Question of the Week | Premeal Glucose is Too Low
RL carb counts and takes 1 unit of insulin for every 10 gms of carbohydrate. RL also uses a correction ratio and takes 1 unit for every 40 points above their glucose target of 120. RL’s asks you what to do if their premeal glucose is less than 70 before their lunch meal at work. RL often has blood sugar drops right before lunch and usually eats a sandwich, chips, berries and some sparkling water for lunch.
Given the situation, what is the best recommendation for JL to do if their pre-lunch glucose is less than 70 mg/g?
- Immediately eat 15gms of berries and recheck glucose in 15 minutes.
- Decrease usual insulin carb coverage for this meal by 1 or 2 units.
- Encourage JL to eat lunch immediately and give insulin afterward.
- Discuss which strategies would work best for RL in this situation.
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Enroll in our upcoming webinar
Solving Glucose Mysteries for Type 1
Airs live on August 9th at 11:30 am PST
Why do the blood sugars keep dropping after meals? Is the basal insulin set correctly? What adjustments are needed for exercise?
During this webinar, 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 1 diabetes.
Objectives:
- Describe common glucose mysteries encountered by people with type 1 diabetes.
- Using a stepwise approach, evaluate factors affecting glucose patterns.
- State interventions to increase time-in-range and improve quality of life.
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.
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 the Week | Best treatment for abrasion?
JR is 38 years old and takes insulin twice a day. They mention they were going to the bathroom at night, lost their balance and scraped their shin. They put a band-aid on it, but want you to take a look.
What is the best approach to treat the abrasion?
- Clean carefully with sanitizing gel, apply topical antibiotic and observe for signs of infection.
- Discuss creating a safe path to the bathroom at night and assess the abrasion for severity.
- Replace the band-aid with gauze and suggest they make an appointment with podiatry.
- Take a photo of the abrasion, wash with soap and water, and apply iodine around the perimeter.
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Want to learn more about this question?
Foot Screening Bundle – Purchase Now and save $15!
3 Steps to Save Feet Webinar + Monofilament 20-Pack + ADA Foot Chart
Can’t join us live?
Don’t worry, we will send you a link to the recorded version.
FREE Handouts and Resources
3 Steps to Save Feet – Assess, Screen, Report Handout. This handout walks health care professionals through the steps involved in a 10-minute foot assessment and monofilament screening. Also includes a Screening Form to document and report findings.
Foot Care Teaching Sheet – Steps to Healthy Feet. This handout covers the important elements of foot care for people living with diabetes with simple and straightforward language.
Foot Care Teaching Sheet in Spanish– Pasos Para Tener Pies Sanos. This handout covers the important elements of foot care for people living with diabetes with simple and straightforward language.
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.
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 the Week | Best action to treat a corn?
A person with diabetes has small corn on their pinky toe and it bothers them when walking.
What is the best first action?
- Instruct them on to how to safely use a liquid corn remover.
- Encourage them to buy a shoe size larger than their usual shoe size.
- Carefully trim the corn with a sterile instrument and cover with gauze padding.
- Refer the person to a foot specialist.
Click Here to Test your Knowledge
Want to learn more about this question?
Foot Screening Bundle – Purchase Now and save $15!
3 Steps to Save Feet Webinar Airs live today, July 19th at 11:30 am PST
Can’t join us live?
Don’t worry, we will send you a link to the recorded version.
FREE Handouts and Resources
3 Steps to Save Feet – Assess, Screen, Report Handout. This handout walks health care professionals through the steps involved in a 10-minute foot assessment and monofilament screening. Also includes a Screening Form to document and report findings.
Foot Care Teaching Sheet – Steps to Healthy Feet. This handout covers the important elements of foot care for people living with diabetes with simple and straightforward language.
Foot Care Teaching Sheet in Spanish– Pasos Para Tener Pies Sanos. This handout covers the important elements of foot care for people living with diabetes with simple and straightforward language.
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.
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 | Why is Diabetes Foot Care So Important?
Why is it important that people with diabetes pay special attention to taking care of their feet?
- Years of insulin injections can increase risk of lower extremity complications.
- People with diabetes often experience changes in lower extremity sensation and circulation.
- Unusual skin growths are associated with diabetes unless preventative measures are routinely used.
- Everyone with diabetes needs a referral to a Podiatrist to prevent foot problems from starting.
Click Here to Test your Knowledge
Want to learn more about this question?
Join us for our new FREE Webinar
3 Steps to Save Feet; Assess, Screen, and Report
Airs live July 19th at 11:30 am PST (45 to 60 minutes)
All health care professionals are invited to join us to learn strategies to protect lower extremities during this FREE Webinar.
Coach Beverly will walk participants through the 3 Step Process to Save Feet; Assess, Screen and Report. She will provide simple and clear instructions on how to assess and inspect feet, along with risk assessment and action steps. We will share free teaching tools, strategies, and documentation forms adapted from the Lower Extremity Prevention Program (LEAP) that you can immediately implement in your practice setting.
CEs: 1.0 CEs for $19 or No CEs for FREE
Topics include:
- Effective foot assessment made easy
- How to use a monofilament to assess sensation
- Using screening form to report findings
Can’t join us live?
Don’t worry, we will send you a link to the recorded version.
FREE Handouts and Resources
3 Steps to Save Feet – Assess, Screen, Report Handout. This handout walks health care professionals through the steps involved in a 10-minute foot assessment and monofilament screening. Also includes a Screening Form to document and report findings.
Foot Care Teaching Sheet – Steps to Healthy Feet. This handout covers the important elements of foot care for people living with diabetes with simple and straightforward language.
Foot Care Teaching Sheet in Spanish– Pasos Para Tener Pies Sanos. This handout covers the important elements of foot care for people living with diabetes with simple and straightforward language.
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.
NEW! Order Monofilament (5.07) for Diabetes Foot Screening 20-Pack
People with diabetes are at increased risk of foot complications. By using a 5.07 monofilament (delivers 10gms of linear pressure) to assess for loss of sensation, diabetes health care professionals can immediately identify high-risk feet and take steps to protect lower extremities. Basic foot care education and intervention can reduce the risk of amputation by over 50 percent.
We are excited to provide these single-use 5.07 monofilaments in packs of 20.
We have included instructions on how to assess and inspect feet, along with risk assessment and action steps. We enhanced the teaching tools and forms from the Lower Extremity Prevention Program (LEAP) and are excited to share them with our community of diabetes advocates.
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 use of Monofilament to Check Feet?
ADA Standards of Care recommend using a 5.07 monofilament to evaluate for loss of protective sensation in lower extremities in people with diabetes. Which of the following statements is most accurate regarding using a monofilament to assess lower extremities?
- When using the monofilament, test above or below thickened or callused skin.
- Be careful not to bend the monofilament when testing for sensation.
- Alternate between hot and cold testing with monofilament testing to enhance accuracy.
- Rotate monofilament testing between the medial malleolus and distal phalanges for best results.
Click Here to Test your Knowledge
Want to learn more about this question?
Join us for our new FREE Webinar
3 Steps to Save Feet; Assess, Screen, and Report
Airs live July 19th at 11:30 am PST (45 to 60 minutes)
All health care professionals are invited to join us to learn strategies to protect lower extremities during this FREE Webinar.
Coach Beverly will walk participants through the 3 Step Process to Save Feet; Assess, Screen and Report. She will provide simple and clear instructions on how to assess and inspect feet, along with risk assessment and action steps. We will share free teaching tools, strategies, and documentation forms adapted from the Lower Extremity Prevention Program (LEAP) that you can immediately implement in your practice setting.
CEs: 1.0 CEs for $19 or No CEs for FREE
Topics include:
- Effective foot assessment made easy
- How to use a monofilament to assess sensation
- Using screening form to report findings
Can’t join us live?
Don’t worry, we will send you a link to the recorded version.
FREE Handouts and Resources
3 Steps to Save Feet – Assess, Screen, Report Handout. This handout walks health care professionals through the steps involved in a 10-minute foot assessment and monofilament screening. Also includes a Screening Form to document and report findings.
Foot Care Teaching Sheet: This handout covers the important elements of foot care for people living with diabetes with simple and straightforward language.
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.
NEW! Order Monofilament (5.07) for Diabetes Foot Screening 20-Pack
People with diabetes are at increased risk of foot complications. By using a 5.07 monofilament (delivers 10gms of linear pressure) to assess for loss of sensation, diabetes health care professionals can immediately identify high-risk feet and take steps to protect lower extremities. Basic foot care education and intervention can reduce the risk of amputation by over 50 percent.
We are excited to provide these single-use 5.07 monofilaments in packs of 20.
We have included instructions on how to assess and inspect feet, along with risk assessment and action steps. We enhanced the teaching tools and forms from the Lower Extremity Prevention Program (LEAP) and are excited to share them with our community of diabetes advocates.
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 the Week | Best advice on adding new med, Mounjaro
The FDA recently approved the new ‘twincretin” dual incretin hormone therapy called Tirzepatide (Mounjaro). The provider wants to start a person with type 2 diabetes on this new medication and asks for your consultation. The person’s current medications for type 2 diabetes include metformin, empagliflozin (Jardiance), semaglutide (Ozempic), and Pravachol. What is the best response to the provider?
- Inform provider that Tirzepatide (Mounjaro) is contraindicated in people taking SGLT-2 Inhibitors.
- Recommend stopping the semaglutide (Ozempic) before starting the Tirzepatide (Mounjaro).
- Reinforce the importance of prescribing a CGM before starting Tirzepatide (Mounjaro).
- Request provider also prescribes Glucagon rescue med in case of severe hypoglycemia.
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Want to learn more about this question? Read our blog
New Dual Incretin Injectable – “TwinCretin”
The FDA just approved a novel, dual incretin hormone therapy called Tirzepatide (Mounjaro).
This new twin incretin injectable 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.
Enroll in our Test Taking Practice Exam Toolkit | FREE Webinar
Are You Ready for Exam Success?
Join us live Thursday, June 30th at 11:30 am PST
Learn Test-Taking Secrets with Coach Bev – Option to add on 200+ Computerized Practice Test Questions for $49
During this webinar, Coach Beverly will help you transform your nervousness into focused energy that will help you succeed. She will provide test-taking tips based on her experience taking the certification exam six times.
To provide plenty of practice, Coach Beverly will sample 20 test questions that have been plucked from our Test Taking Toolkit during this live webinar.
She will explain how to dissect the question, eliminate wrong answers and avoid getting lured in by juicy answers.
Two Ways to Join
Includes a review of 20 sample test questions with test taking strategies.
This includes access to the recorded version of this webinar on your Online University Student Portal.
Plus, the Test Taking Toolkit provides you with over 200+ sample online practice questions, simulating the exam experience.
A perfect way to assess your knowledge and create a focused study plan, while increasing your test-taking confidence.
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Question of the Week | Best blood sugar fix?
LS wears an insulin pump and uses lispro insulin. LS has an average basal rate of 0.6 units and hour, a 1:15 carb ratio and a 1:50 correction ratio. Based on the ambulatory glucose profile, LS is experiencing elevated glucose levels from 4am to 7am. To get glucose to target, what is the best next step?
- Add basal insulin glargine to prevent Somogyi effect
- Make sure LS isn’t consuming carbohydrates after 10pm
- Ask LS to double check their CGM insertion site
- Increase the basal rate to prevent glucose elevations
Click Here to Test your Knowledge
Want to learn more about this question? Join us for our upcoming webinar
Test Taking Practice Exam Toolkit | FREE Webinar
Are You Ready for Exam Success?
Join us live Thursday, June 30th at 11:30 am PST
Learn Test-Taking Secrets with Coach Bev – Option to add on 200+ Computerized Practice Test Questions for $49
During this webinar, Coach Beverly will help you transform your nervousness into focused energy that will help you succeed. She will provide test-taking tips based on her experience taking the certification exam six times.
To provide plenty of practice, Coach Beverly will sample 20 test questions that have been plucked from our Test Taking Toolkit during this live webinar.
She will explain how to dissect the question, eliminate wrong answers and avoid getting lured in by juicy answers.
Two Ways to Join
Includes a review of 20 sample test questions with test taking strategies.
This includes access to the recorded version of this webinar on your Online University Student Portal.
Plus, the Test Taking Toolkit provides you with over 200+ sample online practice questions, simulating the exam experience.
A perfect way to assess your knowledge and create a focused study plan, while increasing your test-taking confidence.
Want to learn more about Diabetes Care? View our
Virtual DiabetesEd Specialist Conference
30+ CEs
Airs October 12-14th, 2022
Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.
Download Course 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.
Join us LIVE for this Virtual Course and enjoy a sense of community!
Team of expert faculty includes:
- Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES – Educator of the Year, 2020
- Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
- Ashley LaBrier, MS, RD, CDCES, Diabetes Program Coordinator
Two Registration Options
Virtual DiabetesEd Specialist Conference Deluxe | 30+ CEs
Deluxe Option for $499: Virtual Program includes:
- Q & A Session with the instructor after each webinar.
- LIVE Presentations by our team of experts.
- State of the art review of current diabetes care and technology.
- Resources for each session.
- Access to free podcasts and video recordings within a week of each live session for one year.
Deluxe Version includes Syllabus, Standards and Swag*:
- Diabetes Educator Course 2022 Syllabus Hard Copy – over 100 pages -This spiral-bound workbook contains the printed version of all of the instructor’s slides.
- ADA 2022 Standards of Care Book -The ADA Standards of Medical Care in Diabetes is a key resource for healthcare professionals involved in diabetes care, education, and support.
- DiabetesEd Services highlighters, Medication PocketCard, Tote Bag and Pen
Virtual DiabetesEd Specialist Conference Basic | 30+ CEs
Basic Option for $399: Virtual Program includes:
- Q & A Session with the instructor after each webinar.
- LIVE Presentations by our team of experts.
- State of the art review of current diabetes care and technology.
- Resources for each session.
- Access to free podcasts and video recordings within a week of each live session for one year.
Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
Question of the Week | New diabetes at 13, best next step?
MR is 13 years old, and went to urgent care because they weren’t feeling well and told the Provider “I feel so tired all the time and I have to go the bathroom a lot”. The provider draws labs and gets a urine sample. The A1C is 8.7% with some ketones in the urine. The antibody results aren’t back yet. Based on the ADA Standards and this information, what is the best action?
- Start MR on basal insulin
- Order a nutrition consult ASAP and provide MR with a meter
- Initiate GLP-1 therapy to help lower glucose and A1C
- Start metformin therapy, then add exenatide XR if needed
Click Here to Test your Knowledge
Want to learn more about this question? Join us for our upcoming webinar
Test Taking Practice Exam Toolkit | FREE Webinar
Are You Ready for Exam Success?
Join us live Thursday, June 30th at 11:30 am PST
Learn Test-Taking Secrets with Coach Bev – Option to add on 200+ Computerized Practice Test Questions for $49
During this webinar, Coach Beverly will help you transform your nervousness into focused energy that will help you succeed. She will provide test-taking tips based on her experience taking the certification exam six times.
To provide plenty of practice, Coach Beverly will sample 20 test questions that have been plucked from our Test Taking Toolkit during this live webinar.
She will explain how to dissect the question, eliminate wrong answers and avoid getting lured in by juicy answers.
Two Ways to Join
Includes a review of 20 sample test questions with test taking strategies.
This includes access to the recorded version of this webinar on your Online University Student Portal.
Plus, the Test Taking Toolkit provides you with over 200+ sample online practice questions, simulating the exam experience.
A perfect way to assess your knowledge and create a focused study plan, while increasing your test-taking confidence.
From Tots to Teens | Level 2 | $29 for 1.5 CEs
Recorded & Ready to Watch!
This course includes updated goals and guidelines for children living with type 1 or type 2 diabetes. This course discusses the special issues diabetes educators need to be aware of when working with children with diabetes and their families. We discuss the clinical presentation of diabetes, goals of care, and normal growth and development through the early years through adolescence. Strategies to prevent acute and long term complications are included with an emphasis on positive coping for family and child with diabetes.
Objectives:
- Discuss the goals of care for Type 1 and Type 2 Kids with Diabetes
- State Strategies to prevent acute and chronic complications
- Discuss the importance of positive psychosocial adjustment and resources
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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