Rationale of the Week | Steroids, Sugar Spikes and Management Strategies
For our March 2nd Question of the Week, over 58% of respondents chose the best answer!
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 53 yrs old with type 2 diabetes, BMI of 24.3 and is recovering from a COVID infection. In addition to metformin, a SGLT-2i and a weekly GLP-1 RA, JR is on daily prednisone. Morning blood glucose levels are in the low 100’s, lunch and dinner blood glucose levels are in the 250-300 range.
Which of the following is the best treatment intervention to get lunch and dinner blood glucose levels to goal?
Answer Choices:
- Initiate a low carb meal plan
- Add NPH or 70/30 insulin in morning
- Start evening basal insulin and gradually increase
- Ask provider to stop or reduce prednisone dose
As shown above, the most common choice was option 2, the second most common answer was option 1, then option 4, and finally option 3.
Getting to the Best Answer
If you are thinking about taking the certification exam, the content of this practice test question will set you up for success. The exam often presents vignettes that compel test takers to determine which option offers the BEST answer based on the action times of different insulins.
Answers & Rationale
Answer 1 is incorrect, 16.77% chose this answer. “Initiate a low carb meal plan “. JR has a BMI that is less than 25, which indicates a healthy weight. In addition, JR is recovering from COVID, so making sure they are eating adequate calories and healthy carbs during this recovery phase is very important. Lastly, the spike in blood glucose between lunch and dinner is an expected response since JR is taking morning prednisone.
AM steroids cause hyperglycemia through lunch and dinner.
Answer 2 is correct, 58.87% of you chose this answer. “Add NPH or 70/30 insulin in morning”. YES! Since morning steroids increase insulin resistance throughout the day, especially around lunch and dinner time, morning NPH insulin works remarkably well. This is because NPH action time peaks within 4-10 hours of injection. Another option is to use 70/30 insulin, which is a combination of 70% NPH (or basal) insulin plus 30% bolus. This insulin used before the first meal of the day, can help prevent lunch and dinner blood sugars from going above target later in the day.
Dosing for NPH or 70/30 depends on several factors, including steroid dose, diabetes type and history, body weight and health status. See our article on Steroids and Sugar Spikes – Management Strategies
Answer 3 is incorrect, 11.94% of you chose this answer “Start evening basal insulin and gradually increase”. When people are on morning steroids, their overnight blood sugars generally trend down. Basal insulin isn’t the best choice for addressing mid day to evening glucose elevations.
Answer 4 is incorrect, 12.42% of you chose this answer. “Ask provider to stop or reduce prednisone dose”. While it is true that stopping the prednisone will improve blood glucose levels, it could also contribute to a worsening health status. One of the most effective treatments for people with a serious COVID infection is steroid therapy to decrease inflammation, especially in the lungs. We approach this situation understanding that the steroid is essential and we can help with glucose management to promote recovery.
Want to learn more about this topic? Join Coach Beverly during the Virtual Conference, where she will be discussing treatment strategies for hyperglycemia secondary to steroids.
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!
ADCES Desk Reference + 5th Ed Review Guide Book Bundle
The 5th Edition ADCES Desk Reference & 5th Edition Review Guide Bundle –our most popular AADE Book Bundle for exam preparation!
What is included in the ADCES Book Bundle?
The Art & Science of Diabetes Self-Management Education Desk Reference – 5th Edition
Major Features:
- practical information educators can use with patients to avoid complications and comorbidities
- risks and benefits of CGM and the educator’s role in working with patients who use CGM
- updated info on incorporating the ADA, AADE, and AND joint position statement and algorithm of care into a DSME program
ADECES Review Guide for the Diabetes Care and Education Specialist Exam – 5th Edition
Includes an answer key with rationales for all questions included in the guide!
Major Features:
- 480 + multiple-choice questions
- Strategies for preparing for and taking the exam
3 self-assessment tests that cover three main content sections on the CDCES Exam:
- Assessment of Diabetes and Prediabetes
- Interventions for Diabetes and Prediabetes
- Disease Management
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!
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.
Question of the Week | Get Your Calculator Ready!
JR wants to lose weight in the next 30 days by drinking less juice. There are 100 calories per glass of juice and JR usually drinks 3 glasses a day.
How much weight would JR lose by only drinking 1 glass a day?
- 0.85 pounds
- It depends on the type of juice
- 1.7 pounds
- 3000 calories
Click here to test your knowledge!
Preparing for the CDCES Exam |
FREE Webinar
Airs live on March 11, 2021 | 11:30 am – 1:00 pm (PST)
This course will transform your test anxiety into calm self-confidence and test-taking readiness.
Topics Covered Include:
- Implications of new certification name, CDCES for our specialty
- Exam requirement updates for 2021.
- Exam eligibility and test format
- Strategies to succeed along with a review of study tips and test-taking tactics.
- We will review sample test questions and the reasoning behind choosing the right answers.
- Learn how to focus your time and prepare to take the CDCES Exam. We provide plenty of sample test questions and test-taking tips!
Can’t join us live?
Don’t worry, we will send you a link to the recorded version.
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!
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.
Meet Ashley, LaBrier, MS, RD, CDCES
Registered Dietitian Nutritionists are the food and nutrition experts who can translate the science of nutrition into practical solutions for healthy living.
To celebrate Registered Dietitians, we are interviewing an emerging leader in the field and our Virtual Conference Speaker, Ashley LaBrier.
Interview with Speaker, Ashley LaBrier, MS, RD, CDES
Ashley LaBrier, MS, RD, CDES, is an innovator in the field of diabetes, nutrition, and technology. Ashley is a consultant, and the Diabetes Education Program Coordinator at the Salinas Valley Medical Clinic’s Diabetes & Endocrine Center.
Ms. LaBrier is passionate about providing person-centered education to empower those who live with diabetes. Having been diagnosed with type 1 diabetes herself nearly 20 years ago, she combines her professional knowledge with personal experience and understanding.
Meet Ashley in person at our Virtual Diabetes Specialist Course on April 17, 2021
1. Question – What do you love about being a RD and Diabetes Specialist?
Ms. Labrier – There are a few things I REALLY love about being a dietitian and working with those living with diabetes:
At our clinic, education visits are purposely scheduled to allow adequate time to really understand the needs of each individual and make personalized suggestions. I LOVE that our work allows us to get to know the people we work with so intimately. This knowledge ultimately translates into providing meaningful support based on individual needs.
I also love teaching group education classes. There are few things more energizing than a room full of people who have come together to learn more about their diabetes. These classes always lead to great questions, dialogue, and connection. Hearing people leave an education class feeling empowered to conquer their diabetes and live a more healthful life is so satisfying for me personally and professionally.
Lastly, translating nutrition and diabetes so it “makes sense” – I find it satisfying to see that “light bulb moment” after explaining a new concept.
Question – How do you anticipate nutrition recommendations changing for people with diabetes lives over the next few years?
Ms. LaBrier – I’m not sure how nutritional guidelines will change in the next few years, but I’d like to see more research exploring the long-term health impact of the popular diets, particularly the ketogenic diet and other higher fat and protein diets. I also hope that dietary guidelines begin to factor in the social and environmental consequences of what we eat, not just nutrition alone. What we eat impacts our health and the planet – sustainability is key.
Question – Over the past year, what has been most challenging about providing diabetes care during the pandemic?
Ms. LaBrier – The pandemic has brought so much uncertainty to our lives. In working with our participants at the clinic, many have lost their jobs and are experiencing financial hardship. Some are busy caring for children or elderly or have lost a loved one. Others are more isolated from their social circles and support systems. Many have found it difficult to manage stress because certain activities that bring joy have been suspended. All of these factors, and many more, have complicated the picture for our community. Although every person has individual concerns, it seems like many individuals and families are stretched thin. They may have competing priorities and concerns that make managing a chronic condition more difficult than ever before.
Question – What actions can Diabetes Specialists take to counsel people with diabetes who are facing food insecurity?
Ms. LaBrier – a key in working with individuals who face food insecurity is approaching the situation with compassion and a desire to understand.
Ask questions and make an honest effort to understand the struggles that they are facing around obtaining food. Not only does this help to build trust between the specialist and person with diabetes, but providing effective assistance is more realistic when you know what struggles they are facing. Being aware of the resources in your local community is especially important. Social workers can assist in applying for financial and food assistance programs. Plus local and affordable farmers markets and food banks can help sustain people through rough times. f
Question: Would you share your hobby (ies) and how you maintain work life balance?
Ms. LaBrier – My fiancé and I make an effort to get outside for fresh air cocktails regularly. We live in a beautiful area and enjoy paddle boarding, runs on the beach, hiking, camping trips, or walks in the neighborhood. Even on the busy days we maintain our work life balance by prioritizing time together doing these activities.
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.
Happy International Women’s Day – Celebrating Our Kenyan Sisters
This month we are celebrating our amazing sister organization, Just One Person.
Just One Person is a sustainable model program that prepares girls in rural Kenya for post-secondary opportunities, supporting their development towards economic independence. Diabetes Education Services donates the profit from the sale of the Pancreas Pillow to help fund school scholarships and seminars for other girls in rural Kenya.
A treadle sewing machine and cloth
Mwanaidi’s story:
Mwanaidi, of Just One Person, has hand-sewn hundreds of beautiful Pancreas Partners in her hometown in Kenya and shipped them to the Diabetes Education Services office in California, so we can share them with you.
While Mwanaidi was waiting for admission to college she began sewing the “pancreas pillows” that Diabetes Education Services sells in the US. She used a donated treadle sewing machine, a pattern designed by Just One Person (JOP) Executive Director, Emma Sisia, and traditional leso cloth.
Just One Person’s graduates are committed to sharing their knowledge and resources with their mothers, sisters, neighbors, and daughters for generations to come.
Mwanaidi joined the Just One Person (JOP) project in rural Kenya after her high school recognized her potential. Mwanaidi graduated from high school in 2010 and subsequently, became a certified chef. She uses the income from her job to help support her family of 7 siblings along with her mother and father.
All Pancreas Partner profits are donated to www.justoneperson.org.
After paying Mwanaidi for her beautiful work, Diabetes Education Services donates the profit from the sale of the Pancreas Pillow to help fund school scholarships and seminars for other girls in rural Kenya. Other alumnae of JOP have followed suit and are continuing to produce these wonderful pillows to help ensure the sustainability of our program.
Just One Person’s philosophy is that girls are members of our organization for life. They are committed to sharing their knowledge and resources with their mothers, sisters, neighbors, and daughters for generations to come.
At Diabetes Education Services we are dedicated to supporting the growth and well-being of our future generations.
Save your spot for our
Virtual DiabetesEd Specialist Conference | April 15-17, 2021
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 interested in taking the CDCES or BC-ADM exam or are seeking a state-of-the-art review of current diabetes care, this course is for you.
DiabetesEd Virtual Conference Flyer 2021
Diabetes Ed Virtual 3-Day Schedule 2021
Entire Program Fee: $399
Dates: April 15-17, 2021
3 Expert Speakers
CEs: 30+ CE hours
Live Webinar Schedule: All webinars start and end times are in Pacific Standard Time
Come join our Virtual DiabetesEd Specialist Program.
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
In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
Prepare for CDCES or BC-ADM certification or earn hours for renewal.
Your registrations include access to all the Online Sessions plus Bonus Courses through December 31st, 2021.
This virtual program includes:
3 day live webinar courses from April 15th-17th (20 CEs) + enrollment in our Bonus Bundle (14.0+ CEs) from now through December 2021.
- Live Q & A Session with the instructor after each webinar
- Presentations by our team of experts
- Handouts and Resources for each session
- Post-test questions
- A sense of community
- If you can’t attend the live webinars, a recorded version will be posted later the same day for viewing.
View full Conference Schedule and Faculty.
DiabetesEd Virtual Conference Flyer 2021
Diabetes Ed Virtual 3-Day Schedule 2021
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!
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.
CDCES or BC-ADM – Which Certification is Right for me? | FREE Webinar
Are you considering pursuing certification in diabetes care, but are not sure which certification is right for you and how to get started?
Coach Beverly is excited to share her insights on determining the best certification choice and the pathway to success. She will share her personal journey on achieving both her CDCES and BC-ADM over 20 years ago and how these credentials have impacted her opportunities as a diabetes specialist and president of her own company. We hope you can join us!
Webinar Topics
- Discuss the similarities and differences between the CDCES and BC-ADM credentials
- CDCES or certified diabetes care and education specialist
- BC-ADM or board certification in advanced diabetes management
- List the academic and experiential qualifications to take both exams
- Explore which certification best match your personal and professional goals
- Describe the steps to study and prepare for exam success for both certifications
Save your spot for our
Virtual DiabetesEd Specialist Conference | April 15-17, 2021
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 interested in taking the CDCES or BC-ADM exam or are seeking a state-of-the-art review of current diabetes care, this course is for you.
DiabetesEd Virtual Conference Flyer 2021
Diabetes Ed Virtual 3-Day Schedule 2021
Entire Program Fee: $399
Dates: April 15-17, 2021
3 Expert Speakers
CEs: 30+ CE hours
Live Webinar Schedule: All webinars start and end times are in Pacific Standard Time
Come join our Virtual DiabetesEd Specialist Program.
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
In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
Prepare for CDCES or BC-ADM certification or earn hours for renewal.
Your registrations include access to all the Online Sessions plus Bonus Courses through December 31st, 2021.
This virtual program includes:
3 day live webinar courses from April 15th-17th (20 CEs) + enrollment in our Bonus Bundle (14.0+ CEs) from now through December 2021.
- Live Q & A Session with the instructor after each webinar
- Presentations by our team of experts
- Handouts and Resources for each session
- Post-test questions
- A sense of community
- If you can’t attend the live webinars, a recorded version will be posted later the same day for viewing.
View full Conference Schedule and Faculty.
DiabetesEd Virtual Conference Flyer 2021
Diabetes Ed Virtual 3-Day Schedule 2021
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.
Type 1 Diabetes Resources | Free Resource Friday
Type 1 Diabetes Resources
Below is a list of helpful online resources for Type 1 Diabetes. They include sites for national organizations like the American Diabetes Association (ADA), sites for diabetes interest groups, and other participant organizations that provide helpful diabetes tips and opportunities to join online groups.
Click the links below to visit the website:
- Let’s fight Type 1 Together | American Diabetes Association (ADA)
- Mental Health Resources Directory | ADA
- Type 1 Diabetes Resources and Support | Juvenile Diabetes Research Foundation: Explore our informational guides or make a personal connection with someone experienced with type 1 diabetes (T1D). The JDRF community has you covered.
- Empowering Youth with Type 1 Diabetes |The Chris Dudley Foundation
- The National Institutes of Health Diabetes Resources | CDC
- The College Diabetes Network: Focuses Specifically on Young Adults with Diabetes | College Diabetes Network
- The Diabulimia Helpline: for Individuals Having Eating Problems
- Beyond Type 1 Diabetes
- Connected in Motion: Peer-Based Sports & Outdoor Adventures for those with Type 1 (in U.S. and Canada) | Connected In Motion
- Diatribe: Library of Online Resources, Blog & Community Forums
- Diabetes Education: At times it might seem overwhelming, but you can thrive with diabetes, and a Diabetes Care and Education Specialist can help. Includes a link to find a diabetes program near you.
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!
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.
5 Myths About Exercise, Sitting and Sleep Unpacked
I started walking while working 7 years ago after reading research on how “sitting was the new smoking”. I purchased my treadmill desk in 2013 and since that time, I have been walking 7 miles a day, through a combination of my treadmill desk and outdoor strolls.
Over the past 7 years, I have accumulated almost 18,000 miles in an attempt to prevent heart disease, cancer, and a myriad of other chronic health problems. But it seems there is more to the story.
Is “sitting the new smoking?”
The Terry Gross interview with Daniel Lieberman, a professor at Harvard in the department of human evolutionary biology, put my beliefs into question. Dr. Lieberman recently penned a book called “Exercised”, which details his research finding and dispels some commonly held myths.
Besides being a super-smart paleoanthropologist and professor, Lieberman has also spent a lot of time with indigenous hunter-gatherers in Africa and Latin America. He has observed and cataloged how much time they spend walking, running, lifting, carrying, and sitting.
Surprising Findings. 5 myths unpacked.
- You have to walk 10,000 steps a day to be healthy.
Based on current hunter-gathering behaviors, Dr. Lieberman calculates our ancestors walked about 5 miles a day or 10,000 steps. The average adult in America walks about half of that distance or 5,000 steps a day which equals 2.5 miles. This number might be even lower over the past year, given the pandemic and people working from home.
Even though we walk less than our ancestors, Lieberman is encouraging. He says if 10,000 steps feel out of reach, it’s okay to aim for less, as long as the person focuses on movement and engaging muscles to prevent atrophy. Any movement is better than no movement!
“The more we study physical activity, the more we realize that it doesn’t really matter what you do,” Lieberman says. “You don’t have to do incredible strength training … to get some benefits of physical activity. There’s all different kinds of physical activity, and it’s all good in different ways.”
Daniel lieberman
2. Hunter-gatherers sit a lot less than modern humans.
Not true. Surprisingly, research on hunter-gatherers reveals that they sit for 10 hours a day on average, which is the same amount of times the average American sits.
Humans are designed to conserve energy in case of a lack of adequate nutrition. Most hunter-gatherers Lieberman studied don’t have chairs, but they spent a great deal of time sitting. This lack of chairs is actually associated with better spine and back health (see more below)
3. Sitting is really that bad for us.
Interrupted sitting is a far better approach than nestling your body in a comfy chair for hours at a time.
Time spent sitting at work isn’t the major problem. It’s leisure time sitting for hours at a time that is associated with poor health outcomes like heart disease, cancer, or diabetes.
But regardless of sitting at work or home, just getting up every once in a while, every 10 minutes or so makes a big difference in health outcomes.
Try to intentionally get up frequently to go to the bathroom or pet the dog or make yourself a cup of tea. Even though you’re not spending a lot of energy, you’re turning on your muscles. Since muscles are the largest organ in your body, using them decreases inflammation and burns fat and glucose.
4. You can prevent back pain by getting lumbar support or a fancy chair.
Another myth.
Up until recently, only the upper class had chairs with a seatback. Most human beings usually sat on the ground, stools, or benches. The problem with chairs with backs is that sitting becomes more of a passive activity since you use fewer muscles to stabilize your upper body.
Using chairs with seat backs result in weaker back muscles that begin to atrophy due to disuse.
Chairs with lumbar support and lots of cushioning may encourage sitting for longer periods of time, which may further contribute to muscle loss.
5. Getting 8 hours of sleep a night is essential for well being
Based on Lieberman’s research of people who live in places where there is no electricity and computer screens, they don’t sleep more hours than the average American.
People in regions without electricity sleep on average 6.7 to 7.1 hours a night.
Lieberman says we need to stop sleep shaming.
It is true, that not getting enough sleep (4-5 hours a night) can be detrimental to health. But, if a person is getting 6 or 7 hours of sleep a night and they feel fine, that is what is most important.
Thanks for reading this article by Coach Bev who is typing while walking on her treadmill.
Read the complete article here: Just Move: Scientist Author Debunks Myths About Exercise and Sleep
Please see our Exercise Resource Page for handouts to share
Save your spot for our
Virtual DiabetesEd Specialist Conference | April 15-17, 2021
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 interested in taking the CDCES or BC-ADM exam or are seeking a state-of-the-art review of current diabetes care, this course is for you.
DiabetesEd Virtual Conference Flyer 2021
Diabetes Ed Virtual 3-Day Schedule 2021
Entire Program Fee: $399
Dates: April 15-17, 2021
3 Expert Speakers
CEs: 30+ CE hours
Live Webinar Schedule: All webinars start and end times are in Pacific Standard Time
Come join our Virtual DiabetesEd Specialist Program.
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
In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!
Prepare for CDCES or BC-ADM certification or earn hours for renewal.
Your registrations include access to all the Online Sessions plus Bonus Courses through December 31st, 2021.
This virtual program includes:
3 day live webinar courses from April 15th-17th (20 CEs) + enrollment in our Bonus Bundle (14.0+ CEs) from now through December 2021.
- Live Q & A Session with the instructor after each webinar
- Presentations by our team of experts
- Handouts and Resources for each session
- Post-test questions
- A sense of community
- If you can’t attend the live webinars, a recorded version will be posted later the same day for viewing.
View full Conference Schedule and Faculty.
DiabetesEd Virtual Conference Flyer 2021
Diabetes Ed Virtual 3-Day Schedule 2021
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.
Diabetes Month & World Diabetes Day
November 14th, is Dr. Banting’s Birthday
World Diabetes Day is celebrated in honor of Dr. Fredrick Banting, whose leadership, tenacity, and belief led to the discovery of insulin.
The discovery of insulin has saved the lives of countless millions of people over the past hundred years and will continue to save millions of lives in the near future and beyond.
During a hot summer in 1921, Dr.Banting secured space to test out his theory at the University of Toronto. Along with his colleague, Charles Best, and a bare-bones lab, they conducted dozens of experiments on dogs, which ultimately led to the discovery of insulin.
Dr. Banting and Charles Best began their experiments ligating the pancreases of dogs, thinking this would prevent destruction by the digestive pancreatic juices, and then isolating the extract from the islet cells. They then processed the extract from the islet cells and injected this extract they called “insulin” into diabetic dogs. According to an audio interview with Dr. Best, by July 1921, they had 75 positive examples of insulin lowering blood glucose levels in dogs.
In February 1922, doctor Frederick Banting and biochemist John Macleod published their paper on the successful use of an alcohol-based pancreatic extract for normalizing blood glucose levels in a human patient.
Here are some photos of the first insulin bottles produced by the University of Toronto and Eli Lilly.
Soon, word of their discovery got out and the race was on to produce enough insulin to treat the flood of type 1 patients arriving in Toronto to receive this miracle injection.
But, as with any amazing discovery, there is always more to the story.
One of the biggest barriers to Banting was the simple fact that he was not involved in the field of diabetes research. The idea leading to the discovery of insulin came to him after preparing a lecture on the pancreas and diabetes, a subject he knew little about. He wasn’t a trained researcher and thus securing support for the project was initially difficult.
First Children to Receive Insulin
The first patient to receive insulin was a ‘welfare’ case at Toronto General Hospital – no clinical trial structure to say the least. People from Canada/US flooded into Toronto to receive treatment. Banting struggled with the lack of accessibility of insulin – volume needed issues of purification.
The earliest patients were “selected”, some youths from Canada/US, some soldiers with diabetes (probably because of Banting’s service in the First World War), and then later some select private patients. During this time they were working hard to increase the volume and continue to improve the purification process. Insulin was available for testing in the US, namely through Dr. Elliot Joslin in the late summer of 1922.
Takes a Team
While Best played a critical and important role, credit must also go to Professor Macleod, from the University of Toronto, who provided the lab space, showed Dr. Banting how to operate on dogs, provided his student Best and suggested they switch from saline to alcohol to purify the ‘extract’. Dr. Macleod also secured the support of JB Collip, the 4th man on the team, and the first person to purify insulin for human use. Best is also known for pushing Banting to return to the research during a particularly dark period of failure.
Dr. Banting – Fun and Interesting Facts
- Sold insulin patent for $1
- Was wounded during the First World War and received the Military Cross
- Youngest Nobel Laureate in Medicine
- First Canadian on the cover of Time Magazine
- Among the last Canadians to receive a knighthood and have the title, Sir Frederick Banting
- One of only two “non-Americans” to have a Second World War Liberty Ship named after him (USS Frederick Banting)
- Has as a crater on the Moon named after him (between Apollo 15 & 17 landing sites).
Want to Learn More About Dr. Banting?
Visit Banting House FaceBook Page
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!
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