Rationale of the Week | Diabetes and Earth Health interconnected?

For last week’s practice question, we quizzed test takers on how diabetes and earth health are interconnected. 78% of respondents chose the best answer, GREAT JOB. We want to share this important information, so you can pass it on to people living with diabetes and your colleagues. We can all take action to protect the earth and prepare for extreme climate events.

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question

Question: According to a NIH systematic literature review, there is clear evidence that diabetes and climate change are interconnected. Which of the following situations are due to the impact of a changing climate?

Answer Choices:

  1. Lack of healthy food supply due to disrupted agricultural production.
  2. Shortages of medications, insulin and other diabetes supplies.
  3. Increased risk of cardiovascular events and death in people with diabetes due to extreme heat.
  4. All of the above

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

Getting to the Best Answer

Answer one – 15.05% chose this answer, and it is accurate “Lack of healthy food supply due to disrupted agricultural production.” It is true that extreme weather can result in agricultural production disruptions. In our community, many fields that were once green with trees and crops, now are brown and barren. There is not enough water to keep crops alive and growing. When the healthy food supply is limited, people living with diabetes may turn to lower-cost, processed foods which are environmentally unfriendly and low in nutrients.

Answer two1.46% of you chose this answer and it is accurate, “Shortages of medications, insulin, and other diabetes supplies.” It is true that with recent climate disasters, like the Camp Fire, Hurricane Katrina in 2005, and Hurricane Harvey in 2017, resulted in people not being able to access, afford or safely store their medications, including insulin. In addition, we are experiencing supply chain disruptions in D50 (25 grams of glucose in a 50 ml prefilled syringe (50% glucose)) to treat hypoglycemia and certain intravenous fluids are in short supply. Other diabetes products and medications could be impacted in the future.

Answer three6.07% of respondents chose this answer and it is accurate, “Increased risk of cardiovascular events and death in people with diabetes due to extreme heat.” It is true that people with diabetes are at greater risk of experiencing dehydration and cardiovascular events during periods of extreme heat. With the increasing frequency of extreme heat episodes, there is an associated increased risk of heat-related death and cardiovascular events for people living with diabetes. Several studies reveal that people with diabetes have a higher risk of death on hot days, and are more likely to need emergency care and those with a history of heart disease are most vulnerable.

Finally, Answer four – 77.43% chose this answer, “All of the above.” YES. Great job, all of the answers are true, there is clear evidence that diabetes and climate changes are interconnected. As Diabetes Specialists, I believe we can make a difference by leaning into our unique blend of behavior change skills, advocacy, and scientific knowledge.
We can take a two-fold approach:

  1. Take action to help slow and reverse climate change – Read our blog on actions we can start taking today.
  2. Help people with diabetes to be prepared for natural disasters. Read our blog on How to Get Ready

Studying for the CDCES Exam?

Enroll in CDCES Online Prep Bundle + 5th Ed ADCES Review Guide Book | 47 CEs

This bundle includes our CDCES Online Prep Bundle plus the ADCES Review Guide.

The online bundle includes Level 1, Level 2, and Level 3 (Boot Camp), plus two bonus courses. The ADCES Review Guide offers over 480+ practice questions and is a fantastic independent study tool and comprehensive resource for the Diabetes Care and Education Specialist Exam.


What is a Certified Diabetes Care and Education Specialist?

Read More: What is a CDCES?

First awarded in 1986, as Certified Diabetes Educator (CDE) credential and in 2020 with a new name: Certified Diabetes Care and Education Specialist (CDCES) to more accurately reflect the specialty. CDCES has become a standard of excellence for the delivery of quality diabetes education. Those who hold this certification are known to possess comprehensive knowledge of and experience in diabetes prevention, management, and prediabetes.

Becoming a Certified Diabetes Care and Education Specialist (CDCES) is one of the best professional and personal decisions I have ever made.” – Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM


Why become a CDCES?
Three Reasons from Coach Beverly

Read More: 3 Reasons to Become a CDCES

The best part of becoming a CDCES is working with my colleagues and people living with diabetes. As diabetes educators, we hear compelling and beautiful life stories. I am astounded by the barriers they face and inspired by their adaptability, problem-solving skills, and resilience.

– Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM

Reason 1: CDCES is a widely recognized certification by employers and health care professionals throughout the U.S.  This credential demonstrates a specialized and in-depth knowledge in the prevention and treatment of individuals living with pre-diabetes and diabetes.

Reason 2: Currently, 10% of people in the U.S. have diabetes and another 35% have pre-diabetes which means 45% of Americans are running around with elevated blood glucose levels.  Given this epidemic, there will be plenty of future job opportunities.

Reason 3: Having my CDCES along with my nursing degree, has opened many doors of opportunity; from working as an inpatient Diabetes Nurse Specialist in a hospital to working as a Manager of Diabetes Education in the outpatient setting to starting my own consulting company.


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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.