June eNews  | DiabetesEd Scholarships & 7 Reasons for Gratitude

Happy June!

Coach Beverly is feeling grateful

For this newsletter, I am practicing my gratitude out loud and sharing it with you all.

Here are 7 things I am grateful for:

1. My birthday is in early June.
2. June kicks off Pride Month.
3. We welcome a new team member and blog contributor, Monique Jackson.
4. A new glucagon treatment is available, with updated Glucagon Cards you can download for FREE or check out on our CDCES Coach app.
5. We are holding our first LIVE DiabetesEd Specialist Course in San Diego in over a year, which will include; Diabetes Flash Mob, DiaBingo, Prizes, fantastic meals, networking, laughing, and learning together.
6. There are 2 scholarships available for our Diabetes Ed Live Seminar.
7. Lastly, I am deeply grateful for my remarkable family, friends, my Diabetes Ed Team, all of YOU, and this opportunity to live and contribute every day.

In this newsletter, we address topics ranging from hemoglobinopathies to inclusion to new glucagon meds.

Bryanna and I had a lot of fun putting this newsletter together because it rings so true to the mission of our company; to be inclusive and welcoming, to celebrate each individual while leaving judgment behind. To lift each other up, especially during hard times. To offer hope, promote curiosity, and let you always know that we believe in you.

Happy June everyone,

Coach Beverly, Bryanna, and Jackson

Click here to read our full June 2021 newsletter.

Featured Blogs

• Theresa Garnero on Inclusive Practices for LGBTQ+ community
• African American’s at Risk for falsely low A1Cs
• Meet Monique Jackson, new blog contributor
• New Glucagon Rescue Med
• Rationale of the Week
• Question of the Week
• 2 Scholarships Available

Featured Items

• Live Seminar in San Diego
• Live Webinar Updates
• Preparing for CDCES FREE Webinar – July 8th
• Preparing for BC-ADM FREE Webinar – July 15th
• On Sale: ADA Standards of Care Book
• Free Resources Catalog

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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.

For our May 25th Question of the Week, 71% of respondents chose the best answer, which is awesome! However, for safety and teaching purposes, we still want to “take a closer look” at this question at aim for 100% correct responses the next go around.

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: Mr. J is started on 100 units U-500 twice a day.

Which of the following administration techniques would ensure he gets the right dose?

Answer Choices:

1. Using a U-100 syringe, withdraw 100 units.
2. Using a U-500 syringe, withdraw 20 units.
3. Using a U-500 pen, dial to 100 units.
4. Using a U-500 pen, covert to 20 units.

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

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 will present questions that require test takers to be familiar with accurate dispensing of diabetes medications, injectables and insulins, including the concentrated versions.

Answers & Rationale

Answer 1 is incorrect, 7.11% chose this answer, “Using a U-100 syringe, withdraw 100 units.” This answer is wrong because when withdrawing U-500 insulin from a vial, a U-500 insulin syringe must be used (see image). Since U-500 insulin is 5x’s the concentration of U-100 insulin, drawing up 100 units of U-500 insulin in a U-100 syringe would deliver 500 units of insulin (or 5x’s too much and could be life threatening). See Concentrated insulin card below.

When using a U-500 syringe, no conversion is needed since the syringe automatically delivers the correct dose of U-500 insulin. No conversion, calculations or adjustments required.

Answer 2 is incorrect, 12.64% of you chose this answer, “Using a U-500 syringe, withdraw 20 units.” When using a U-500 syringe, no conversion is needed since the syringe automatically delivers the correct dose of U-500 insulin. No conversion, calculations or adjustments required. For example, if the order reads “100 units of U-500 concentrated insulin twice a day”, using a U-500 syringe, the person would withdraw 100 units of U-500 insulin.

Answer 3 is correct, 71.25% of you chose this answer, “Using a U-500 pen, dial to 100 units.” YES, GREAT JOB! If the order reads “100 units of U-500 concentrated insulin twice a day”, using a U-500 pen, the person would dial to 100 units of U-500 insulin. The pens automatically deliver the correct dose in less volume. No conversion, calculations or adjustments required.

Answer 4 is incorrect, 9.00% of you chose this answer, “Using a U-500 pen, covert to 20 units.” When using a U-500 pen, no conversion is needed since the U-500 pen is specifically created to deliver the correct dose of U-500 insulin. For example, if the order reads “100 units of U-500 concentrated insulin twice a day”, using a U-500 pen, the person would dial to 100 units of U-500 insulin.

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

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Brand New Online Advanced Courses | Level 4!

We are so excited to expand our Level 4 – Advanced Level & Specialty Topics Series!

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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.

June is Pride Month and in honor of providing best care for our LGBTQ+ community, we are highlighting an expert interview, with my dear friend and colleague, Theresa Garnero, APRN, BC-ADM, MSN, CDCES.

Theresa is a trailblazer and advocate in the field and she reminds us that whether we provide services in the hospital, clinic, or outpatient settings, we can take steps to help all people we serve feel welcome and included. We know that many people from the LGBTQ+ community with prediabetes or diabetes may delay seeking medical care to avoid the pain of social stigma often experienced in medical settings.

“Members of the lesbian, gay, bisexual, transgender and queer (LGBTQ) community have unique health disparities and worse health outcomes than their heterosexual counterparts, which has clinical relevance in the delivery of diabetes care and education. Diabetes care and education specialists are in a pivotal position to help this medically-underserved and vulnerable population get the best possible care.” – ADCES

By paying careful attention to each person’s experience from the moment they walk in the door until we say goodbye, we can find ways to create a more inclusive environment. This awareness of the details, such as inclusive gender questions on intake forms or gender-neutral signage on the bathrooms, are great first steps to show your care and respect for those you work with.

For more information on this topic, we turn to our expert for insights and resources.

Interview with Ms. Theresa Garnero, APRN, BC-ADM, MSN, CDCES

1. What inspired you to write the ground-breaking article for on “Providing Culturally Sensitive Care for the Lesbian, Gay, Bisexual, and Transgender (LGBT) community” in Diabetes Spectrum, gosh – already 10 years ago now?

I heard a researcher at a national conference go on and on about needing to screen the daughters of women with polycystic ovarian syndrome (PCOS) for diabetes since there is a strong link between PCOS and type 2. She never discussed the population of women that have the highest rates of PCOS – lesbians (38% of lesbians have PCOS vs. 14% of heterosexual women¹). So I went up to the mic and asked her if she was aware of Agrawal’s work showing lesbians have the highest rate of PCOS. I was flabbergasted when she said yes. I responded she might want to include that most vulnerable population in her talk as we need to screen all women at risk.

It got me thinking about how could a well-known professor at a national diabetes conference willingly withhold data about an under-served population? So, I began to comb through the existing research that impacts the LGBTQ community with regards to diabetes care and prevention. And I was astonished what I found. So, I wrote the article and was so glad the ADA published it. But why wasn’t this part of the conversation back then? Even now? And I still ask, why won’t ADA reply to my inquiries to include this special population within their Standards of Care?

2. What’s the first step our readers could do to provide inclusive care to the sexual and gender minority population of people with prediabetes and diabetes who seek care?

Actually take steps to include this special population. I think there are several opportunities to do this, starting with making sure their environment gives clues that it is a safe place for the LGBTQ community to seek care. Remember, this community is used to outright hostility from within the healthcare system and are often reluctant to self-disclose out of fear for getting substandard care.  I once worked with a man with type 1 diabetes who was gay tell me that his endocrinologist told him he deserved every low he got, and that when he’d go to the emergency department, they refused for his husband to be by his side And that happened in the gay mecca of San Francisco! Imagine other “less tolerant” places.

If they see you don’t have a clue because you have old forms with old terms, they most likely won’t come out. And if they don’t come out, then you don’t have all the data to make an individualized plan. So, you can check your assessment forms to see if you use inclusive terms. Do you actually ask for LGBTQ status by asking for sexual orientation, gender identification and relationship status (not marital status)? And collect the aggregate data! Just because it’s not measured doesn’t mean it doesn’t exist. Do you have clues in your waiting room that it’s safe and friendly for this group (like post a little rainbow flag)? Do you include LGBTQ risk factors for health outcomes in your materials? Do you tell people you are here to help everyone, no matter their situation or who they’re with? I realize change is slow, but collectively as individuals, and nationally, we can make it a better place for this underserved population.

3. “Inclusive Care” seems to be the new buzz phrase, but I bet most diabetes care and education specialist think they are being inclusive. I mean, how could you not be?

Because if you don’t even know a certain segment of those you care for have unique risk factors, and arguably worse – you have no clue who that vulnerable population is in your practice – you aren’t doing all you can to provide quality care to all you serve. It’s estimated that the number of LGBTQ individuals with diabetes equals that of the amount of people with type 1, so it’s not a small number we’re talking about. As an example, let’s apply this to Social Determinants of Health. We talk about the research showing how your zip code has more to do with your health than your DNA, particularly as it relates to food insecurity. But did you know LGBTQ individuals and families have the highest rates of food insecurity? Why isn’t that research included in diabetes mainstream publications and conferences?

According to research presented by the Williams Institute², more than 1 in 4 LGBTQ adults (27%), approximately 2.2 million people, experienced a time in the last year when they did not have enough money to feed themselves or their families, compared to 17% of non-LGBTQ adults.

And when you add racial/ethnic sub-populations within the LGBTQ community, the stats are staggering:

• Among LGBTQ people, 42% of African-Americans, 33% of Hispanics, 32% of American Indians and Alaskan Natives, and 21% of Whites reported not having enough money for food in the past year.

4. I was thrilled to see the handout that you wrote about inclusive care for the ADCES. That’s a start for sure. How do you think this came about?

Thank you! I am so excited to see our national organization pay attention to the LGBTQ population and help get the word out about what we can do. I think because they are interested in us being the best diabetes care and education specialist that we can and including everyone is part of that. I had also just spoken at the AADE conference in Houston. We had a panel of professionals and researchers that represented the LGBTQ community. (I had spoken previously at AADE, but that was just by myself and this last time was so special.) I’m truly impressed with how much research that has transpired in these 10 years.

5. Any closing thoughts?

I’d say that a willingness to learn is so important. As is recognizing one’s personal biases. We certainly don’t agree with the lifestyles of all we serve, but it is not our role to judge or let those biases interfere with helping someone find a path to thriving with diabetes. And just know, it takes time to get up to speed. I’d encourage readers to check out the ADCES handout and watch this funny video clip that a colleague sent me. Honestly, it is hard to keep up with the terms, even for someone like me who helped to get this topic on the diabetes radar. This video made me crack up and appreciate the nuance of all the terms. I bet your audience would like it too. You can check out the “What “The Sex Talk” Looks Like Now, by Alternatino. Thanks so much, Beverly, for your willingness to discuss the topic. I truly hope it helps your readers improve their care delivery.

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Ms. Theresa Garnero, APRN, BC-ADM, MSN, CDCES  trail-blazed several innovations in the field of diabetes in the years that followed being awarded the national Diabetes Educator of the Year by the American Association of Diabetes Educators (2004).

Her latest efforts involve trying to reach people with prediabetes and type 2 who are currently not being reached with our face-to-face programs. How? She created the Sweet People Club  an all online program which uses a flipped classroom concept so people can follow the Diabetes Prevention Program and also manage type 2 through a series of professionally-made videos (ahem, nearly 150 of them!) that they can watch at a time that is convenient for them, then ask questions through the portal, as well as meet virtually face-to-face real time with a Registered Dietitian twice a month.

If you’d like access to experience what the program is like, she is sharing her work and invites your feedback. Visit https://www.sweetpeopleclub.com/pro/ or email her for questions at [email protected] 

List of Resources

ADCES Inclusive Care for LGBTQ+ People with Diabetes Handout – this handout provides definitions, terms to avoid, and a cultural competency checklist to help you move towards improving inclusivity within your practice.

All Gender Restroom Sign PDF

A Guide To Gender Identity Terms by NPR – A glossary for gender identity terms to use more inclusive language.

Diabetes Prevention and Management for LGBTQ+ People Handout – this handout includes research of diabetes within the LGBTQ community, along with clinical considerations, programs, and resources for diabetes educators to use within their practice.

Policies on Lesbian, Gay, Bisexual, Transgender & Queer (LGBTQ+) issues – this resource by the American Medical Association lists all the current healthcare policies in place for the LGBTQ community.

Helio’s LGBTQ+ Health Updates Resource Center – this is a “collection of news articles and features that provide the latest information on the unique health needs of individuals in the LGBTQ+ community.”

1. Agrawal et al: Prev. of polycystic ovaries and polycystic ovary syndrome in lesbian women compared w heterosexual women. Fert Steril 82:1352-57, 2004.
2. FOOD INSECURITY AND SNAP PARTICIPATION IN THE LGBT COMMUNITY. (n.d.).
3. Sweet People Club

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Wow! This is fantastic news. I sit for the CBCDE Exam for the 7th time next year, and I am definitely going to take advantage of this remote feature! ~ Coach Beverly

The Certification Board for Diabetes Care & Education (CBDCE) is now offering the opportunity to take your Certified Diabetes Educator (CDCES) exam remotely!

By the end of this year, you will have the option to take your certification exam using their new Live Remote Online Proctoring (LRP) platform.

Get Familiar with the Requirements

During your exam appointment, you will be connected with a moderator who will guide you through the process and be there throughout your entire exam. You will need to share your screen and broadcast yourself during your entire exam. Your workspace should be quiet, tidy, and free of any study notes/materials.

No electronics, besides the computer you are taking the test on are allowed. However, since there may be math questions, a basic calculator is allowed after clearance by the moderator. A 10-minute break is an option, but no changes to completed test questions are allowed after the break. In addition, the moderator will need to rescan your workspace to make sure it is free of study notes and materials. After you take the exam, you will instantly get a report of your results.

To connect to the LRP platform, you will need a computer with a webcam and microphone. The CBDCE recommends that you run compatibility tests before your exam to ensure your equipment is compatible.

To learn more about LRP, watch the 4-minute video below and read the Guide to Live Remote Online Proctoring (LRP)

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Studying for the CDCES Exam?
Join us for our Becoming a CDCES FREE Webinar

Join us to get ready to succeed a the CDCES Exam. This course will transform your test anxiety into calm self-confidence and test-taking readiness.
Topics covered include:

• Changes in requirements for 2021
• Exam eligibility and test format
• Strategies to succeed
• Review of study tips and test-taking tactics.

We will review sample test questions and the reasoning behind choosing the right answers.
After registering, you will receive a confirmation email containing information about joining the webinar.

Intended Audience: This FREE webinar is designed for individuals or groups of diabetes educators, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants and other health care providers interested in achieving excellence in diabetes care and becoming Certified Diabetes Care and Education Specialists®.

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See Full Calendar for upcoming webinars and Virtual Courses.

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

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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.

1. Hepatitis B Vaccine
2. Screening for prostate cancer
3. Referral to podiatry
4. Antibody testing to confirm diagnosis

Click here to test your knowledge!

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Want to learn more about this topic? Enroll in our

Level 4 | Type 2 Intensive | 2.0 CEs

Objectives:

1. Discuss the current epidemiology of type 2 diabetes.
2. Describe the classification, terminology & diagnostic criteria for diabetes.
3. Identify the eight pathophysiologic defects associated with the ominous octet.
4. Describe evidence and strategies to prevent type 2 diabetes.
   State strategies to implement a person-centered approach to those with diabetes.
5. Discuss key aspects of type 2 diabetes management including education, therapeutic lifestyle changes, glucose, lipid, and hypertension management plus referrals.
6. Understand the overarching principles of management of type 2 DM including.
   1. Classes of the diabetes medications
   2. Treatment of dyslipidemia/hypertension
   3. Screening for, prevention, and treatment of microvascular complications
   4. Psychosocial support

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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.

For our May 18th Question of the Week, 76% of respondents chose the best answer, which is awesome! We still want to “take a closer look” at this question.

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: CT was diagnosed with type 2 diabetes three years ago. The current medication regimen includes 1000 mg of metformin twice daily and 70 units of glargine at night. CT wears an intermittent sensor, and you look at the glucose trends together on CT’s phone app. You both agree that there are consistent postmeal spikes up to 250 almost every day after lunch and dinner. The lowest blood sugar readings are in the 100s. BMI is 33.8 and CT says, “I never feel full”. The most recent A1C is 8.2%, urinary albumin creatinine ratio less than 30.

Based on this information, what intervention would be most likely help CT get to recommended ADA targets?

Answer Choices:

1. Add on low-dose sulfonylurea to prevent hypoglycemia.
2. Suggest adding a GLP-1 Receptor Agonist.
3. Hold metformin, and switch to basal-bolus therapy.
4. Encourage CT to get more active, especially after meals.

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

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 will present questions that require test takers to be familiar with the stepwise approach to type 2 diabetes management in a variety of settings and situations.

For a complete listing of diabetes medications, please Download our Medication PocketCards.

Answers & Rationale

Answer 1 is incorrect, 2.51% chose this answer, “Add on low-dose sulfonylurea to prevent hypoglycemia.” Although we might consider this option, we can quickly identify a “tacked on” second half of the answer that makes it a wrong choice. One of the major side effects of sulfonylureas is hypoglycemia, so adding this class of medication wouldn’t prevent hypoglycemia, it would actually increase the risk of low blood sugars.

Answer 2 is correct, 76.57% of you chose this answer, “Suggest adding a GLP-1 Receptor Agonist.” GREAT JOB! Given the fact that CT is on 70 units of basal plus metformin and is experiencing postmeal spikes up to 250 almost every day after lunch and dinner and “never feels full”, adding a GLP-1 is the best choice. Adding a GLP-1 will decrease post meal hyperglycemia and postprandial glucose. In addition, GLP-1s can decrease appetite and increase feelings of satiation. Before suggesting addition of this medication class, it is important to consider insurance coverage and out of pocket cost, since cost could be a barrier.

Answer 3 is incorrect, 9.83% of you chose this answer, “Hold metformin, and switch to basal-bolus therapy.” According to the ADA, when initiating basal bolus insulin therapy for people with type 2 diabetes, they recommend continuing metformin to decrease insulin resistance. The ADA also suggests considering adding a GLP-1 RA or SGLT-2 Inhibitor before switching to basal bolus therapy.

Answer 4 is incorrect, 11.09% of you chose this answer, “Encourage CT to get more active, especially after meals.” While activity is important, this goal is very vague and not really actionable. In addition, “getting active after meals” will certainly improve health and is a great recommendation, but is not likely to drop the A1c to less than the goal of 7% or help with appetite.

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

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Want to learn more about this topic? Join us for our upcoming

Level 4 | Solving Glucose Mysteries for Type 2 | 1.5 CEs | Ready to Watch!

Why are glucose levels elevated in the morning? When should insulin be started?  What is the next step to get A1c to target?

During this course Coach Beverly addresses each of these glucose mysteries and more, using a person-centered approach.  She describes a stepwise approach to evaluate glucose patterns and correct common issues encountered by people living with type 2 diabetes.

By attending this webinar, you will gain confidence in evaluating glucose patterns and making recommendations for improvement.

Objectives

1. Describe common glucose mysteries encountered by people with type 2 diabetes.
2. Using a stepwise approach, evaluate factors affecting glucose patterns.
3. State interventions to increase time-in-range and improve quality of life.

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Join us for our Live Webinars

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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.

For the past year, as the only diabetes nurse educator at a local FQHC clinic, I have had to fine-tune my nutrition coaching skills. We are hoping to hire a dietitian soon, but in the meantime, I am trying to find my nutrition groove as I work with Spanish-speaking clients, kids to elders, and everyone in between.

For many years, I shied away from using the plate method and mostly relied on dietary recalls and figuring out changes needed to improve the health quotient of their current meal plan.

However, as people walk into my clinic room, I am surprised by how many are drawn to the oversized healthy plate place-mats sitting on my display table. They ask, “Can I eat these foods?” This sparks a lively and constructive conversation on new approaches to eating.

Based on this enthusiastic response, after I complete the dietary recall, I jump into our food conversation using the plate method. Whether am I coaching kids to elders on healthy eating, this approach seems to get the best response. If needed, I will dive into more detail around carb serving sizes and matching carbs to insulin.

Using the plate method allows me to keep it person-centered and help them include their favorite foods to maintain the pleasure of eating.

How I use the Plate Method:

This teaching tool is ideal because it has appealing pictures of the different foods that make it easy to provide a quick review of the food groups and their impact on blood sugars and overall health.

In addition, these plates represent a variety of cultures and eating styles, and come in several languages. Here is the one in Spanish I use all the time.

5 Main Pointers

Take a vegetable tour: I start on the left side of this place mat, which has pictures of a variety of healthy high fiber vegetables, which I emphasize are low in calories and packed with nutrients. Then I ask which vegetables are they currently eating and provide encouragement to continue and expand their veggie choices, if possible. “Enjoy an abundance of these super foods, that fill you up, feed your good bacteria, decrease inflammation, help manage blood sugars and support a healthy weight.”

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Next stop – CARBS and Beans – There is a lot of misinformation around the carbohydrate group and many people tend to lump them in the “bad food” category. We discuss the carbs they are consuming and discuss some they might be missing out on, like fruits or tortillas, thinking they were off-limits. I encourage 3 servings of fruit daily, (the size of a closed fist) spread throughout the day.
Beans, the magical fruit! I make an intentional effort to sing the praises of beans. They are the inexpensive, fiber-packed nutrition superstars and they are so versatile.
A big focus with carbs is portion sizes. The actual amount of carbs someone is consuming is really easy to underestimate. For this part, I DO pull out my rubber food models, which are as popular as ever.

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Canned and Frozen veggies are good for you. Many people may not have access to fresh vegetables or refrigeration. Canned vegetables and soups are often a cheaper, more realistic option. They can choose low sodium if they have hypertension or they can rinse off salty, often less expensive canned vegetables. If they have access to a freezer, frozen veggies offer as many nutrients (and sometimes more) than fresh vegetables, especially if they have been on the shelf for a while.
I encourage starting meals with soups, salads, or water if they are trying to lose weight.

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Protein and meats – Our discussion focuses on serving sizes and healthy ways to prepare low fat or skinless meats. If their LDL cholesterol is above target, we will include a discussion on meat alternatives and review cheese consumption.

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Sugary Beverages, Sweet Treats, and Snacks – Coffee with a little cream and sugar is fine, but those coffee drinks topped with whip cream can pack lots of carbs and unwanted calories. Replacing sports drinks and sodas with water or unsweetened tea can make a huge difference in glucose levels and body weight.

Mindless muching. I find many people munching on snacks and sweet treats (especially in the evenings) out of boredom or in response to stress. Helping people ask themselves, “Am I really hungry?” before that first bite can make a big difference. Also keeping track of the emotion associated with “mindless snacking” can help people discover other strategies to deal with uncomfortable feelings.

The plate method is simple, engaging of fun. We can customize the plate based on their food favorites and help individuals and families improve their health and feel better!

Resources To Check Out

Get Started on the ADA Diabetes Food Hub – Sign up to save recipes, create a personalized grocery list, and more.

Please visit the ADA’s Diabetes Food Hub recipe page.
They have an abundance of recipes based on budget, preferred foods, time of day, etc… Plus, they also provide the nutrition facts, and it’s FREE!
ADA website: https://www.diabetesfoodhub.org/ 

Check out Awesome photos and ideas modeling the “Diabetes Plate Method”

USDA Plate Method Website has lots of great info

USDA Diabetes Meal Planning in Spanish

Order ADA Placemat in Spanish

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Join us for our live streaming of our brand new course

Level 4 | Insulin Calculation Workshop – From Injections to Pumps | 1.5 CEs

Determining basal and bolus rates for multiple daily injections or insulin pumps can seem overwhelming.  This 90-minute course provides participants with a step-by-step approach to determine basal rates, bolus ratios and how to problem solve when blood glucose levels aren’t on target. During this 90-minute course,  Coach Beverly will provide abundant case studies to give participants hands-on practice and build confidence when calculating insulin doses for a variety of situations.

Objectives:

1. Describe using formulas to determine appropriate insulin dosing.
2. Discuss strategies to determine and fine-tune basal insulin dose
3. Describe how to determine and fine-tune bolus rates including coverage for carbs and hyperglycemia.
4. Using a case study approach, utilize calculations to determine the best insulin dosing strategy.

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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.

Managing diabetes can be tough! Something that people rarely talk about is how tough type 1 diabetes can be and how many people find diabetes to be stressful and challenging.

That’s why we are excited to share an opportunity for people living with type 1 diabetes to join a new NIH-supported study that is part of a collaboration between T1D Exchange and the University of California, San Francisco (UCSF).

Note from Coach Beverly

I have had the pleasure of working as an Embark facilitator for the past year.

I can personally share with you that this program offers so much meaningful hands-on problem solving and support for those who join. Participants not only receive practical information but gain valuable insights into approaches for self-care.

I highly recommend this program to anyone with type 1 diabetes who is feeling frustrated and tired and ready to make changes with the help of a supportive team!

Embark Program Details

The program begins with a group workshop (8-12 adults with type 1 diabetes) (held virtually online on a Saturday), followed by online video group meetings and/or individual phone calls with either a psychologist or Certified Diabetes Educator.

The program interventions are strictly behavioral, meaning that participants will not be asked to change or try any new medications or devices.

Participants will receive gift cards for their time and there are no costs to you or to your insurance. There is no age limit to taking part, you just need to be 19 years or older!

If you know people living with type 1 diabetes, please share this information with them. Our hope is that they will be interested in learning more about this exciting new program.

Research Participants Needed:
Are you…
– An adult (19 years +)
– Diagnosed with Type 1 Diabetes for at least 1 year
– Unhappy with your recent Hemoglobin A1C of 7.5% or higher
– Feeling overwhelmed, frustrated, “burned out” with living with diabetes
If you answered YES to the above questions, you may qualify to participate in EMBARK. The purpose of this study is to work compassionately to help you better manage your distress with diabetes and to reach your management goals.

More info on Embark Website

Or you can call: 1-855-850-3599 (toll free) or email us at: [email protected]. Thank you, UCSF EMBARK Team

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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.