish at 30-45. For this reason, this is not the best answer.
Finally, Answer 4 is incorrect. 4.59% chose this answer, “Creatinine of 1.5 and urinary albumin creatinine ratio of 300 mg/g or greater.” There are two major indicators of kidney health for people with diabetes, Glomerular Filtration Rate (GFR) and Urinary Albumin Creatinine Ratio (UACR). According to the ADA Standards, to have a healthy kidney function, JR would need a GFR of 60 or greater and a UACR less than 30 mg/g. In this response, we only know the creatinine level (which is elevated), but no GFR is calculated. In addition, the UACR is very elevated at 300 mg/g. For these reasons, this is not the best answer.
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!
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
Two Registration Options
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
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.
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.
Preparing for BC-ADM Exam? Learn about Exam updates at Free Webinar | Feb 9th
Are you Preparing for the BC-ADM Exam?
We have some exciting exam updates to share.
Join Coach Beverly, Wednesday February 9th at 11:30 am PST for everything you need to know to prepare!
Becoming Board Certified in Advanced Diabetes Management (BC-ADM) provides an opportunity for diabetes specialists with an advanced degree in their field (plus a professional license as an advanced practice nurse, registered dietitian, registered pharmacist, or provider) to increase the breadth and depth of their diabetes knowledge. The scope of advanced diabetes practice includes management skills such as medication adjustment, medical nutrition therapy, exercise planning, counseling for behavior management, and psychosocial issues.
Attaining optimal diabetes management includes using a person-centered approach coupled with assessment, screening, management, and monitoring of acute and chronic diabetes co conditions. This webinar will review changes in requirements 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. We hope you can join us for this webinar.
Can’t join us live? No worries! Registrants get priority notification and link to recorded version within 24 hours.
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
Two Registration Options
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
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.
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.
Question of Week | How do they calculate UACR?
What best describes how to measure urinary albumin creatinine ratio?
- Divide blood creatinine results with urinary albumin secretion rate.
- Collect 24-hour urine sample and add alkaline solution to determine albumin ratio quantity.
- Draw a fasting blood sample to determine ratio of creatinine in grams to albumin in milligrams.
- Divide urinary albumin concentration in milligrams by creatinine concentration in grams.
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.
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
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
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.
2022 ADA Standards – New Updates and Findings
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!
Start reviewing the Standards Today with our CDCES Coach App!
Click below to download our CDCES Coach App to read the Standards today.
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:
- A review of changes and updates to the 2022 ADA Standards of Medical Care
- Identification of key elements of the position statement
- 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!
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 | Who needs a CGM based on New ADA Standards?
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.
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!
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
Two Registration Options
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
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.
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.
Question of Week | Healthy Kidney Labs?
Evaluating kidney function is important to determine the most beneficial treatment interventions. Which of the following measurements would indicate that JR has healthy kidney function?
- 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
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
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
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.
Preparing for the CDCES Exam FREE Webinar | Jan 26th
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.
What is a Certified Diabetes Care and Education Specialist?
Read More: What is a CDCES? First awarded in 1986, as Certified Diabetes Educator (CDE) credential and in 2020 with a new name: Certified Diabetes Care and Education Specialist (CDCES) to more accurately reflect the specialty. CDCES has become a standard of excellence for the delivery of quality diabetes education. Those who hold this certification are known to possess comprehensive knowledge of and experience in diabetes prevention, management, and prediabetes. “Becoming a Certified Diabetes Care and Education Specialist (CDCES) is one of the best professional and personal decisions I have ever made.” – Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM 
Why become a CDCES?
Three Reasons from Coach Beverly
Read More: 3 Reasons to Become a CDCES “The best part of becoming a CDCES is working with my colleagues and people living with diabetes. As diabetes educators, we hear compelling and beautiful life stories. I am astounded by the barriers they face and inspired by their adaptability, problem-solving skills, and resilience.” Reason 1: CDCES is a widely recognized certification by employers and health care professionals throughout the U.S. This credential demonstrates a specialized and in-depth knowledge in the prevention and treatment of individuals living with pre-diabetes and diabetes. Reason 2: Currently, 10% of people in the U.S. have diabetes and another 35% have pre-diabetes which means 45% of Americans are running around with elevated blood glucose levels. Given this epidemic, there will be plenty of future job opportunities. Reason 3: Having my CDCES along with my nursing degree, has opened many doors of opportunity; from working as an inpatient Diabetes Nurse Specialist in a hospital to working as a Manager of Diabetes Education in the outpatient setting to starting my own consulting company.
Studying for the CDCES Exam?
Enroll in CDCES Online Prep Bundle + 5th Ed ADCES Review Guide Book | 47 CEs
This bundle includes our CDCES Online Prep Bundle plus the ADCES Review Guide.
The online bundle includes Level 1, Level 2, and Level 3 (Boot Camp), plus two bonus courses. The ADCES Review Guide offers over 480+ practice questions and is a fantastic independent study tool and comprehensive resource for the Diabetes Care and Education Specialist Exam.
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:
- A review of changes and updates to the 2022 ADA Standards of Medical Care
- Identification of key elements of the position statement
- 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!
[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.
![](/wp-content/uploads/2023/01/insta-png-v5.png")
