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Question of the Week | ADA Standards for Gestational Diabetes

Question of the Week Diabetes Education Services

LS has type 1 diabetes and is here for the first visit after confirmation of pregnancy. LS has been using non-adjunctive continuous glucose monitoring (CGM) along with insulin pump therapy to manage diabetes. Previous visits have focused on preconception counseling and last A1c was 6.4%. 

According to the 2024 ADA Standards of Care, what do we recommend regarding glucose monitoring during pregnancy? 

  1. Recommend continued CGM use with the addition of post-prandial glucose monitoring. 
  2. LS can continue use of non-adjunctive CGM device approved for use during pregnancy.
  3. Recommend continued CGM with the addition of scheduled blood glucose monitoring.
  4. Recommend LS move to blood glucose monitoring and check fasting, pre-prandial and post-prandial glucose values.

Want to learn more about this question?

Join us live on June 11th at 11:30 am PST for our

Pregnancy & Diabetes

Level 2 Standards of Care Intensive

Pregnancy and Diabetes Webinar, June 11th, 2024.

Pregnancy with diabetes is confronted with a variety of issues that require special attention, education, & understanding. This course reviews those special needs while focusing on Gestational Diabetes & Pre-Existing Diabetes. Included are the most recent diagnostic criteria, management goals, & prevention of complications during pregnancy. This is a helpful review for Certification Exams & those who want more information on people who are pregnant & live with diabetes.

Objectives:

  1. List three issues that affect pregnancy with diabetes.
  2. Describe the unique attributes of pre-existing diabetes in pregnancy & gestational diabetes.
  3. State the diagnostic criteria & management goals for gestational diabetes.
  4. Potential short-term & long-term complications of fetal exposure to hypoglycemia.
  5. Prevention measures to keep mother & baby healthy.

Learning Outcome:

Participants will gain knowledge of special considerations, individualized goals, and standards for people experiencing diabetes during pregnancy to improve outcomes.

Target Audience:

This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research. 

CDR Performance Indicators:

  • 9.6.7
  • 9.6.8
  • 10.3.1

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working diabetes specialist and a nationally recognized diabetes expert.

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Question of the Week | What is the cause of this emergency room visit?

Question of the Week Diabetes Education Services

LS is a 29-year-old who arrives in the emergency room with known history of type 2 diabetes. BMI is 23.9 and they are on basal insulin therapy and an oral medication to help “clear extra sugar”. On admission, their blood glucose is 189, pH is 7.2 and LS has 3+ betahydroxybyturate.

What is the most likely cause of these lab results?

  1. LS is omitting insulin to lose weight.
  2. There is a lab error in the glucose reading.
  3. LS is taking a SGLT-2 Inhibitor.
  4. New onset of cardiorenal syndrome.

Want to learn more about this question?

Join us live on June 13th at 11:30 am PST for our

Hospitals & Hyperglycemia

Level 2 Standards of Care Intensive

Webinar on Hyperglycemia Standards June 13, 2024

Research demonstrates the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge. This course reviews the evidence that supports inpatient glucose control & outlines practical strategies to achieve targets in the inpatient setting. We incorporate the latest American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provide links to resources & inpatient management templates.

Objectives:

  1. Describe the impact of hyperglycemia in the hospital setting.
  2. Discuss the importance of inpatient glucose control.
  3. List three strategies to get glucose to the goal in the hospital setting.

Learning Outcome:

The diabetes care team will gain insights and knowledge of special considerations, individualized goals, and standards for inpatients with diabetes that they can include in their practice.

Target Audience:

This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research. 

CDR Performance Indicators:

  • 9.6.7
  • 9.6.8
  • 10.3.1

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working diabetes specialist and a nationally recognized diabetes expert.

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Question of the Week | KR is on Metformin & 4 Weeks Pregnant. Best action?

Question of the Week Diabetes Education Services

KR has polycystic ovary syndrome and takes metformin 850mg twice daily.  KR just discovered they are 4 weeks pregnant. Fasting glucose is 103 mg/dl.

According to ADA Guidelines, if prediabetes diagnosis is confirmed, what is the next step?

  1. Continue metformin through first trimester.
  2. Start basal insulin, stop metformin.
  3. Add human basal bolus insulin.
  4. Stop metformin, start sulfonylurea.

Want to learn more about this question?

Join us live on June 11th at 11:30 am PST for our

Pregnancy & Diabetes

Level 2 Standards of Care Intensive

Pregnancy and Diabetes Level 2 Webinar on June 11, 2024

Pregnancy with diabetes is confronted with a variety of issues that require special attention, education, & understanding. This course reviews those special needs while focusing on Gestational Diabetes & Pre-Existing Diabetes. Included are the most recent diagnostic criteria, management goals, & prevention of complications during pregnancy. This is a helpful review for Certification Exams & those who want more information on people who are pregnant & live with diabetes.

Objectives:

  1. List three issues that affect pregnancy with diabetes.
  2. Describe the unique attributes of pre-existing diabetes in pregnancy & gestational diabetes.
  3. State the diagnostic criteria & management goals for gestational diabetes.
  4. Potential short-term & long-term complications of fetal exposure to hypoglycemia.
  5. Prevention measures to keep mother & baby healthy.

Learning Outcome:

Participants will gain knowledge of special considerations, individualized goals, and standards for people experiencing diabetes during pregnancy to improve outcomes.

Target Audience:

This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research. 

CDR Performance Indicators:

  • 9.6.7
  • 9.6.8
  • 10.3.1

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working diabetes specialist and a nationally recognized diabetes expert.

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Question of the Week | Are statins indicated for Peds with Diabetes?

Question of the Week Diabetes Education Services

Based on the ADA Standards, in addition to dietary intervention, lifestyle and glucose management, when is it indicated to consider starting statin therapy for pediatrics with diabetes?

  1.  When LDL is still greater than 100 with a BMI of 25 or more.
  2.  After age 10, if LDL is still greater than 130 at 6 months.
  3. Only if LDL and triglycerides are greater than 90thpercentile.
  4. Statins are only indicated for individuals 18 years and older.

Want to learn more about this question?

Join us live on May 30th at 11:30 PST for our

From Tots to Teens

Level 2 Standards of Care Intensive

Diabetes webinar with Coach Beverly on May 30, 2024

This course includes updated goals & 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 & their families. We discuss the clinical presentation of diabetes, goals of care, & normal growth & development through the early years through adolescence. Strategies to prevent acute & long-term complications are included with an emphasis on positive coping for families & children with diabetes.

Objectives:

  1. Discuss the goals of care for Type 1 and Type 2 Kids with Diabetes.
  2. State Strategies to prevent acute and chronic complications.
  3. Discuss the importance of positive psychosocial adjustment & resources.

Learning Outcome:

Attendees will have comprehensive knowledge of special considerations, individualized goals and standards for children with diabetes to include in their practice.

Target Audience:

This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research. 

CDR Performance Indicators:

  • 9.6.7
  • 9.6.8
  • 10.3.1

Instructor: Beverly Thomassian RN, MPH, CDCES, BC-ADM is a working diabetes specialist and a nationally recognized diabetes expert.

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Question of the Week! | Best treatment for hypoglycemia with gastroparesis?

Question of the Week Diabetes Education Services

JR has type 1 diabetes and was recently diagnosed with gastroparesis. JR is a runner and has not been able to exercise recently due to nausea, vomiting, bloating, and intestinal pain. They experience hypoglycemia about 3 times a week.

Based on this information, what is the best treatment for hypoglycemia?

                    1. Glucose tabs or gels
                    2. Skittles or gummies
                    3. High carb, low fiber snack bar
                    4. Peanut butter crackers

Want to Learn More About this Topic?

Join our Virtual DiabetesEd Training Conference

Now Recorded & Ready to Watch

Virtual DiabetesEd Training Conference, 3 days, 30+ CEs.

Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, and “aha” moments for our Virtual DiabetesEd Training Conference.

Attendees will leave this conference with new tools and a refreshed understanding of the latest advances in person-centered diabetes care.  Our team highlights the ADA Standards of Care, medications, behavior change, technology, medical nutrition therapy, and more!

Our instructors co-teach the content to keep things fresh and lively. 


Program Details

  • Registration Fee: $399-$569 (see more about reg. options below)
  • Friend Discount: For 3 or more people, each person saves $50 off their registration. Email us at [email protected] with the name and email of each registrant to get the discount!
  • CEs: 30+ CEs | 18 units for Virtual Conference plus 10+ Bonus CEs. CEs can be applied toward CDCES’s initial application or renewal.
  • Speakers: View Conference Faculty
 
Comparison of Virtual DiabetesEd Training Bundles

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Question of the Week | Assessment of Hypoglycemia

Question of the Week Diabetes Education Services

LM has had type 2 diabetes for over 30 years and takes 1000 mg metformin BID, 30 units of glargine at bedtime, 25 mg empagliflozin, as well as daily lisinopril and lovastatin. A1c was 7.2%, LDL: 56, and eGFR was 38 mL/min/1.73m2 last visit. CGM ambulatory glucose profile report indicates a time in range of 71%, time below range of 4%, and time above range of 25%. LM reports living on a fixed income, relying on social security, and an increase in recent financial stress. They are concerned they may not have enough money to purchase foods by the end of the month.

Select the best answer considering LM’s potential risk factors for hypoglycemia?

  1. LM has chronic kidney disease, and we note he is taking an ACE and SGLT-2.
  2. Basal insulin therapy alone. 
  3. Income status.
  4. All the above.

Unlock insights for managing diabetes distress with the experts!

Join us live on June 17 & 24, 2024 for our

ReVive 5 Diabetes Training Program: 

The 2024 ADA Standards of Care now recommends annual screening for diabetes distress. If you are wondering how to screen for distress and tailor education based on the results, we encourage you to join this unique training program.

This two-session training provides the essential steps to address diabetes distress combined with an innovative approach to helping people make sense of their glucose data. 

The first session is team-taught by experts in the field of diabetes distress and effective communication approaches. Dr. Larry Fisher kicks off the program by describing the difference between depression and distress and interpreting Diabetes Distress screening results. Dr. Susan Guzman uses a case study approach and step-by-step communication strategies to address responses from the Diabetes Distress screening tool. This session includes an abundance of evidence-based approaches that you can apply in your clinical setting. 

Coach Beverly leads the second session.  During this three-hour program, Beverly describes insulin dosing strategies, meter and sensor data interpretation, and common issues encountered by people using diabetes technology.  Case studies include tools to help individuals discover what changes are needed to get glucose to target, coupled with the communication skills discussed in the first session. In conclusion, the team of instructors review a case study that pulls together all the ReVive 5 elements. 

“ReVive 5” breathes new life into our relationship with diabetes, bringing a fresh perspective to both the person with diabetes and the provider.

ReVive 5 Program PDF Flyer

Can’t join live? That’s okay. Your registration guarantees you access to the recorded version of the series, along with podcasts and resources for one full year.

Accredited Training Program:

  • 15+ CEs – Includes the 7-hour ReVive 5 Training Program, Certificate, and 5 FREE bonus courses to supplement content.
  • A comprehensive set of assessment tools, educational materials, log sheets, and resources.

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

Speakers Interviews – Learn more about the ReVive 5 Team

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Question of the Week | RD feels overwhelmed by all this sensor data. Best action?

Question of the Week Diabetes Education Services

RD is 82 years old, on basal insulin with bolus insulin at breakfast and dinner if need. RD just started using a sensor to track their daily blood sugars. After using the sensor for a few weeks, they share that they are feeling anxious and don’t know what to do with all this information. They even took extra bolus insulin yesterday to try and get blood sugars down. RD’s time in range is over 70%. 

Which of the following is the most appropriate intervention?

  1. Refer RD to a mental health provider who specializes in diabetes.
  2. Reassure RD that their time is range is on target and they are not at risk of complications.
  3. Suggest that RD stops using a sensor and resumes using a glucose meter.
  4. Explore feelings of anxiety associated with the data and glucose levels.

Unlock insights for managing diabetes distress with the experts!

Join us live on June 17 & 24, 2024 for our

ReVive 5 Diabetes Training Program: 

The 2024 ADA Standards of Care now recommends annual screening for diabetes distress. If you are wondering how to screen for distress and tailor education based on the results, we encourage you to join this unique training program.

This two-session training provides the essential steps to address diabetes distress combined with an innovative approach to helping people make sense of their glucose data. 

The first session is team-taught by experts in the field of diabetes distress and effective communication approaches. Dr. Larry Fisher kicks off the program by describing the difference between depression and distress and interpreting Diabetes Distress screening results. Dr. Susan Guzman uses a case study approach and step-by-step communication strategies to address responses from the Diabetes Distress screening tool. This session includes an abundance of evidence-based approaches that you can apply in your clinical setting. 

Coach Beverly leads the second session.  During this three-hour program, Beverly describes insulin dosing strategies, meter and sensor data interpretation, and common issues encountered by people using diabetes technology.  Case studies include tools to help individuals discover what changes are needed to get glucose to target, coupled with the communication skills discussed in the first session. In conclusion, the team of instructors review a case study that pulls together all the ReVive 5 elements. 

“ReVive 5” breathes new life into our relationship with diabetes, bringing a fresh perspective to both the person with diabetes and the provider.

ReVive 5 Program PDF Flyer

Can’t join live? That’s okay. Your registration guarantees you access to the recorded version of the series, along with podcasts and resources for one full year.

Accredited Training Program:

  • 15+ CEs – Includes the 7-hour ReVive 5 Training Program, Certificate, and 5 FREE bonus courses to supplement content.
  • A comprehensive set of assessment tools, educational materials, log sheets, and resources.

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

Speakers Interviews – Learn more about the ReVive 5 Team

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

Question of the Week | Euglycemic DKA – What is Best Intervention?

Question of the Week Diabetes Education Services

KT is a 54-year-old, who presents to the emergency room with nausea and vomiting. KT weighs 58kg, has been feeling very tired and has diabetes and hypertension.

Meds include: losartan, metformin, and empagliflozin.

Labs: Na 140, K 4.0, Chloride 99, Bicarb 15,  Glucose 189, Anion Gap 26, pH 7.1 and positive urine ketones.

After infusing 2 liters of normal saline, what would be the best intervention for KT?

  1. Give another 2 liters of NS with 20 meq/L of KCL
  2. Continue current therapy.
  3. Start insulin infusion with a dextrose-based solution.
  4. Give an amp of sodium bicarbonate.

Want to learn more about this question?

Keynote Presentation on DKA & Euglycemic DKA at

16th Annual Conference

Expanding the Universe of Diabetes Care hosted by CA ADCES

May 3-4th at Universal City, CA

2024 ADCES Conference in Universal City, CA

Beverly will be speaking on DKA and EDKA on Saturday – May 4, 2024 at 11:30 am

Below is Saturday’s schedule of topics and flyer for more information. We hope to see you there!

>>Register for the Conference

>>Flyer for Event

  • Discover the secrets to a successful and sustainable Diabetes Education Program – Tony Song, MBA
  • Exercise Success Part 3 & 4 – Jacqueline Thompson, MS, RD, CDCES, MES 
  • Dynamic Duo: Registered Dietitian & Pharmacist Co-Appointments in Diabetes Care – Christal Pham, PharmD, APh, CDCES, Melanie Barbee, MS, RDN, CDCES, DipACLM 
  • Advocacy Update: Breakdown the Barriers to Evidence-Based Diabetes Care – Teresa Martin MS RDN CDCES LD 
  • New criteria and treatment guidelines for DKA, Euglycemic DKA, and HHS – Beverly Thomassian, RN, MPH, CDCES, BC-ADM 
  • Exercise Success Part 4 – Jacqueline Thompson, MS, RD, CDCES, MES 
  • Diabetes Technology: Understanding the Differences in the Latest CGMs and Pumps – David Ahn, MD

Location: Hilton at Universal Studios, 555 Universal Hollywood Drive, Universal City, CA 91608 – Get your hotel reservations by April 2.
 
Group Link for room reservations4: Please refer to group code CDCES when booking. Guests can also call our In-House Reservations Dept. at 818-623-1434 from 7am-7pm, Monday-Sunday.  

Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!

Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and our CPEU courses have received Prior Approval* from the Commission of Dietetic Registration (CDR), Provider DI002. Since our CPEU courses received Prior approval* from the CDR, these CPEU courses satisfy the CE requirements for the CDCES /BC-ADM regardless of your profession! 

The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.