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Question of Week | What Teaching Tip for New Med – finerenone?

JR has a GFR of 43 and lives with type 2 diabetes.  JR excitedly brings you an article that talks about finerenone (Kerendia), a newly approved non-steroidal mineralocorticoid receptor antagonist which is indicated for people with chronic kidney disease (CKD) associated with Type 2 diabetes.

If JR is started on this medication, what instruction would you provide?

  1. Make sure to take this medication on an empty stomach
  2. Contact the provider if you notice ankle swelling
  3. Notify your provider if you experience a non-productive cough
  4. Avoid taking medication with grapefruit or grapefruit juice.

Click here to test your knowledge!

Need a hint? Check out our New Updated Med Cheat Sheets 2021 (page 2).


Enroll in our Virtual DiabetesEd Specialist Program!

Did you miss the live conference? No worries! You can register now to watch on-demand

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.

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!

CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.

Two Registration Options


Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs

Deluxe Virtual Program for $459 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

+Plus Syllabus, Standards and Swag:

  • Diabetes Educator Course 2021 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
  • DiabetesEd Services highlighters, Medication PocketCard and Pen

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs

Basic virtual program for $359 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! 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!


Bonus Courses worth 12+ CEs, FREE

When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!

  • Test Taking Toolkit – Over 200 sample test questions!
  • Level 2 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach 1.5 CEs
  • Level 2 – Hospital and Hyperglycemia 1.5 CEs
  • Level 2 – Hyperglycemic Crisis, DKA and HHS Standards 1.0 CEs
  • Level 2 – Meds Management Update for Type 2 – 1.5 CEs
  • Level 2 – Setting up a Successful Diabetes Program 1.5 CEs
  • Level 2 – Pregnancy and Diabetes 1.5 CEs
  • Level 2 – From Tots to Teens – Diabetes Standards 1.5 CEs
  • Level 2 – Older Adults and Diabetes 1.5 CEs
  • Mindfulness and Compassion in the Diabetes Encounter – 1.0 CE

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

[yikes-mailchimp form=”1″]

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.

September eNews  | Insulin Update, New Meds, Cheat Sheet Additions

September eNews  | Insulin Update, New Meds, Cheat Sheet Additions

September News – Medication Updates

There has been a flurry of activity in the pharmacologic world of diabetes lately. We are working hard to keep our tools up-to-date to share with our diabetes community.

Our printed Diabetes Medication PocketCards is now updated to reflect the latest GFR cut-offs for the SGLT-2 Inhibitors. Plus, we have expanded our Concentrated Insulin Card to include more dosing and shelf life details.

Last month, the FDA approved exenatide XR for pediatric use. This is the second GLP-1 RA approved for kids, but the first once-a-week injectable option. Our electronic PocketCard version reflects this update.

More good news! A biosimilar insulin, Semglee, is now FDA approved for “pharmacy-level substitution” in place of the higher-priced glargine. This will hopefully result in important cost savings for individuals.

We highlight the new FDA-approved medication for people with type 2 diabetes and chronic kidney disease which slows progression and protects against CV events. Plus, we share info on the new ACL and PCSK9 Inhibitors for lipid management. These new meds are included in our downloadable Lipid/HTN Cheat Sheet for your clinical practice. Thanks to our expert PharmD contributors!

Lastly, we need your help in encouraging people living with type 1 to consider joining the EMBARK Study. Living with type 1 diabetes can be tough, and enrolling in the EMBARK study provides meaningful support, problem-solving strategies, and a little cash for people living with T1DM.

There is so much happening in our country right now. We send you wishes for peace, safety, and health.

Keep cool everyone,

Coach Beverly & Bryanna

Click here to read our full September 2021 newsletter.

Featured Blogs

Upcoming Events & Resources


Enroll in our Virtual DiabetesEd Specialist Program!

Did you miss the live conference? No worries! You can register now to watch on-demand

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.

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!

CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.

Two Registration Options


Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs

Deluxe Virtual Program for $459 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

+Plus Syllabus, Standards and Swag:

  • Diabetes Educator Course 2021 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
  • DiabetesEd Services highlighters, Medication PocketCard and Pen

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs

Basic virtual program for $359 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! 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!


Bonus Courses worth 12+ CEs, FREE

When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!

  • Test Taking Toolkit – Over 200 sample test questions!
  • Level 2 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach 1.5 CEs
  • Level 2 – Hospital and Hyperglycemia 1.5 CEs
  • Level 2 – Hyperglycemic Crisis, DKA and HHS Standards 1.0 CEs
  • Level 2 – Meds Management Update for Type 2 – 1.5 CEs
  • Level 2 – Setting up a Successful Diabetes Program 1.5 CEs
  • Level 2 – Pregnancy and Diabetes 1.5 CEs
  • Level 2 – From Tots to Teens – Diabetes Standards 1.5 CEs
  • Level 2 – Older Adults and Diabetes 1.5 CEs
  • Mindfulness and Compassion in the Diabetes Encounter – 1.0 CE

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

[yikes-mailchimp form=”1″]

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.

Rationale of the Week | Best intervention for JR?

Our August 31st Question of the week quizzed test takers on interventions. Over 90% of respondents chose the correct answer. Great job! We thought that this was an important topic to review, so we can pass on correct info to people living with diabetes.

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 43 with type 2 diabetes who shows up for their usual visit and happens to mention that they have had moments of feeling dizzy over the past few months.  A few times, they have checked their blood sugars during these spells, and they were 121 and 136.  JRs medications include glipizide 10mg BID, metformin 1000mg BID, lisinopril 20mg, atorvastatin 20mg.  JR has lost about 10 lbs since their last visit by eating more whole foods and grains and less fast foods. 

Based on this assessment, what is the next best action?

Answer Choices:

  1. Suggest that JR starts on aspirin given their cardiovascular risk profile.
  2. Recommend JR get a home blood pressure monitor.
  3. Assess if JR might need a sleep study to evaluate for sleep disorders.
  4. Encourage JR to increase activity level, to decrease cardiovascular risk.

As shown above, the most common choice was option 3, the second most common answer was option 1, then option 2, and finally option 4.

Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.

Answer 1 is incorrect. 2.93% chose this answer, “Suggest that JR starts on aspirin given their cardiovascular risk profile.” Aspirin therapy is recommended for those 50 and older with existing or at risk for a cardiovascular event. Since JR is younger than 50, this is not the best answer.

Answer 2 is correct. 90.79% of you chose this answer, “Recommend JR get a home blood pressure monitor.” Yes, GREAT JOB. Most of you chose this best answer. Most likely, the dizziness is a result of lower blood pressure secondary to weight loss and treatment with an ACE Inhibitor (lisinopril). The ADA Standards recommend that people on blood pressure medications self-monitor their blood pressure at home to detect changes in pressure that warrant a reduction or intensification of anti-hypertensive therapy.

Answer 3 is incorrect. 2.51% of respondents chose this answer, “Assess if JR might need a sleep study to evaluate for sleep disorders.” While it is true that many people with diabetes have sleep disorders, in this case study there is not enough supporting clinical symptoms to support a sleep study. For example if JR was complaining of waking up tired or waking up gasping for air, plus they exhibit other risk factors, then further sleep evaluation might be warranted.

Finally, Answer 4 is incorrect. 3.77% chose this answer, “Encourage JR to increase activity level, to decrease cardiovascular risk.” Encouraging activity to improve health is an important part of self-care coaching. However, in this case, since JR is complaining of “dizziness”, for safety, we might even back off a little from recommending activity until we determine the cause of JRs dizziness.

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 topic and more?

Enroll in our Virtual DiabetesEd Specialist Program!

Did you miss the live conference? No worries! You can register now to watch on-demand

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.

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!

CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.

Two Registration Options


Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs

Deluxe Virtual Program for $459 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

+Plus Syllabus, Standards and Swag:

  • Diabetes Educator Course 2021 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
  • DiabetesEd Services highlighters, Medication PocketCard and Pen

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs

Basic virtual program for $359 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! 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!


Bonus Courses worth 12+ CEs, FREE

When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!

  • Test Taking Toolkit – Over 200 sample test questions!
  • Level 2 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach 1.5 CEs
  • Level 2 – Hospital and Hyperglycemia 1.5 CEs
  • Level 2 – Hyperglycemic Crisis, DKA and HHS Standards 1.0 CEs
  • Level 2 – Meds Management Update for Type 2 – 1.5 CEs
  • Level 2 – Setting up a Successful Diabetes Program 1.5 CEs
  • Level 2 – Pregnancy and Diabetes 1.5 CEs
  • Level 2 – From Tots to Teens – Diabetes Standards 1.5 CEs
  • Level 2 – Older Adults and Diabetes 1.5 CEs
  • Mindfulness and Compassion in the Diabetes Encounter – 1.0 CE

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

[yikes-mailchimp form=”1″]

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 Week | Getting to the Right Carb Count

LS uses an insulin pump and CGM.  Most recent report reveals LS is running 56% time in range and 44% above target range. LS asks for help with carb counting.  A typical breakfast includes: ½ cup of milk, 2 tablespoons peanut butter and 1 piece whole grain bread, 3 oz’s of grapes and one cup of black coffee with Splenda. LS’s insulin to carb ratio for breakfast is 1:12, for lunch and dinner is 1:15.

Based on this, how much insulin does LS need for breakfast?

  • 3.1 units
  • 2.4 units
  • 3.0 units
  • 2.5 units

Click here to test your knowledge!


Want to learn more about this topic and more?

Enroll in our Virtual DiabetesEd Specialist Program!

Did you miss the live conference? No worries! You can register now to watch on-demand

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.

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!

CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.

Two Registration Options


Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs

Deluxe Virtual Program for $459 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

+Plus Syllabus, Standards and Swag:

  • Diabetes Educator Course 2021 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
  • DiabetesEd Services highlighters, Medication PocketCard and Pen

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs

Basic virtual program for $359 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! 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!


Bonus Courses worth 12+ CEs, FREE

When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!

  • Test Taking Toolkit – Over 200 sample test questions!
  • Level 2 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach 1.5 CEs
  • Level 2 – Hospital and Hyperglycemia 1.5 CEs
  • Level 2 – Hyperglycemic Crisis, DKA and HHS Standards 1.0 CEs
  • Level 2 – Meds Management Update for Type 2 – 1.5 CEs
  • Level 2 – Setting up a Successful Diabetes Program 1.5 CEs
  • Level 2 – Pregnancy and Diabetes 1.5 CEs
  • Level 2 – From Tots to Teens – Diabetes Standards 1.5 CEs
  • Level 2 – Older Adults and Diabetes 1.5 CEs
  • Mindfulness and Compassion in the Diabetes Encounter – 1.0 CE

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

[yikes-mailchimp form=”1″]

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.

Rationale of the Week | Thick calluses coupled with leg pain?

Our August 24th Question of the week quizzed test takers on thick calluses coupled with leg pain. 61% of respondents chose the correct answer. We thought that this was an important topic to discuss further, so we can pass on correct info to people living with diabetes.

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 has lived with type 1 diabetes for over twenty years. JR arrived in the clinic with thick calluses on both feet and complaints of calf pain when walking for more than 10 minutes. JR’s pulses are difficult to palpate.

What diagnosis best matches JR’s presentation?

Answer Choices:

  1. Peripheral polyneuropathy.
  2. Diabetes venous stasis syndrome.
  3. Peripheral arterial disease.
  4. Charcot foot.

As shown above, the most common choice was option 3, the second most common answer was option 1, then option 2, and finally option 4.

Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer. If you want to learn more about lower extremities, we invite you to join our Virtual Course or check out our Level 2 Online Courses.

Answer 1 is incorrect. 15.33% chose this answer, “Peripheral polyneuropathy.” This juicy answer is tempting, however it does not match the symptoms detailed by JR. A person with peripheral polyneuropathy will typically complain of numbness, tingling and leg pain at night. They may also have thick calluses. However, there are two clues that indicate a mismatch between question and answer. JR is “complaining of calf pain when walking for more than 10 minutes with difficulty locating pulses.” These chief complaints indicate a different pathology. Keep reading to find out more.

Answer 2 is incorrect. 14.50% of you chose this answer, “Diabetes venous stasis syndrome.” This is another juicy answer with a made up condition that is designed to sound familiar. In general, with venous disease, pulses are still palpable since there is adequate blood flow to lower extremities. There are two clues that indicate a mismatch between question and answer. “JR is complaining of calf pain when walking for more than 10 minutes with difficulty locating pulses.” These chief complaints indicate a different pathology. Keep reading to find out more.

Answer 3 is correct. 60.64% of respondents chose this answer, “Peripheral arterial disease.” YES, this is the BEST answer. Great job. JR is exhibiting the classic signs of inadequate arterial blood flow to the lower extremities, or peripheral arterial disease. JR’s complaints of “calf pain when walking for more than 10 minutes with difficulty locating pulses” indicate poor arterial circulation and warrant referral to a provider for complete CV risk assessment.

Finally, Answer 4 is incorrect. 9.53% chose this answer, “Charcot foot.” This answer is tempting. Charcot foot is characterized by severe foot inflammation and structural collapse. Since JR is “complaining of calf pain when walking for more than 10 minutes with difficulty locating pulses”, these symptoms do not match the usual complaints associated with Charcot foot. Good try, see answer 3 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 topic and more?

Enroll in our Virtual DiabetesEd Specialist Program!

Did you miss the live conference? No worries! You can register now to watch on-demand

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.

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!

CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.

Two Registration Options


Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs

Deluxe Virtual Program for $459 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

+Plus Syllabus, Standards and Swag:

  • Diabetes Educator Course 2021 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
  • DiabetesEd Services highlighters, Medication PocketCard and Pen

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs

Basic virtual program for $359 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! 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!


Bonus Courses worth 12+ CEs, FREE

When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!

  • Test Taking Toolkit – Over 200 sample test questions!
  • Level 2 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach 1.5 CEs
  • Level 2 – Hospital and Hyperglycemia 1.5 CEs
  • Level 2 – Hyperglycemic Crisis, DKA and HHS Standards 1.0 CEs
  • Level 2 – Meds Management Update for Type 2 – 1.5 CEs
  • Level 2 – Setting up a Successful Diabetes Program 1.5 CEs
  • Level 2 – Pregnancy and Diabetes 1.5 CEs
  • Level 2 – From Tots to Teens – Diabetes Standards 1.5 CEs
  • Level 2 – Older Adults and Diabetes 1.5 CEs
  • Mindfulness and Compassion in the Diabetes Encounter – 1.0 CE

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


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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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 Week | Best intervention for JR?

JR is 43 with type 2 diabetes who shows up for their usual visit and happens to mention that they have had moments of feeling dizzy over the past few months.  A few times, they have checked their blood sugars during these spells, and they were 121 and 136.  JRs medications include glipizide 10mg BID, metformin 1000mg BID, lisinopril 20mg, atorvastatin 20mg.  JR has lost about 10 lbs since their last visit by eating more whole foods and grains and less fast foods. 

Based on this assessment, what is the next best action?

  1. Suggest that JR starts on aspirin given their cardiovascular risk profile.
  2. Recommend JR get a home blood pressure monitor.
  3. Assess if JR might need a sleep study to evaluate for sleep disorders.
  4. Encourage JR to increase activity level, to decrease cardiovascular risk.

Click here to test your knowledge!


Want to learn more about this topic and more?

Enroll in our Virtual DiabetesEd Specialist Program!

Did you miss the live conference? No worries! You can register now to watch on-demand

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.

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!

CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.

Two Registration Options


Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs

Deluxe Virtual Program for $459 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

+Plus Syllabus, Standards and Swag:

  • Diabetes Educator Course 2021 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
  • DiabetesEd Services highlighters, Medication PocketCard and Pen

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs

Basic virtual program for $359 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! 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!


Bonus Courses worth 12+ CEs, FREE

When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!

  • Test Taking Toolkit – Over 200 sample test questions!
  • Level 2 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach 1.5 CEs
  • Level 2 – Hospital and Hyperglycemia 1.5 CEs
  • Level 2 – Hyperglycemic Crisis, DKA and HHS Standards 1.0 CEs
  • Level 2 – Meds Management Update for Type 2 – 1.5 CEs
  • Level 2 – Setting up a Successful Diabetes Program 1.5 CEs
  • Level 2 – Pregnancy and Diabetes 1.5 CEs
  • Level 2 – From Tots to Teens – Diabetes Standards 1.5 CEs
  • Level 2 – Older Adults and Diabetes 1.5 CEs
  • Mindfulness and Compassion in the Diabetes Encounter – 1.0 CE

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

[yikes-mailchimp form=”1″]

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.

Virtual DiabetesEd Specialist Conference | 30+ CEs

Join our Virtual DiabetesEd Specialist Program!

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.

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!

CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.

Two Registration Options


Virtual DiabetesEd Specialist Conference Deluxe | 30+ CEs

Deluxe Virtual Program for $459 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

+Plus Syllabus, Standards and Swag:

  • Diabetes Educator Course 2021 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
  • ADA 2021 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 and Pen

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Virtual DiabetesEd Specialist Conference Basic | 30+ CEs

Basic virtual program for $359 includes:

  • Presentations by our team of experts
  • Q & A Session with the instructor after each webinar
  • State-of-the-art review of current diabetes care and technology.
  • Resources for each session
  • Access to FREE podcast and recorded webinars within a week of each live session for one full year.

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! 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!


Bonus Courses worth 12+ CEs, FREE

When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!

  • Test Taking Toolkit – Over 200 sample test questions!
  • Level 2 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach 1.5 CEs
  • Level 2 – Hospital and Hyperglycemia 1.5 CEs
  • Level 2 – Hyperglycemic Crisis, DKA and HHS Standards 1.0 CEs
  • Level 2 – Meds Management Update for Type 2 – 1.5 CEs
  • Level 2 – Setting up a Successful Diabetes Program 1.5 CEs
  • Level 2 – Pregnancy and Diabetes 1.5 CEs
  • Level 2 – From Tots to Teens – Diabetes Standards 1.5 CEs
  • Level 2 – Older Adults and Diabetes 1.5 CEs
  • Mindfulness and Compassion in the Diabetes Encounter – 1.0 CE

2021 Diabetes Educator Course Flyer & Schedule (subject to change)


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

[yikes-mailchimp form=”1″]

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.

Rationale of Week – | Which One is Autonomic Neuropathy? We made an oops!

For our August 17th Question of the Week, 39% of respondents chose the best answer. This is due in part to our error. We mis-keyed the best answer for the first 96 respondents (we quickly fixed it as soon as we discovered the error). So, you may want to retake this question before you read on to discover the answer. Coach Bev sincerely apologizes if this caused any of you distress! But today, we are making it right. Thanks for your patience and ongoing participation!

Before we start, if you don’t want any spoilers and you tried the question on Tuesday morning, you can answer below: Answer Question

Question 1: Which of the following are considered diabetes autonomic neuropathies?

  1. Decreased sexual arousal, pins and needles sensations in lower extremities.
  2. Loss of protective sensation and urinary incontinence.
  3. Resting tachycardia and esophageal dysmotility.
  4. Hypoglycemia unawareness and insensate feet.

As shown above, the most common choice was option 3, the second most common answer was option 4, then option 1, and finally option 2.


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.  Don’t forget to leverage your common sense and vast health care knowledge to get the best answer for specialty topics like microvascular disease. Be familiar with nerve disease presentation and screening as listed in the ADA Standards of Care on Microvascular health and treatment options. We also invite you to join our webinar (see below). Also, the tests will often provide a 2 part answer, one part being correct and the other part incorrect. Of course, if any part of the answer is incorrect, it is not the best answer. A great test taking tip to hold onto to when your sympathetic nervous system is in full gear. You got this, Coach Beverly

A note on Autonomic Neuropathy. This condition causes nerve damage to the autonomic nervous system which is in charge of digestion, sexual function, heart rate, and the adrenergic flight or fight response. The autonomic nervous system also “oversees” the energy-conserving parasympathetic response including bladder control, heart rate slowing, eye pupil constriction, and more.

Answers & Rationale

Answer 1 is incorrect, 19.49% chose this answer, “Decreased sexual arousal, pins and needles sensations in lower extremities.” This is a juicy answer. Autonomic dysfunction can affect sexual function, but it doesn’t affect libido or sexual desire. In addition, the pins and needles sensation is due to the nerve damage associated with peripheral neuropathy. Since both parts of this answer aren’t correct, this answer is false.

Answer 2 is incorrect, 16.61% of you chose this answer, “Loss of protective sensation and urinary incontinence.” Loss of protective sensation is associated with peripheral neuropathy. However, urinary incontinence is often a result of autonomic neuropathy. Since both parts of this answer aren’t correct, this answer is false.

Answer 3 is correct, 39.62% of you chose this answer, GREAT JOB! “Resting tachycardia and esophageal dysmotility.” Elevated heart rate while resting is a concerning sign and is often associated with cardiac autonomic neuropathy and increased risk of a cardiac event. Autonomic neuropathy can affect the motility of the entire GI track, including the esophagus. The more commonly recognized GI autonomic neuropathy is gastroparesis. Since both conditions, resting tachycardia and esophageal dysmotility, are associated with autonomic neuropathy, this is the best answer.

Answer 4 is incorrect, 24.28% of you chose this juicy answer “Hypoglycemia unawareness and insensate feet.” Since hypoglycemia unawareness is associated with a diminished adrenergic response to low blood glucose levels, it is considered an autonomic neuropathy. However, insensate feet are due to peripheral nerve damage associated with ongoing hyperglycemia. Since both parts aren’t correct, this answer is false.

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 topic?

Join us for our

Level 2 | Microvascular Complications, Eye Kidney, & Nerve Disease Standards | 1.5 CEs

This course provides you with the need-to-know information regarding the microvascular complications of diabetes. We start with a brief overview of the pathophysiology and clinical manifestations then sum up with prevention strategies and screening guidelines. This straight-forward program will provide you with information you can use in your clinical setting and also provides critical content for the diabetes educator exam.        

Objectives:

  1. Eye, kidney and nerve disease
  2. Modifiable and non-modifiable risk factors for diabetes complications
  3. Screening guidelines and prevention strategies.

See Full Calendar for upcoming webinars and events.

Can’t make it live? All paid registrants are guaranteed access to the video presentation, handouts and podcasts.


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

[yikes-mailchimp form=”1″]

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.