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.

Is worth all the work?

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.

A message of hope

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.

Reducing A1C

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.

• Fourth Quartile – The individuals who were able to bring their A1C’s down to 5.9% that started in the highest quartile at an average of 9.9% saw an average of 3.8 years added to their life expectancy.
• Third Quartile – Those who brought it down to 7.7% from 9.9% in the third quartile saw an average 3.4-year gain.
• Second Quartile – Participants in the second quartile with a change of 7.7% to 6.8% only saw a 0.5-year change in life expectancy.
• First Quartile – No change in life expectancy was seen for those in this quartile who went from a 6.8% HbA1c down to 5.9% HbA1c.

Lowering Systolic Blood Pressure

Lowering blood pressure added just over a year to the participant’s life expectancy.

• Fourth Quartile: The average baseline blood pressure was 160.4 mm Hg
• Third Quartile: Participants with a 139.1 mm Hg saw 1.1 years gained in life expectancy.
• Second Quartile: A 128.2 mm Hg was associated with a 1.5-year gain in life expectancy.
• First Quartile: The highest increase in life expectancy for blood pressure was for those at 114.1 mm Hg with a 1.9 year gain.

Lowering LDL Cholesterol

Participants with lower LDL cholesterol, saw a change in life expectancy by a few months.

• Fourth Quartile: The baseline was 146.2 mg/dL.
• Third Quartile: Those who had a 107.0 mg/dL saw a half-year increase in life expectancy.
• Second Quartile: Those who had an 84.0 mg/dL saw a 0.7 year gain in life expectancy.
• First Quartile: Individuals who had a 59 mg/dL saw a 0.9-year gain in life expectancy.

Lowering Body Mass Index

Participants who were able to decrease their BMI saw a increased life expectancy by a few years.

• Fourth Quartile: The baseline BMI was 41.4 (fourth quartile) with the lower three quartiles seeing a change in life expectancy.
• Third Quartile: For individuals with a BMI of 33.0, they saw an additional 2 years of life expectancy
• Second Quartile: Those who had a BMI of 28.6 saw an additional 2.9 years of life expectancy
• First Quartile: Those living with Type 2 with a BMI of 24.3 see an additional 3.9 years of life expectancy

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.

Join us live next Tuesday and Thursday as we continue our Level 2 – Standards of Care Intensive live updates! Read more and enroll below.

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 BC-ADM Exam?
We have some exciting exam updates to share.

Join Coach Beverly, Thursday, April 7th 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 a priority notification and a link to the recorded version within 24 hours.

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.

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

• Plant Based Eating Recipes and Resources
• Carbohydrate Counting Resources

Read more in this Circulation Article.

Want to learn more about this topic?

You are invited to join our Virtual Conference on April 13 -15th. Our expert speaker, Ashley LaBrier, MS, RD, CDCES, will be providing a half-day presentation on this important topic!

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

 Download Course Schedule |  Download Course Flyer

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.

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?

1. GLP-1 RA and low dose aspirin
2. ACE and ARB for blood pressure management
3. Basal insulin and a diuretic
4. SGLT-2 and ACE or ARB

Click Here to Test your Knowledge

Want to learn more about this question?  Join us for 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.

 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:

• 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.

Are you preparing for the CDCES Exam?

Join us live on March 31st, 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 2022.
• Exam eligibility and test format
• Strategies to succeed along with a review of study tips and test-taking tactics.
• We will review sample test questions and the reasoning behind choosing the right answers.
• Learn how to focus your time and prepare to take the CDCES Exam. We provide plenty of sample test questions and test-taking tips!

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

Studying for the CDCES Exam?

Enroll in CDCES Online Prep Bundle + 5th Ed ADCES Review Guide Book | 47 CEs

Join us for 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.

 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:

• 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

Basic Option for $399: 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.

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:

• 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.
• About 20 – 30% of people with Medicare or private insurance currently utilize DSMES services.
• To maintain quality, at least one of the DSMES team members needs to have either a CDCES or BC-ADM.
• Less focus on “checking the box” when delivering curriculum and more focus on the individual needs.

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.

Getting to the Best Answer

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!

Want to learn more about this topic? You are invited to view our Setting Up a Successful DSMES Program.

Setting up a Successful DSME Program Standards | Level 2 $29 | 1.5 CEs

Recorded & Ready to Watch!

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:

1. Describe DSME program examples from across the country.
2. List the six standards for creating a successful DSME program
3. Discuss marketing strategies for success
4. Describe Medicare Reimbursement for diabetes care and education

Join us for 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

 Download Course Schedule |  Download Course Flyer

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.

Metformin is one of the most widely dispensed oral diabetes medications for good reason. It works great, lowering A1c 1-2% points, with an added benefit of dropping LDL cholesterol levels. It doesn’t cause hypoglycemia or weight gain and it is incredibly cheap. Many pharmacies offer a 3 month supply of this highly effective glucose-lowering medication for $10 or less, and that’s without insurance. This medication also seems to boost the diversity of the gut microbiota, in particularly increased levels of the very beneficial Akkermansia muciniphila.

However, it does have a few drawbacks. A small group of people on metformin will experience a B₁₂ deficiency. This B₁₂ deficiency may manifest as neuropathic pain or anemia.

Plus, a percentage of people will experience upset stomach, bloating, and diarrhea. People with these complaints will often respond better to the extended-release version (metformin XR), which isn’t any more expensive and it can be taken once a day. See our Mediation PocketCards for more info.

How prevalent is B₁₂ Deficiency with metformin?

Currently, the ADA Standards have no clear recommendation for checking B₁₂ for those on metformin, but it does note that long-term metformin use is associated with B₁₂ deficiencies and that “measuring B₁₂ levels should be considered for those with type 1 diabetes, peripheral neuropathy or unexplained anemia”.

To add to this, a study published this month in Human Nutrition and Metabolism, found the prevalence of B₁₂ deficiency appears to be about 17% in people on metformin therapy. The highest rates of B₁₂ deficiency were seen in those taking metformin for 2 years. Moreover, vitamin B₁₂ deficiency is influenced by the occurrence and duration of diabetes.

They also measured the intake of vitamin B₁₂ in the daily diet of the study participants. Those with lower vitamin B₁₂ blood levels were also consuming less foods rich in vitamin B₁₂ in their daily meal plan.

Recommendations for Regular B₁₂ Monitoring and Replacement

The authors of this article suggest that routine monitoring for vitamin B₁₂ serum levels is needed in people with T2DM, particularly when metformin is used for more than 2 years with a dose of over 1000 mg per day. They also recommend further studies are needed to assess the correlation between metformin duration and dose and patients with T2DM and other metabolic syndromes.

B₁₂ replacement therapy

This article, nor the ADA Standards recommend dosing for B₁₂ replacement therapy. However, based on several articles, including this 2005 Cochrane review, high-dose oral replacement (1 mg to 2 mg per day) for B₁₂ deficiency, seems to be as effective as parenteral B₁₂ administration for correcting anemia and neurologic symptoms.

Conclusion – Vitamin B₁₂ deficiency is associated with worsening nerve pain and anemia. Testing B₁₂ levels for those on long-term metformin therapy, especially for those taking more than 1000 mg of metformin a day seems like a reasonable approach. Increasing the intake of foods high in vitamin B₁₂ and providing oral B₁₂ replacement therapy of 1 mg to 2 mg a day, are both helpful interventions to boost B₁₂ levels.

Resources from our Article Library

Plant Based Eating Resources and Recipes

Carbohydrate Counting Resource Page

Want to learn more about this topic?  Enroll in our

Meds Management for Type 2 Standards | 1.5 CEs

Recorded & Ready to Watch!

Coach Beverly will highlight the key elements of the latest Medication Guidelines by AACE and ADA. We will explore clinical factors to consider when determining the best strategy to improve glucose management in people with type 2 diabetes and other co-conditions. There will be a special focus on cardiovascular risk reduction and renal protection.

Objectives:

1. Describe the role of Diabetes Care and Education Specialists in stopping clinical inertia
2. Discuss using the latest ADA and AACE Guidelines to determine the best therapeutic approach.
3. Using the ADA and AACE Guidelines, describe strategies to initiate and adjust injectable therapy.

Enroll in the entire
Level 2 | Standards of Care Intensive Series | 20 CEs | $199

2022 Updates Airs March 17 – May 26, 2022

This bundle is specifically designed for healthcare professionals who want to learn more about the ADA Standards of Diabetes Care for their clinical practice or for those who are studying for the BC-ADM or the CDCES certification exam.

• 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
• Recorded on February 3, 2022 – ADA Standards of Care | 2.0 CEs
• Recorded on March 17, 2022 – Setting up a Successful Diabetes Program 1.5 CEs
• Recorded on March 22, 2022 – Lower Extremity Assessment 1.5 CEs
• Recorded on March 24, 2022 – Meds Management for Type 2 – 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

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

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.

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?

1. Loss of protective sensation (LOPS).
2. Peripheral arterial disease (PAD).
3. Autonomic neuropathy.
4. Small nerve fiber neuropathy.

Click Here to Test your Knowledge

Want to learn more about this question?  Join Coach Beverly for our Level 2 updates!

Lower Extremity Assessment Standards | Level 2
$29 for 1.5 CEs

Join us live Tuesday March 22nd at 11:30 am PST

Join us live on March 22, 2022, at 11:30 am PST for our Level 2 | Lower Extremity Assessment Standards live webinar

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:

1. Describe the risk factors for lower extremity complications
2. Discuss prevention strategies
3. Demonstrate steps involved in a lower extremity assessment

Meds Management for Type 2 Standards | 1.5 CEs

Join us live Thursday March 24th at 11:30 am PST

Join us live on March 24, 2022, at 11:30 am PST for our Level 2 | Meds Management for Type 2 Standards live webinar

Coach Beverly will highlight the key elements of the latest Medication Guidelines by AACE and ADA. We will explore clinical factors to consider when determining the best strategy to improve glucose management in people with type 2 diabetes and other co-conditions. There will be a special focus on cardiovascular risk reduction and renal protection.

Objectives:

1. Describe the role of Diabetes Care and Education Specialists in stopping clinical inertia
2. Discuss using the latest ADA and AACE Guidelines to determine the best therapeutic approach.
3. Using the ADA and AACE Guidelines, describe strategies to initiate and adjust injectable therapy.

Enroll in the entire
Level 2 | Standards of Care Intensive Series | 20 CEs | $199

2022 Updates Airs March 17 – May 26, 2022

This bundle is specifically designed for healthcare professionals who want to learn more about the ADA Standards of Diabetes Care for their clinical practice or for those who are studying for the BC-ADM or the CDCES certification exam.

• 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
• Recorded on February 3, 2022 – ADA Standards of Care | 2.0 CEs
• March 17, 2022 – Setting up a Successful Diabetes Program 1.5 CEs
• March 22, 2022 – Lower Extremity Assessment 1.5 CEs
• March 24, 2022 – Meds Management for Type 2 – 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

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.

 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:

• 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.