Rationale of the Week | Primary Goals for the DPP?
For last week’s practice question, we quizzed participants on primary goals of the DPP. 62% 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
Question: The Diabetes Prevention Program (DPP) primary lifestyle intervention goals include achieving and maintaining a minimum of 7% weight loss and 150 minutes of moderate-intensity physical activity per week.
What outcomes are expected from these intervention goals?
Answer Choices:
- DPP lifestyle intervention resulted in a 58% reduction of rate of diabetes over 3 years.
- Sustained interventions over 15 years reduced risk of progression to type 2 diabetes by 27%.
- Achieving 150 minutes of moderate-intensity activity per week without weight loss is adequate to reduce incidence of type 2 diabetes.
- All the above.
Getting to the Best Answer
Answer 1 is incorrect. 20.14% chose this answer. “DPP lifestyle intervention resulted in a 58% reduction of rate of diabetes over 3 years.” A is correct but is not the best answer. The initial DPP study included 1,079 participants who participated in lifestyle interventions and found a 58% reduction in the rate of diabetes.
Answer 2 is incorrect. 11.95% of you chose this answer. “Sustained interventions over 15 years reduced risk of progression to type 2 diabetes by 27%.” B is correct but not the best answer. The 15-year follow-up study validated that diabetes incidence was reduced by 27% for lifestyle intervention participants.
Answer 3 is incorrect. About 6.31% of respondents chose this. “Achieving 150 minutes of moderate-intensity activity per week without weight loss is adequate to reduce incidence of type 2 diabetes.” Response C is correct but not the best answer. Weight loss is an important factor in reducing the risk of diabetes progression; however, the DPP study found that even without achieving weight loss goals, the incidence of type 2 diabetes was reduced by 44% if at least 150 minutes of physical activity per week was achieved.
Finally, Answer 4 is correct. 61.60% chose this answer. “All of the above.” Answer D is correct and is the best answer.
References:
- American Diabetes Association Professional Practice Committee; 3. Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes—2024. Diabetes Care1 January 2024; 47 (Supplement_1): S43–S51. https://doi.org/10.2337/dc24-S003
National Diabetes Prevention Program Coverage Toolkit. Downloaded on July 19th, 2024 from https://coveragetoolkit.org.
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!
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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
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 | Most important action in case of fire?
JR lives with type 1 diabetes and uses an insulin pump and sensor. They live in an area that is fire prone and JR asks you about how they should prepare for an emergency if evacuation is required.
What action is most important?
- Make sure they have their health history documented and stored in a watertight bag.
- Prepare an emergency kit that includes at least one week’s worth of diabetes supplies.
- Keep a fire extinguisher within easy reach and know the exit routes.
- Reach out to emergency responders ahead of time to let them know that JR has type 1 diabetes.
Want to learn more about this question?
Join us live on July 18th, for our
Type 2 Diabetes Intensive
Level 4 | Advanced Level & Specialty Topics
This course provides a detailed overview of the pathophysiology of type 2 diabetes, prevention strategies, & cardiovascular risk reduction. In addition, we highlight type 2 treatment approaches including nutrition, activity, oral & injectable medications plus screening & treatment guidelines for micro & macrovascular diseases. Through case studies & discussion, we highlight strategies to focus on a person-centered approach along with attention to psychosocial care for people living with diabetes.
Objectives:
- Discuss the current epidemiology of type 2 diabetes.
- Describe the classification, terminology & diagnostic criteria for diabetes.
- Identify the eight pathophysiologic defects associated with the ominous octet.
- Describe evidence and strategies to prevent type 2 diabetes.
- State strategies to implement a person-centered approach to those with diabetes.
- Discuss key aspects of type 2 diabetes management including education, therapeutic lifestyle changes, glucose, lipid, & hypertension management plus referrals.
- Understand the overarching principles of management of type 2 DM.
Learning Outcome:
Attendees will be able to articulate and integrate into practice the impact, goals, and management strategies for people living with type 2 diabetes.
Target Audience:
This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research.
CDR Performance Indicators:
- 10.4.2
- 10.5.1
Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 15 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert.
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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our Level 4 | Type 2 Diabetes Intensive awards 2.0 CPEUs in accordance with the Commission on Dietetic Registration’s CPEU Prior Approval Program.
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 | Why did 16 year old stop taking meds?
For last week’s practice question, we quizzed participants on Why a 16 year old stopped taking their medication. 88% 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
Question: A 16 year old tells you they stopped taking their diabetes medications. “It doesn’t seem to matter whether or not I take them”.
What is the best response?
Answer Choices:
- Acknowledge their honesty and ask them to discuss with their provider.
- Gently remind them that stopping their meds is dangerous.
- Ask them if they are experiencing trauma at home.
- Explore possible reasons for this action.
Getting to the Best Answer
Answer 1 is incorrect. 6.9% chose this answer. “Acknowledge their honesty and ask them to discuss with their provider.” The first part of this answer is correct. We want to acknowledge their honesty and provide a non-judgmental environment. However, we want to explore their feelings further as part of this current appointment instead of stopping the conversation and deferring to the provider. For more information on this topic, you are invited to our Language and Diabetes Webinar. We hope you can join us. See below for more info!
Answer 2 is incorrect.2.39% of you chose this answer. “Gently remind them that stopping their meds is dangerous.” This person is experiencing diabetes distress, so we want to acknowledge their feelings and explore strategies to decease distress. When people with diabetes are experiencing distress, approaching the situation with curiosity and non-judgment is always the best approach. For more information on this topic, you are invited to our Language and Diabetes Webinar. We hope you can join us. See below for more info!
Answer 3 is incorrect. About 1.59% of respondents chose this. “Ask them if they are experiencing trauma at home.” While trauma at home can cause significant distress, this individual has stopped taking their diabetes medications since they are not sure if they actually work. Asking about trauma at home doesn’t match the concern they are verbalizing at this moment. When people with diabetes are experiencing distress, approaching the situation with curiosity and non-judgment is always the best approach. For more information on this topic, you are invited to our Language and Diabetes Webinar. We hope you can join us. See below for more info!
Finally, Answer 4 is correct. 89% chose this answer. “Explore possible reasons for this action.” YES, this is the best answer and almost 90% of respondents chose this answer. GREAT JOB. When people with diabetes are experiencing distress, approaching the situation with curiosity and non-judgment is always the best approach. For more information on this topic, you are invited to our Language and Diabetes Webinar. We hope you can join us. See below for more info!
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!
Want to learn more about this question?
Join us live on July 11th at 11:30 am PST for our
Language and Diabetes FREE Webinar
What we say matters.
As educators, advocates, spouses, friends, and providers, our use of language can deeply affect the self-view of people living with diabetes every day.
Intentional communication is a powerful tool that can uncover trauma, identify barriers, and move both the provider and person with diabetes toward a greater understanding of the issues involved.
The language used in the health care setting is immensely important in determining trust, mutual respect, and meaningful long-term relationships.
Topics covered include:
- Learn phrases, words, and approaches that can be left behind.
- Describe diabetes language that is respectful, inclusive, person-centered, and imparts hope.
- Discuss how to evaluate for ACE and provide trauma-informed care
- Practice communicating about diabetes using phrases free from judgment with a focus on a strength-based approach
This webinar is free and you can view it at any time, on any device. To earn CEs, you can purchase this course at our online university store.
Coach Beverly Thomassian, RN, MPH, BC-ADM, CDCES
Author, Nurse, Educator, Clinician, and Innovator, Beverly has specialized in diabetes management for over twenty years. As president and founder of Diabetes Educational Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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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.
Keeping Cool in the Heat – Tips for People with Diabetes
Hotter Temperatures Worsen Diabetes Outcomes
Increasing global temperatures are expected to impact the health of people living with diabetes and lead to worse outcomes, according to an article published in the Journal of Community Hospital Internal Medicine Perspectives,
People with diabetes are at greater risk of experiencing dehydration and cardiovascular events during periods of extreme heat. Several studies reveal that people with diabetes are more likely to need emergency care during heat waves and those with a history of heart disease are most vulnerable.
Heatwaves can pose increased health risks for people with diabetes due to several factors:
- Increased Cardiovascular Strain: People with diabetes already have a higher risk of cardiovascular issues. The stress of heat waves and high temperatures can further strain the cardiovascular system, increasing the risk of heart-related complications.
- Heat Stress: Heat waves can cause heat stress, especially in individuals with diabetes who may have autonomic neuropathy. Autonomic neuropathy affects the body’s ability to regulate temperature, making it more challenging to adapt to hot weather.
- Dehydration: High temperatures can lead to excessive sweating and fluid loss, increasing the risk of dehydration. Dehydration can affect blood glucose levels and can be associated with hyperglycemia. It can also make it more challenging to manage diabetes effectively.
- Medication Storage: Extreme heat can impact the effectiveness of insulin. Storing insulin at temperatures outside the recommended range can lead to reduced potency, making it less effective in managing blood sugar levels.
- Protect Insulin Pumps and Glucose Meters: If you use an insulin pump or glucose meter, make sure to keep them out of direct sunlight and heat. High temperatures can affect their accuracy and performance.
To keep healthy and reduce risk during heatwaves, we have put a list together of actions people with diabetes can take to stay safe in the heat.
Actions that help people with diabetes stay safe during extreme heat.
Download PDF Handout of 19 Actions Here
- Stay Hydrated: The heat can lead to increased fluid loss through sweating. Dehydration can affect blood sugar levels, so it’s crucial to drink plenty of water throughout the day. Avoid sugary drinks and opt for water or sugar-free beverages.
- Choose the Right Time for Physical Activity: If engaging in outdoor activities, try to do so during cooler parts of the day, such as early morning or late evening. Heat can affect energy levels and might lead to fluctuations in blood sugar levels.
- Wear Proper Footwear: Pavement and walkways can exceed 150 degrees and walking barefoot can lead to serious burns. Always wear shoes. Also, be aware that hot weather can cause feet to swell. Wear comfortable, well-fitting shoes and socks helps to prevent blisters and potential foot injuries.
- Dress Lightly: Wear light, breathable clothing that allows your skin to stay cool and sweat to evaporate. Loose-fitting, moisture-wicking fabrics are ideal for hot weather.
- Use Sunscreen and hats: Protect your skin from sunburn with sunscreen, long sleeves, pants, and hats. Also don’t forget shoes to prevent sunburned feet.
- Be Prepared for Emergencies: Always carry a form of medical identification that indicates you have diabetes, along with emergency contact information. If away from home, inform companions about your condition and what to do in case of an emergency.
- Seek Shade and Take Breaks: When spending time outdoors, find shaded areas and take frequent breaks to rest and cool down. Avoid direct exposure to the sun, especially during peak heat hours (typically 10 am to 4 pm).
- Plan Meals Mindfully: Eat light, refreshing meals that require minimal cooking. Fresh fruits, vegetables, and salads are excellent options during hot weather.
- Use Fans and Air Conditioning: If possible, stay in air-conditioned or well-ventilated spaces. Electric fans can also help circulate air and make you feel cooler.
- Close Curtains and Blinds: Keep curtains and blinds closed during the hottest parts of the day to block out direct sunlight and reduce indoor temperatures.
- Take Cool Showers or Baths: A cool shower or bath can help lower your body temperature and provide temporary relief from the heat.
- Use Cooling Products: Consider using cooling towels, vests, or gel packs to help lower body temperature. Use Wet Cloths or Ice Packs: Apply a cold, damp cloth to the forehead, neck, and wrists. Ice packs in these areas can also help cool down.
- Create Cross-Ventilation: Open windows on opposite sides of your home to create a cross-breeze, allowing cooler air to flow through.
- Stay Informed: Keep an eye on weather forecasts and heat advisories. Stay informed about the temperature and be prepared for extreme heat.
- Limit the Use of Heat-Producing Appliances: Avoid using heat-producing appliances like ovens and stoves during the hottest parts of the day. Opt for microwave cooking or cold meals instead.
- Avoid Hot Cars: Steering wheels, seat covers, and seatbelts can become very hot. Check first before touching. Temperatures inside a car can rise rapidly and become life-threatening.
- Check on Vulnerable Individuals: Keep an eye on elderly relatives, neighbors, and those with health conditions who may be more susceptible to heat-related issues.
- Communicate with Healthcare Team: It’s essential to take proactive steps to stay cool and prevent heat-related illnesses. If you or someone else experiences symptoms of heat exhaustion or heatstroke (such as dizziness, confusion, rapid pulse, or vomiting), seek medical attention immediately.
- Download PDF Handout of 19 Actions Here and share it with colleagues and individuals with diabetes.
Join us LIVE in San Diego for our DiabetesEd Training Conference
October 9th-11th, 2024
Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego on October 9-11, 2024.
You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.
Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy!
Each day, we provide a healthy breakfast, including fresh coffee, to kick off your morning. Our instructors co-teach the content to keep things fresh and lively. Plus, we play DiaBingo to reinforce key content. In addition, we provide plenty of movement breaks led by volunteers from the audience. Did we mention delicious lunches and a conference meeting space just minutes from San Diego Bay?
Friend Discount: 3 or more only $559-$799 (based on registration package) per person. Email us at info@diabetesed.net with the name and email of each registrant to get the discount!
Time: The course is Wednesday through Friday. Join us for breakfast at 7:00 a.m. each day. The class begins at 8:00 a.m. and ends at 5:00 p.m. on Wednesday and Thursday and at 3:00 p.m. on Friday.
Who should attend? 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 healthcare providers interested in staying up to date on current practices of care for people with diabetes and preparing for the certification exams.
Registration Fee includes:
- 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
- 18+ CEs: earned at the Live Seminar (RDs earn 18.75 CEs while Nurses & CA Pharmacists earn 22.75 CEs)
- 10 Bonus Online Courses, Earn 10+ CEs: As a course attendee, you automatically receive a bonus online course bundle of 13 online courses valued at over $179. Coach Beverly carefully chose each of these courses based on student feedback on which content best helped them succeed at the certification exams and in their clinical practice. You will be given instructions after you purchase the course on how to enroll in our Online University and get started!
- Healthy breakfast all days, gourmet lunch both days and refreshments.
- E-version of the syllabus
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
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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.
AH-HA – A Fresh Approach to DSME
AH-HA – A Fresh Approach to DSME
by Beverly Thomassian, RN, MPH, CDCES, BC-ADM
As diabetes professionals, we have all witnessed that moment of clarity that lights up a person’s face when they experience that “AHA” moment. As educators, the “AHA” experience is the end result we work toward; it sends a strong signal that there is a breakthrough; a new understanding that comes from deep inside. That is what the AH-HA Diabetes Self-Management Program is all about. This highly interactive person-driven program uses a “discovery learning” approach to diabetes education. It recognizes the individual’s experience and expertise and builds confidence that they can succeed in trying new strategies to improve their diabetes self-management and quality of life. The good news is that the approach is straightforward to implement. Additionally, educators can use the AH-HA approach with individuals or in a group setting.
There are three main components to the AH-HA approach:
- Set up a judgment-free zone.
- Support informed and “wise” decisions.
- Use the 5 M framework for problem-solving.
Judgement Free Zone
Creating a judgment-free zone during diabetes coaching and education sessions lays the groundwork to make meaningful connections. This “safety zone” provides individuals with a place to share their truth and have someone acknowledge and recognize what they are going through. It also helps to identify areas of distress and collaborate on problem-solving. Setting a judgment-free zone also opens the door to more fruitful conversation when gathering groups together in person or virtually. To create this environment, the facilitators need to establish the ground rules. For example, the facilitator might say, “There are no good or bad blood sugars or good or bad foods. If a person is stressed out and eats a donut, they are not cheating; they are choosing to have a donut. If people have blood glucose levels out of range, they are not failing; they need support and help with problem-solving based on their lived experiences.” If someone uses judgmental terms during the session, the educator gently reminds them that this is a judgment-free zone and encourages them to rephrase it.
Informed vs. “Wise” Decision
When discussing diabetes self-management goals and behavior adjustments, the AH-HA program encourages individuals to make not only “informed” choices (that work for their diabetes) but also “wise” choices. Wise choices consider and recognize the individual’s values, preferences, needs, and wants. For example, if a person tells you, “I am going to cut out carbs to get my blood sugars under target,” we would acknowledge that this might be an informed choice. “Yes, cutting out carbs will likely lower your blood sugars, but is it a “WISE” choice?” Does it match their values, preferences, needs, and wants? Or would cutting out carbs significantly decrease their life’s pleasure and joy? Of course, the ultimate decision is up to the individual, but it is worth helping them explore and consider their choices out loud. After all, diabetes lasts a lifetime, and we want to support daily quality of life while reducing the risk of complications.
The next step is to encourage participants to choose an experiment they would like to work on to see how it affects their blood sugars. They can use fingerstick glucose monitoring, or a continuous glucose monitor, to evaluate the results of their actions and decide whether to continue the experiment or try something different.
The 5 M’s Framework
In the AH-HA model, participants are asked to guess the 5 “M” words that impact blood glucose levels. Monitoring is not one of the official M’s because it results from the 5 M’s and is referred to as the glucose number.
The 5 M’s for Diabetes Self-Management Include:
- Mood – including emotions, diabetes distress, and physical stress
- Medicines – type and dose
- Movement – physical activity
- Meals – food, beverages, and portions
- Minutes – the timing of medicine, meals, movement, and monitoring
Initially, facilitators explore the meaning of each of the 5 M’s and continue to use them as a discussion framework in each session.
The repetition of returning to the 5 M’s each meeting provides participants with a way to organize and integrate diabetes information into their own lives.
This method is quick and doesn’t focus on teaching all the ins and outs of diabetes. Instead, the instructors lean into the lived experience and expertise of the individuals in their own lives.
Over time, participants start to intuitively use the 5 M framework to discuss their diabetes self-management efforts. The 5 M’s also help participants adopt new problem-solving skills and expand their thinking beyond self-blame and the immediate outcome of their decisions. Plus, since the participants are coming up with their own solutions, it provides them with a customized plan for future and similar situations.
The 5 M framework helps participants become quickly engaged in individual sessions and conversations with other group members. In group settings, other members may point out other M’s to consider or provide words of support. In individual settings, educators can recognize the M currently being addressed and explore if another M might also be worth considering. For example, an educator might say, “I hear you are taking your medicines every day, yet your blood sugars are still above your target goal. Would you consider adding any other M’s to your experiment?”
Coach Beverly is one of the diabetes education specialists co-leading virtual group classes as part of the ongoing research on the AH-HA study. As an instructor and observer, she has witnessed the effectiveness of this approach firsthand. Participants who might be initially unsure about the AH-HA program approach quickly become more engaged in their own diabetes self-management and are excited to help coach and support other class members. You are welcome to download a PDF of this article for your reference and to share it with your colleagues. Plus, since this study is ongoing, people living with type 2 diabetes who meet the criteria are encouraged to sign up to benefit from this free 5-session program.
Here is to more “AH-HA” moments and transformation of diabetes self-management education through self-discovery. I want to give special thanks to my mentor and lead facilitator, Susan Guzman, PhD, who inspires me with new and profound communication approaches each time we collaborate.
Download PDF of this Article to Share.
References
The AH-HA! Project: Transforming Group Diabetes Self-Management Education Through the Addition of Flash Glucose Monitoring – William H. Polonsky, Addie L. Fortmann, Emily C. Soriano, Susan J. Guzman, and Martha M. Funnell
Kloss KA, Funnell MM, Nwankwo R. Going Beyond Education: A Practical Framework for Diabetes Self-Management and Decision-Making. ADCES in Practice. 2022;10(5):8-12. doi:10.1177/2633559X221114871
Great news. There is still space for individuals with type 2 diabetes to join this FREE virtual AH-HA research program led by a team of experts.
Innovative Diabetes Education Program: AHHA Study
A NEW research opportunity for people with Type 2 Diabetes
Are you a diabetes health care professional or person with diabetes who is ready to get on track with your diabetes?
We want to encourage you to let your community know about an exciting research opportunity.
We are inviting people diagnosed with type 2 diabetes less than 5 years ago, who live anywhere in the U.S., with a most recent A1C of 7.5% or higher to click this link below to see if they qualify for the study.
If so, the Behavioral Diabetes Institute is conducting a research study examining how innovative new approaches to diabetes education might help to improve glucose outcomes and quality of life outcomes. Participants will be randomly assigned to take part in one of two different live, online, group education programs. Each group program will be lively and informative, and will meet once weekly for 5 weeks in a row.
Also, half of the participants will receive a continuous glucose monitor and free testing supplies.
To find out more and see if you might qualify, click below to apply. Or for more information, email them at ahhastudy@behavioraldiabetes.org or call us at 858-336-8693.
Get Started – Pre-Qualify Here
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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 | What does Medicare Cover?
For last week’s practice question, we quizzed participants on what Medicare will cover. 54% 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
Question: KT just turned 65 and asks you about Medicare Insurance Coverage for Diabetes.
Which of the following is accurate regarding Medicare Coverage for people living with diabetes?
Answer Choices:
- Medicare Part D covers Diabetes Self-Management Education
- Medicare Part A covers Diabetes Prevention Programs.
- Medicare Part B covers durable medical equipment and diabetes medications.
- Medicare Part A covers hospitalization.
Getting to the Best Answer
Answer 1 is incorrect. 15.38% chose this answer. “Medicare Part D covers Diabetes Self-Management Education.” Actually, medicare Part D helps cover the cost of prescription drugs. Part D is optional and only provided through private insurance companies approved by the federal government. However, Part D is offered to everyone who qualifies for Medicare. Costs and coverage may vary from plan to plan
Answer 2 is incorrect. 11.4% of you chose this answer. “Medicare Part A covers Diabetes Prevention Programs.” Actually, medicare part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Answer 3 is incorrect. About 19.66% of respondents chose this. “Medicare Part B covers durable medical equipment and diabetes medications.” Part B doesn’t help cover diabetes medications, but Part B does cover:
- Services from doctors and other health care providers
- Diabetes Self-Management Education
- Outpatient care, Home health care
- Durable medical equipment (like meters, CGMs, wheelchairs, walkers, hospital beds, and other equipment)
- Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)
Finally, Answer 4 is correct. 53.56% chose this answer. “Medicare Part A covers hospitalization.” YES, GREAT JOB. This is the best answer.
Medicare Part A covers:
- Inpatient care in a hospital
- Skilled nursing facility care
- Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
- Hospice care
- Home health care
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!
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Sign up for DiabetesEd Blog Bytes
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our Level 2 | Setting up a Successful DSME Program awards 1.5 CPEUs in accordance with the Commission on Dietetic Registration’s CPEU Prior Approval Program.
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 | Why did 16 year old stop taking meds?
A 16 year old tells you they stopped taking their diabetes medications. “It doesn’t seem to matter whether or not I take them”.
What is the best response?
- Acknowledge their honesty and ask them to discuss with their provider.
- Gently remind them that stopping their meds is dangerous.
- Ask them if they are experiencing trauma at home.
- Explore possible reasons for this action.
Want to learn more about this question?
Join us live on July 11th at 11:30 am PST for our
Language and Diabetes FREE Webinar
What we say matters.
As educators, advocates, spouses, friends, and providers, our use of language can deeply affect the self-view of people living with diabetes every day.
Intentional communication is a powerful tool that can uncover trauma, identify barriers, and move both the provider and person with diabetes toward a greater understanding of the issues involved.
The language used in the health care setting is immensely important in determining trust, mutual respect, and meaningful long-term relationships.
Topics covered include:
- Learn phrases, words, and approaches that can be left behind.
- Describe diabetes language that is respectful, inclusive, person-centered, and imparts hope.
- Discuss how to evaluate for ACE and provide trauma-informed care
- Practice communicating about diabetes using phrases free from judgment with a focus on a strength-based approach
This webinar is free and you can view it at any time, on any device. To earn CEs, you can purchase this course at our online university store.
Coach Beverly Thomassian, RN, MPH, BC-ADM, CDCES
Author, Nurse, Educator, Clinician, and Innovator, Beverly has specialized in diabetes management for over twenty years. As president and founder of Diabetes Educational Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes.
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
Sign up for DiabetesEd Blog Bytes
Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the diabetes certification exams. CBDCE & ADCES does not endorse any preparatory or review materials for the certification exams, except for those published by CBDCE & ADCES.
**To satisfy the requirement for renewal of certification by continuing education for the Certification Board for Diabetes Care & Education (CBDCE), continuing education activities must be applicable to diabetes and approved by a provider on the CBDCE List of Recognized Providers (www.ncbde.org). CBDCE does not approve continuing education. Diabetes Education Services is accredited/approved by the Commission of Dietetic Registration which is on the list of CBDCE Recognized Providers.
Rationale of the Week | Inpatient didn’t get bolus insulin before lunch. What is best action?
For last week’s practice question, we quizzed participants on missing bolus insulin before lunch, how should you follow up? 66% 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
Question: RT is in the hospital with pneumonia. Based on pre lunch glucose check, RT needs 3 units bolus insulin for lunch. RT’s blood glucose before lunch (20 minutes ago) was 173. You walk in room and RT is almost done with lunch.
What is best action?
Answer Choices:
- Give the 3 units of bolus insulin now.
- Hold the bolus insulin since RT is almost done.
- Recheck the glucose now and adjust insulin dose accordingly.
- Call MD for further instructions.
Getting to the Best Answer
Answer 1 is correct. 66.15% chose this answer. “Give the 3 units of bolus insulin now.” YES, this is the BEST answer. Since RT just checked their blood glucose 20 minutes ago, even though they have consumed most of their meal, it is best to give the bolus insulin now so the insulin can help blunt the post prandial increase. It also provides a great teaching moment to encourage individuals to give insulin before eating, to allow the insulin to start working to match the post meal increase from food.
Answer 2 is incorrect. 5.59% of you chose this answer. “Hold the bolus insulin since RT is almost done.” If we hold the bolus insulin, RT’s blood glucose level will go above target since there would be no insulin available to store the incoming carbohydrates in muscle and liver cells as glycogen.
Answer 3 is incorrect. About 18.94% of respondents chose this. “Recheck the glucose now and adjust insulin dose accordingly.” Unfortunately, this is not a good time to determine insulin needs based on glucose. Since RT is eating, the blood sugars are rising and we might end up giving too much insulin based on this temporary increase. It is best to determine insulin dose on premeal glucose and anticipated carb consumption.
Finally, Answer 4 is incorrect. 9.32% chose this answer. “Call MD for further instructions.” No need to call for instructions in this situation. If a person with diabetes experienced this situation at home, they would simply give their insulin mid-meal. In this situation, it won’t cause any harm to give the recommended dose now. It also provides a great teaching moment to encourage individuals to give insulin before eating, to allow the insulin to start working to match the post meal increase from food.
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!
Want to learn more about this question?
Join us live on [Air Date] for our
Hospitals & Hyperglycemia
Level 2 Standards of Care Intensive
Research demonstrates the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge. This course reviews the evidence that supports inpatient glucose control & outlines practical strategies to achieve targets in the inpatient setting. We incorporate the latest American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provide links to resources & inpatient management templates.
Objectives:
- Describe the impact of hyperglycemia in the hospital setting.
- Discuss the importance of inpatient glucose control.
- List three strategies to get glucose to the goal in the hospital setting.
Learning Outcome:
The diabetes care team will gain insights and knowledge of special considerations, individualized goals, and standards for inpatients with diabetes that they can include in their practice.
Target Audience:
This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research.
CDR Performance Indicators:
- 9.6.7
- 9.6.8
- 10.3.1
Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working diabetes specialist and a nationally recognized diabetes expert.
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Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession!
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.
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