Question of Week | JT is Carb limiting to 30gms a day. Best Response?
JT has type 1 diabetes and tells you they are avoiding carbs and trying to eat less than 30gms of carbs daily. JT is 76 years old, with an A1C of 6.6% and a BMI of 22.
What is the best response?
- Suggest JT try to eat a minimum of 30- 45 gms of carb per meal.
- Gently suggest to JT that they might have disordered eating.
- Explore JT’s reasons for avoiding carbs.
- Provide a review of carb portions and refer JT to an RD/RDN.
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ReVive 5 Diabetes Training Program
Whether you are a novice or an expert in providing diabetes care, we invite you to attend this exciting training program that provides the essential steps to address diabetes distress combined with an innovative approach to glucose management that will revolutionize your practice.
“ReVive 5” breathes new life into our relationship with diabetes, bringing a fresh perspective to both the person with diabetes and the provider.
By releasing old habits that no longer serve us, we have the opportunity to create a new life tool kit toolkit in partnership with the person living with diabetes.
The ReVive 5 program is built on international research study results and will revolutionize your approach to diabetes self-management education.
Join our Team of Experts
Team of Experts:
ReVive 5 is taught by a team of 3 Interdisciplinary Experts:
- Lawrence Fisher, Ph.D., ABPP, Professor Emeritus, UCSF
- Susan Guzman, PhD
- Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Accredited Training Program:
- 15.0 CEs – Includes the 7-hour ReVive 5 Training Program, Certificate, and 5 FREE bonus courses to supplement content.
- Free Quarterly ReVive 5 Connect – connect with the instructors to help with problem-solving for an hour four times a year (see dates below).
- A comprehensive set of assessment tools, educational materials, log sheets, and resources.
Dates and Times for ReVive Virtual Training
- For your convenience, we have combined the 4 sessions into 2 half days. Same great content.
- July 19 and 26th from 9 am to 12:30 pm PST. Space is limited, so save your space today!
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
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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 action before starting tirzepatide (Mounjaro)?
AR is 36 years old with type 2 diabetes and a BMI of over 40. Current A1C 7.9%, UACR less than 30, and GFR more than 60. Current diabetes medications include metformin, sitagliptin, and empagliflozin at maximum doses. AR is prescribed the new dual incretin tirzepatide (Mounjaro) to help improve glucose levels and support weight loss.
Before starting tirzepatide (Mounjaro), what action do you recommend to the provider?
- Repeat the UACR and GFR to verify kidney function.
- Stop the sitagliptin.
- Decrease metformin dose to prevent hypoglycemia.
- Evaluate thyroid function.
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New Injectable – “TwinCretin” on Printed PocketCards
We have just added this novel, first in class, dual incretin hormone therapy, Tirzepatide (Mounjaro), to our printed version of our Diabetes Medication PocketCard.
This new twin therapy includes not only a GLP-1 Receptor Agonist, but also a Glucose-dependent insulinotropic polypeptide (GIP), which magnifies the therapeutic effectiveness. The SURPASS studies indicate that study participants experienced an A1C drop of up to 2.5% and weight loss of up to 10kg or more.
Want to learn more about Diabetes Medications?
Virtual DiabetesEd Training Conference | 30+ CEs
Airs October 12-14th, 2022
Join us LIVE for this Virtual Training Conference and enjoy a sense of community!
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
Download Course Flyer | Download Schedule
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
Two Registration Options
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Question of Week | What explains JR’s sudden DKA?
JR, a 67-year-old with type 2 diabetes for seven years and an A1C of 9.7% was started on empagliflozin 10mg two weeks ago. Other labs include a GFR of 49 and a UACR of 34 mg/g. Other diabetes medications include glucotrol 10mg twice daily and sitagliptin 100mg daily. JR sometimes has a few shot’s of whiskey before bed, especially if they had a stressful day. JR’s partner calls you in a panic and says JR is admitted to the hospital in DKA.
What is the most likely explanation?
- Excess alcohol intake leading to starvation ketosis
- Potential side effect of SGLT-2 Inhibitors
- Low GFR and elevated UACR increase hyperglycemic risk
- JR is misdiagnosed and likely has type 1 diabetes
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Want to learn more about Diabetes Medications and Side Effects? Dr. Diana Isaacs will be sorting fact from fiction in our
Virtual DiabetesEd Training Conference | 30+ CEs
Airs October 12-14th, 2022
Join us LIVE for this Virtual Training Conference and enjoy a sense of community!
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
Download Course Flyer | Download Schedule
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
Two Registration Options
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Question of Week | Ambulatory Glucose Profile Confusion
LS is 72 years old with type 2 diabetes and injects insulin 4 times a day. They were started on a CGM device last month and you are looking at the Ambulatory Glucose Profile (AGP) together. You notice their time in range is 60%, their time above range is 38%, in low range is 2% and their coefficient of variation is less than 36%.
What is the best response?
- We still need to improve your coefficient of variation.
- Based on these results, let’s decrease your insulin by 20%.
- Time in range should be 70% or greater for your age group.
- This information is going to help with problem solving.
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Join our Virtual Conference to gain valuable insights from
Technology Expert, Dr. Diana Isaacs
and/or
Join our FREE live Webinar on September 13th, from 11:30 am to 12:15 pm
What We Say Matters: Language that Respects the Individual and Imparts Hope
Many people with diabetes have experienced injustice, trauma, and marginalization, and are often struggling with feelings of shame and blame.
Topics covered include:
- Learn phrases, words, and approaches that can be left behind.
- Describe diabetes language that is respectful, inclusive, person-centered, and imparts hope.
- Discuss how to evaluate for ACE and provide trauma-informed care
- Practice communicating about diabetes using phrases free from judgment with a focus on a strength-based approach.
Intended Audience: A great course for healthcare professionals who want to learn the steps involved in providing a thorough lower extremity assessment.
Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working educator and a nationally recognized diabetes expert.
All hours earned count toward your CDCES Accreditation Information
Two Registration Options
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Question of Week | Abdominal lumps and insulin injections
JL is 67 years old, with a BMI of 23 and A1C of 7.6% and injects insulin 4 times a day to manage their type 1 diabetes. On visual inspection, you notice that there are many areas of lipohypertrophy on JL’s abdominal region.
Which of the following interventions would be the best recommendation?
- Switch to 50/50 insulin twice daily.
- Stop bolus insulin and switch to a GLP-1 RA.
- Switch bolus injections to inhaled insulin.
- Use a higher gauge needles to enhance absorption.
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Want to learn more about Diabetes Care? Join us for our
Virtual DiabetesEd Training Conference
30+ CEs
Airs October 12-14th, 2022
Join us LIVE for this Virtual Training Conference and enjoy a sense of community!
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
Download Course Flyer | Download Schedule
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
Two Registration Options
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Question of Week | Right amount of insulin for 83 year old?
MS is an 83-year-old admitted to the hospital for a broken hip. MS has a BMI of 22.4, A1C of 6.9% on metformin 500mg twice daily. UACR is less than 30 and GFR is 48. The MD writes to stop oral meds in prep for surgery and start on basal-bolus insulin therapy.
Based on MS’s profile, what would be the most accurate formula to calculate their total daily insulin dose?
- 0.3 units of insulin / kg/day
- 0.5 units of insulin /kg/day
- 0.5 – 1.0 units of insulin /kg /day
- Start with 10 units of basal insulin
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Want to learn more about this question? Join us for our
Level 4 | Basal Bolus Therapy in Hospitals | 1.5 CEs
Airs Thursday, August 25th, 2022
Glucose control in the hospital matters! This course provides participants with a step-by-step approach to safely and effectively implement Basal Bolus Insulin Therapy in the inpatient setting. We discuss appropriate insulin dosing based on the patient’s clinical presentation and apply dosing strategies to a variety of case studies. Included are hard-to-manage situations that commonly occur in hospital settings and a discussion of solutions that will keep patients safe and get glucose levels to goal. In addition, sample basal/bolus and insulin drip guidelines plus lots of resource articles are included.
Objectives:
- Discussing appropriate insulin dosing based on the patient’s clinical presentation
- Applying dosing strategies to a variety of case studies
- Introduce hard-to-manage situations that commonly occur in hospital settings
- A discussion of solutions that will keep patients safe and get glucose levels to goal
- Sample basal/bolus and insulin drip guidelines plus lots of resource articles are included
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Question of Week | Should I toss food if it’s past the date?
A person comes into the clinic for a diabetes education appointment. They are on a budget and ask you if they should throw away food if it is older than the date on the package?
What is the most accurate response?
- Manufacturer’s stamp foods with date to comply with federal safety standards.
- Before throwing away the food, look at it and smell or taste it to see if it has gone bad.
- The date on food packaging indicates when it is no longer safe to consume.
- Food packaging dates are federally regulated and help keep consumers safe.
Click Here to Test your Knowledge
Want to learn more about Diabetes Care? Join us for our
Virtual DiabetesEd Training Conference
30+ CEs
Airs October 12-14th, 2022
Join us LIVE for this Virtual Training Conference and enjoy a sense of community!
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
Download Course Flyer | Download Schedule
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
Two Registration Options
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Read more in our blog
Food Dates Can Lead to Unnecessary Waste
Have you inspected a food product that you bought last week and wondered if you should toss it because it expired yesterday? If you said yes, you are not alone.
About 40% of food waste happens in the kitchen, when consumers throw away foods that have passed the expiration date.
Are we throwing away perfectly good food based on the date stamped on the package?
Dates are confusing and they are often not associated with safety concerns. Learn why food and legal experts are asking consumers to reconsider their thinking.
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.
Question of Week | Best Action for Glucagon Rescue with Beer?
RT is a 17-year-old with type 1 diabetes who uses an insulin pump and glucose meter to manage blood glucose levels. RT is out with friends, drinking beers and suddenly passes out. One of RT’s friends carries a glucagon rescue medication and administers it to RT in a panic.
Which of the following statements is most accurate?
- RT will regain consciousness within 15 minutes, so make sure to roll RT on their side.
- RT did not pass out from low blood sugar since they were consuming beer.
- RT will likely have a blunted response to the glucagon rescue medication.
- RT needs immediate administration of oral glucose to promote glycogenolysis.
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Want to learn more about this question?
Enroll in our upcoming webinar series updates
Level 4 | Advanced Level & Specialty Topic Courses | 12+ CEs
Join us live beginning August 9th through November 9th at 11:30 am PST
This bundle is specifically designed for healthcare professionals who want to learn more about Specialty Topics for their clinical practice or for those who are studying for the Board Certified in Advanced Diabetes Management (BC-ADM) certification exam.
2022 Live Webinar Updates
Previously recorded & available for on-demand viewing
- The Impact of Adverse Childhood Experiences on Health | 1.0 CE
- 3 Steps to Save Feet; Assess, Screen, and Report | 1.0 CEs
All courses air at 11:30 a.m. (PST)
- August 9, 2022 | Solving Glucose Mysteries for Type 1 | 1.5 CEs
- August 11, 2022 | Solving Glucose Mysteries for Type 2 | 1.5 CEs
- August 23, 2022 | Insulin Calculation Workshop – From Pumps & Beyond | 1.5 CEs
- August 25, 2022 | Basal Bolus Therapy in Hospital |1.5 CEs
- September 15, 2022 | Type 2 Diabetes Intensive | 2 CEs
- October 26, 2022 | Cancer & Diabetes | 1.25 CEs
- November 9, 2022 | Getting to the Gut (& Skin) | 1.0 CEs
Can’t join us live?
Don’t worry, we will send you a link to the recorded version.
Coach Beverly Thomassian, RN, MPH, BC-ADM, CDCES
Author, Nurse, Educator, Clinician and Innovator, Beverly has specialized in diabetes management for over twenty years. As president and founder of Diabetes Educational Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes.
Read more in our blog
Does Alcohol Intake Blunt Impact of Glucagon?
LS tells you that they frequently attend company mixers where they feel compelled to have at “least a few drinks”, to fit in and network.
The tricky part is that LS lives with type 1 diabetes. Since they don’t have a working pancreas, their circulating levels of insulin and glucagon are often mismatched to their body’s needs.
If LS has several drinks, then loses consciousness from hypoglycemia, will emergency treatment be effective?
There is emerging evidence that glucagon rescue medications may have a blunted response when ingesting alcohol.
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.
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