LR is a 30-year-old with type 1 diabetes. LS uses 25 units of basal insulin and 20 units of bolus insulin (about 6-7 units per meal) per day. Using the rule of 1700, what is LR’s insulin sensitivity factor?
Click Here to Test your Knowledge
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 Schedule | Download Course Flyer
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.
Join us LIVE for this Virtual Course and enjoy a sense of community!
Team of expert faculty includes:
Deluxe Option for $499: Virtual Program includes:
Deluxe Version includes Syllabus, Standards and Swag*:
Deluxe Option for $499: Virtual Program includes:
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.
For last week’s practice question, we quizzed test takers on the cause of JR’s leg pain. 67% of respondents chose the best answer. We want to 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 below: Answer Question
Question: JR is experiencing lower extremity pain and asks to get their gabapentin (Neurontin) renewed? When asked, JR says the pain is so bad in their calf muscles when walking, that they have to sit down and rest. What best describes the cause of JR’s pain?
Answer Choices:
As shown above, the most common choice was option 2, the second most common answer was option 3, then option 4, and then finally option 1.
Answer 1 is incorrect. 4.72% chose this answer, “Loss of protective sensation (LOPS).” This is a juicy answer because people with neuropathy and loss of protective sensation are often prescribed gabapentin to treat nerve pain. However, when we learn that JR’s calf pain only occurs when walking, we experience an “ah-ha” moment. The cause of JR’s pain is lack of arterial blood flow to the lower extremities, also known as peripheral arterial disease (PAD). The classic symptom of PAD is pain in calf muscles or buttocks when walking that is relieved by stopping. Neuropathy is most often described as burning pain in lower extremities that is often worse at night.
Answer 2 is correct. 66.94% of you chose this answer, “Peripheral arterial disease (PAD).” JR is experiencing lack of arterial blood flow to the lower extremities, also known as peripheral arterial disease (PAD). A classic symptom of PAD is pain in calf muscles or buttocks when walking that is relieved by stopping. Perhaps JR was prescribed gabapentin due to an incomplete medical assessment. With this new information, we can collaborate with the provider to see if referral to a vascular specialist is warranted to evaluate if further intervention is needed.
Answer 3 is incorrect. 14.33% of respondents chose this answer, “Autonomic neuropathy.” Autonomic neuropathy in people with diabetes does not cause lower extremity pain. Lower extremity pain is due to small and large nerve fiber destruction or peripheral arterial disease (PAD). People with autonomic neuropathy and diabetes are at higher risk of gastroparesis, sexual dysfunction, resting tachycardia and a myriad of other conditions.
Finally, Answer 4 is incorrect. 14.01% chose this answer, “Small nerve fiber neuropathy.” This answer is tempting because people with small nerve fiber neuropathy are often prescribed gabapentin to treat nerve pain. However, when we learn that JR’s calf pain only occurs when walking, we experience an “ah-ha” moment. The cause of JR’s pain is lack of arterial blood flow to the lower extremities, also known as peripheral arterial disease (PAD). The classic symptom of PAD is pain in calf muscles or buttocks when walking that is relieved by stopping. Small nerve fiber neuropathy is most often described as burning pain that is often worse at night.
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!
People with diabetes are at increased risk of Lower Extremity Complications. This course reviews the steps involved in performing a detailed assessment of the lower extremities, including how to use a monofilament and tuning fork to detect neuropathy. We also discuss the significance of Ankle Brachial Index and strategies to prevent lower extremity complications.
Objectives:
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 Schedule | Download Course Flyer
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.
Join us LIVE for this Virtual Course and enjoy a sense of community!
Team of expert faculty includes:
Deluxe Option for $499: Virtual Program includes:
Deluxe Version includes Syllabus, Standards and Swag*:
Deluxe Option for $499: Virtual Program includes:
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.
Having diabetes is a lot of work. We ask participants with diabetes to change their eating habits, drink water, move more, take a bunch of medications and attend diabetes classes plus see providers on a regular basis. In addition, we collaborate with and encourage them to get their ABC’s (A1C, Blood pressure, Cholesterol) to target.
The short answer is YES. Making these hard fought behavior changes can add years to one’s life.
A recent study published in the JAMA Network last month suggests that people living with Type 2 Diabetes can increase life expectancy by reducing 4 risk factors and hitting specific metabolic targets.
This study evaluated life expectancy increases among 421 people living with type 2 diabetes for those who reduced A1C, systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and body mass index (BMI) with each biometer goal was broken into quartiles.
Providers can shine a light on these findings to encourage people with diabetes to make those difficult behavior changes, and to keep working at it when the going gets tough. Their efforts do make a difference in improving life expectancy and daily quality of life.
Participants who reduced their A1C saw the highest increase in life expectancy compared to the other biometers. For those with the highest A1Cs, lowering their levels added years to their life expectancy.
Lowering blood pressure added just over a year to the participant’s life expectancy.
Participants with lower LDL cholesterol, saw a change in life expectancy by a few months.
Participants who were able to decrease their BMI saw a increased life expectancy by a few years.
Smoking cessation also had an impact with 0.7 years added for women aged 50 to 60 years and 1.1 years for men aged 70 to 80 years of age.
Overall, we hope this news brings hope to those living with Type 2 diabetes and improves care knowing that reaching these goals can extend their lifetime.
To read more click here and here.
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.
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 a priority notification and a link to the recorded version within 24 hours.
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:
Deluxe Option for $499: Virtual Program includes:
Deluxe Version includes Syllabus, Standards and Swag*:
Deluxe Option for $499: Virtual Program includes:
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.
As a nine-year-old, I couldn’t wait for my Grandparents to arrive for Christmas. Since they lived in Canada and we lived in California, we didn’t get to see them enough. Plus, they had eight kids and an old station wagon that could barely make the 1000 mile journey.
In December of 1972, as they tumbled out of the station wagon onto our front lawn, my Grandfather scooped me up in his arms, gave me the biggest hug, and presented me with a bag of beautiful mandarin oranges. His face was glowing with joy as we each peeled the thin skins of that winter citrus fruit and slowly ate each segment. Me and my grandfather had never tried mandarins before and we both fell in love with this magical fruit that day, sitting on my front porch, together. This moment is one of my fondest childhood memories.
Fruit and vegetables ARE magical. They are loaded with fiber, micronutrients, energy, and mostly smell and taste so good. They are mood boosters, feed our healthy gut bacteria, and can lead to meaningful connections. I am a certified vegetable and fruit aficionado, happily sharing my enthusiasm for these fiber and nutrient powerhouses with the people I serve at our rural community clinic. However, many people are not eating the recommended daily dose.
How do we help others rekindle their connection to fruit and vegetables?
Most Americans eat only one serving of fruit and 1½ servings of vegetables daily, far less than what’s recommended. And a quarter of the vegetables consumed are potatoes, and half of those are consumed as fries. I think we need to keep it simple and start with realistic goals that people can achieve. I am excited to share this research with you in the hopes of increasing fruit and veggie intake in America, one bite at a time.
How many servings of Fruit and Veggies a Day to improve health outcomes?
A 2021 study in the journal Circulation backs up the long-standing nutritional guideline that consuming five daily servings of a variety of fruits and vegetables increases lifespan. More specifically, the study encouraged participants to consume at least 2 servings of fruits and 3 servings of vegetables daily.
“People who eat five servings of vegetables and fruit daily have 13 percent lower risk of all-cause death compared to people who eat two servings of fruit and vegetables per day,” says Dong Wang, a faculty member at Harvard Medical School and Brigham and Women’s Hospital in Boston, and one of the study’s researchers. They also had a 12% lower risk of death from cardiovascular disease, a 10% lower risk from cancer, and a 35% lower risk from respiratory disease, compared with people who ate just two daily servings.
The Dietary Guidelines for Americans recommend 2½ cups of vegetables and two cups of fruit daily, which totals about nine servings per day. One “serving” is a half-cup of any vegetables or fruits or a whole cup of salad greens. This study found that after 5 servings a day, there was no additional decrease in mortality. In a way, this is good news.
If we can just encourage people to eat 2 pieces of fruit a day and one serving of veggies with each meal, we are making a significant impact in improving health outcomes.
Eating a rainbow of fruits and vegetable is key because they each contain different beneficial nutrients and antioxidants. According to the study, fruits and vegetables, including leafy greens, citrus fruits, and berries, were associated with lower mortality.
However, starchy vegetables such as peas, corn, and potatoes were not associated with a reduced risk of death or chronic diseases. The study results didn’t find harm or an increased risk of mortality from these options, but they also didn’t decrease mortality. Consider them neutral.
More good news – It doesn’t seem to matter whether people consume fresh, frozen or canned fruits and vegetables. They all offer similar nutrient values. The main consideration is promoting affordable and appealing fruits and veggies based on the individuals’ taste and preferences.
More resources from our Article Library
Read more in this Circulation Article.
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:
Download Course Schedule | Download Course Flyer
Deluxe Option for $499: Virtual Program includes:
Deluxe Version includes Syllabus, Standards and Swag*:
Deluxe Option for $499: Virtual Program includes:
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.
LS is 43 with type 2 diabetes, with an A1C of 8.8%, UACR is 32 mg/g, GFR is 48, and blood pressure is 146/84 or greater on 2 different occasions. Current medications include metformin 1000mg BID, lovastatin 20mg, glipizide 20mg.
Based on the ADA standards of care, in addition to lifestyle encouragement, adding which medications would most improve outcomes?
Click Here to Test your Knowledge
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 Schedule | Download Course Flyer
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.
Join us LIVE for this Virtual Course and enjoy a sense of community!
Team of expert faculty includes:
Deluxe Option for $499: Virtual Program includes:
Deluxe Version includes Syllabus, Standards and Swag*:
Deluxe Option for $499: Virtual Program includes:
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.
Are you preparing for the CDCES Exam?
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.
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
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.
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.
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 Schedule | Download Course Flyer
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.
Join us LIVE for this Virtual Course and enjoy a sense of community!
Team of expert faculty includes:
Deluxe Option for $499: Virtual Program includes:
Deluxe Version includes Syllabus, Standards and Swag*:
Basic Option for $399: Virtual Program includes:
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!
[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.
For last week’s practice question, we quizzed test takers on the most accurate statement based on the new ADA Standards of Care on DSME Programs. 60% of respondents chose the best answer. We want to 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 below: Answer Question
Question: Which of the following best represents the 2022 update to the National Standards for Diabetes Self-Management Education and Support (DSMES)?
Answer Choices:
As shown above, the most common choice was option 1, the second most common answer was option 3, then option 2, and then finally option 4.
Answer 1 is incorrect. 16.73% chose this answer, “Due to the complexity of delivering DSME in today’s health care environment, 2 new standards have been added for a total of 12 Standards.” This was a juicy answer, but not the best one. The authors of this updated Standard of Practice for DSMES, decided that to INCREASE access to DSMES, there needed to be a DECREASE of bureaucracy and paperwork. They managed to maintain the essence of the original 10 Standards in this new streamlined version with only SIX standards. There was also a much needed intensive focus on recognizing and addressing Social Determinants of Health and breaking down barriers to DSMES access.
Answer 2 is incorrect. 11.49% of you chose this answer, “About 20 – 30% of people with Medicare or private insurance currently utilize DSMES services.” I wish this was the best answer. However, according to the ADA Standards, only 6-8% of Medicare recipients participate in DSMES. This lackluster level of participation is due to a multitude of factors and is best addressed by an interdisciplinary action committee, with stakeholders from the community and the health care team. Plus, creating a multi-pronged and thoughtful marketing plan is crucial to raise awareness of DSMES services.
Answer 3 is incorrect. 12.10% of respondents chose this answer, “To maintain quality, at least one of the DSMES team members needs to have either a CDCES or BC-ADM.” In the old days, this was a requirement. However, since many rural communities may not have access to a CDCES or BC-ADM, this requirement has been dropped for over 10 years. The good news is that a variety of health care professionals can make up the DSMES Team. Specifically, the new guidelines say that, “The DSMES team may include one or a variety of healthcare professionals. The evidence recommends the inclusion of dietitians, nurses, pharmacists, or all other disciplines with special certifications that demonstrate mastery of diabetes knowledge and training, such as BC-ADM and CDCES, can support all DSMES services, including clinical assessment.
Finally, Answer 4 is correct. 59.68% chose this answer, “Less focus on “checking the box” when delivering curriculum and more focus on the individual needs.” YES, this is the BEST Answer. The authors who gathered to write this paper, were from different parts of the country serving a wide variety of communities. I believe, by assembling this thoughtfully chosen and diverse group or diabetes advocates and educators, they created a fresh and more inclusive set of standards. The overall theme is more community engagement with a clearn focus on the individual needs versus completing check boxes of educational topics covered. I commend the authors and invite you to peruse this very important document that summarizes the delivery of effective and person centered DSMES.
2022 National Standards for Diabetes Self-Management Education and Support– A joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics.
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!
This course provides you with a succinct overview of the latest standards for Diabetes Self-Management Education (DSME) and Support Programs. If you are taking certification exams or considering setting up a DSME program, this program is designed for you. We highlight the newly revised and simplified 2022 Standards and provide strategies on program implementation. In addition, we discuss Medicare Reimbursement and covered benefits. This course provides insights into the exam philosophy and also highlights critical content areas.
Objectives:
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:
Download Course Schedule | Download Course Flyer
Deluxe Option for $499: Virtual Program includes:
Deluxe Version includes Syllabus, Standards and Swag*:
Deluxe Option for $499: Virtual Program includes:
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.