The Huddle: Conversations with the Diabetes Care Team

On this episode of The Huddle we talk to Mary Lou Perry, who brings more than 30 years of experience in the area of diabetes nutrition clinical practice and was appointed to the ADA Professional Practice Committee last March. Mary Lou shares how others can be a part of the committee, a few key highlights from the 2023 ADA Standards of Care, and examples of how the updated standards can be applied in practice.

Resources:

To read the full 2023 Standards of Care, visit: https://diabetesjournals.org/care/issue/46/Supplement_1

To watch an ADCES webinar that dives a bit deeper into the Standards of Care, visit: http://send.adces.org/link.cfm?r=5gLLYpGIeV6Y9dpuQo-W2A~~&pe=IajtqA5LETl6XmGrk0YTISnsQijzMKrfWkc79cPqpTRNp3eEShKQUAVzFBrLt-EYJga4sPUlv60Ad-aq--2vbw~~&t=VmwSIkiOmBxB5rwPQvGKrw~~

To apply to be a part of an ADA committee, visit: https://diabetes.org/about-us/who-we-are/applications/national-committees-call-applications

For ADA public comment, visit: professional.diabetes.org/SOC

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Chief Executive Officer of the Certification Board for Diabetes Care and Education Specialists (CBDCE) Sheryl Traficano, MBA, CAE, answers common questions about eligibility and requirements for the Certified Diabetes Care and Education Specialist (CDCES) credential. Tune in to get a better understanding of the requirements for hours, and how to accrue them. You’ll also hear about scholarship opportunities and how to apply for them.

Resources:

• Learn more about the credential, including how to apply for and take the exam, at www.CBDCE.org.
• Access study resources for the exam at CDCES Credential (adces.org)
• Access the current Certification Exam handbook from the Certification Board for Diabetes Care and Education (CBDCE) at  https://www.cbdce.org/documents/20123/66178/CBDCE-exam-handbook_Current.pdf/8e2fda09-9289-947c-7587-712a4e74f10a?t=1588269156519
• Episode #52: How to Become a Certified Diabetes Care and Education Specialist: Requirements, Study Tips, Renewal Process and More: https://thehuddle.simplecast.com/episodes/how-to-become-a-certified-diabetes-care-and-education-specialist-requirements-study-tips-renewal-process-and-more
• CBDCE Scholarships: www.cbdce.org/scholarships

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Allyson Hughes, PhD, is an assistant professor at Ohio University’s Diabetes Institute. She’s a research psychologist by training but has developed a unique ability to turn data into policy change. You’ll hear about her unique perspective as a researcher and person with diabetes and get some direction on how you can leverage your research or findings for real change in the world of policy.

Show Notes

• T1D Exchange https://t1dexchange.org/
• Quality Improvement Collaboration through T1D Exchange: https://t1dexchange.org/quality-improvement/collaborative/
• Learn more about the ADCES Annual Conference at www.ADCESmeeting.org
• Get involved with ADCES Advocacy and Virtual Hill Day at www.diabeteseducator.org/advocacy
• Learn more about research at ADCES at www.diabeteseducator.org/research
• Learn more about diabetes technology at www.Danatech.org

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Beyond Type 1 is a global leader in the diabetes community with trustworthy resources on all aspects of diabetes, including healthcare. Julia Flaherty is a content manager at Beyond Type 1 with 20 years of experience living with type 1 diabetes. She’s faced her share of frustrations navigating healthcare and is here to share valuable information and resources that help address the pain points people with diabetes experience when it comes to healthcare coverage.

Resources:

• Beyond Type 1: beyondtype1.org
• Beyond Type 2: beyondtype2.org
• (Blog) Health Insurance 101: Selecting The Right Plan For Managing Type 2 Diabetes
• Suite of T1D insurance resources: https://beyondtype1.org/insurance-type-1-diabetes
• Suite of T2D insurance resources: https://beyondtype2.org/insurance-type-2-diabetes
• Healthcare glossary: https://beyondtype1.org/healthcare-glossary
• Insulin affordability resources: www.Getinsulin.org
• Beyond Type 1 Mental health resources: https://beyondtype1.org/mental-health
• Beyond Type 2 mental health resources: https://beyondtype2.org/mental-health

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Cari Berget, MPH, RN, CDCES, joins The Huddle to discuss the Omnipod® 5 Automated Insulin Delivery system. We’re tapping into her expertise and involvement in clinical trials that used the Omnipod 5 to bring you the practical tips. Tune in to learn who is best suited for automated insulin delivery systems like the Omnipod 5 and how to onboard people with diabetes who would benefit from the Omnipod 5 system.

This episode is sponsored by Insulet, makers of the Omnipod 5 System.

Resources:  

• Cari Berget, Jennifer L. Sherr, Daniel J. DeSalvo, Ryan S. Kingman, Sheri L. Stone, Sue A. Brown, Alex Nguyen, Leslie Barrett, Trang T. Ly, Gregory P. Forlenza; Clinical Implementation of the Omnipod 5 Automated Insulin Delivery System: Key Considerations for Training and Onboarding People With Diabetes. Clin Diabetes 1 April 2022; 40 (2): 168–184. https://doi.org/10.2337/cd21-0083 
• Learn more about the Omnipod 5 system: www.omnipod.com/what-is-omnipod/omnipod-5

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Christie Schumacher PharmD, BCPS, BCACP, BCCP, BC-ADM, CDCES, FCCP, joins The Huddle to talk through the use of GLP-1 and GIP/GLP-1 receptor agonists for your people with type 2 diabetes.  You’ll learn what medications fall into the class of GLP-1 and GIP/GLP-1 receptor agonists, how they work and the benefits they can offer people with type 2 diabetes. These medications can be a useful tool in the therapeutic toolkit as highlighted in the recently updated ADA/EASD consensus statement, so this episode will offer practical considerations when initiating GLP-1 and GIP/GLP-1 receptor agonists in patients and managing possible side effects.

We want to thank our sponsor, Lilly Diabetes, for their support of this episode.
VV-MED-128766 ©2022 Lilly USA, LLC.  All rights reserved

Resources:

• ADA and EASD Consensus Report for the Management of Hyperglycemia in Type 2 Diabetes, 2022:  Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) | Diabetes Care | American Diabetes Association (diabetesjournals.org)
• ADCES Incretin-Based therapies tip sheet: DiabetesEducator.org/docs/default-source/living-with-diabetes/tip-sheets/medication-taking/incretin-based_therapies_tip_sheet_1006202291a90b03-fff9-4b81-98c9-42ef98f0c501.pdf
• Episode Transcript: DiabetesEducator.org/docs/default-source/podcast-docs/incretin-full-show.docx

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Teresa Pearson, MBA, MS, RN, CDCES, FADCES, joins us to talk about population health. She shares her early experience with population health. As you’ll hear, this model of care can greatly reduce total cost of care and improve health outcomes for people with diabetes. It’s a solid approach to demonstrate the value you bring to the diabetes care team, so make sure to listen to the entire episode to get actionable tips on information technology, data and reporting you can start implementing quickly.

Resources:

• ADCES population health resources: DiabetesEducator.org/PopulationHealth
• ADCES Value Toolkit: DiabetesEducator.org/Value
• ADCES Annual Conference information: ADCESmeeting.org

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

The National Practice Survey is conducted once every 5 years to help ADCES understand current trends in the diabetes care and education specialist workforce and how their services are integrated into the full care team. 2022 ADCES President Jan Kavookjian, PhD, MBA, FAPhA, FADCES, joins us to discuss why this survey is so important. She gives us a teaser of some of this year’s findings and explains how the results influence strategic planning and key initiatives at the association. 

ADCES gratefully acknowledges Joanne Rinker, MS, RDN, CDCES, LND, FADCES, Sheryl Traficano and the Certification Board for Diabetes Care and Education, the National Practice Survey writing group and any others involved for their support of the National Practice Survey.

Resources

• Kavookjian J, Bzowyckyj AS, DiNardo MM, et al. Current and Emerging Trends in Diabetes Care and Education: 2021 National Practice and Workforce Survey. The Science of Diabetes Self-Management and Care. 2022;48(5):307-323. doi:10.1177/26350106221120787
• ADCES Blog Post: Key Takeaways from Current and Emerging Trends in Diabetes Care & Education: 2021 National Practice and Workforce Survey: www.diabeteseducator.org/news/perspectives/adces-blog-details/adces-perspectives-on-diabetes-care/2022/10/10/key-takeaways-from-current-and-emerging-trends-in-diabetes-care-education-2021-national-practice-and-workforce-survey
• Value of the DCES Toolkit: www.DiabetesEducator.org/Value
• Ask the Reimbursement Expert: www.diabeteseducator.org/practice/ask-the-expert

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Eva Vivian, PharmD, PhD, BC-ADM, CDCES, FADCES, and Daphne Smith Marsh, PharmD, BC-ADM, CDCES, discuss the impact of health disparities on-site at ADCES22 in Baltimore. You’ll hear their perspectives on the environmental and social factors that contribute to health disparities, both in and out of the clinical setting. You’ll also hear how diabetes care and education specialists and other healthcare professionals can address health disparities in simple, practical ways that meet the needs of the individual while building trust.

Resources:

• ADCES Resources on Health Equity: DiabetesEducator.org/HealthEquity
• ADCES22 On-Demand Sessions: ADCES22.org
• Edgoose J, Quiogue M, Sidhar K. How to Identify, Understand, and Unlearn Implicit Bias in Patent Care. Fam Pract Management. 2019 Jul-Aug;26(4):29-33
• Reid H, Lin O, Fabbro RL, et al. Provider communication in black patients with T2DM is associated with glycemic control. Presented at: American Diabetes Association 80th Scientific Sessions; June 12-16, 2020. Abstract 52-LB.
• Akturk HK, Agarwal S, Hoffecker L, Shah VN. Inequity in racial ethnic representation in randomized controlled trials of diabetes technologies in type 1 diabetes: critical need for new standards. Diabetes Care. 2021;44(6):e121-e123.

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Erin Palinski-Wade, RD, CDCES, LDN, CPT, joins The Huddle to discuss two key nutrients for blood glucose management and overall health: fats and fiber. Many adults with or at risk for type 2 diabetes aren’t getting adequate amounts of these nutrients. In this episode, we dive into the health benefits of dietary fats and fiber, highlight some nutrient-dense sources, like fresh avocado, and share some practical ways individuals can increase their intake of these nutrients.

Disclosure: This episode is sponsored by Fresh Avocados – Love One Today®. Love One Today® is a leading source of the healthiest reasons and tastiest ways to enjoy fresh avocados. A science-based resource, it provides turnkey solutions that make it easy for health professionals to stay on top of the latest research and confidently recommend avocados. 

Episode Notes:

• Love One Today: https://loveonetoday.com/
• 2020-2025 Dietary Guidelines For Americans: https://www.dietaryguidelines.gov/
• Schoeneck, Malin, and David Iggman. “The effects of foods on LDL cholesterol levels: A systematic review of the accumulated evidence from systematic reviews and meta-analyses of randomized controlled trials.” Nutrition, metabolism, and cardiovascular diseases : NMCD vol. 31,5 (2021): 1325-1338. doi:10.1016/j.numecd.2020.12.032
• Reynolds, Andrew N et al. “Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses.” PLoS medicine vol. 17,3 e1003053. 6 Mar. 2020, doi:10.1371/journal.pmed.1003053
• Dana E. King, Arch G. Mainous, Thomas A. Buchanan, William S. Pearson; C-Reactive Protein and Glycemic Control in Adults With Diabetes. Diabetes Care 1 May 2003; 26 (5): 1535–1539. https://doi.org/10.2337/diacare.26.5.1535
• Zhang X, Xiao D, Guzman G, Edirisinghe I, Burton-Freeman B.  “Avocado Consumption for 12 Weeks and Cardiometabolic Risk Factors: A Randomized Controlled Trial in Adults with Overweight or Obesity and Insulin Resistance.” The Journal of nutrition vol. 152,8 (2022): 1851-1861. doi:10.1093/jn/nxac126
• Zhu, Lanjun, Yancui Huang, Indika Edirisinghe, Eunyoung Park, and Britt Burton-Freeman. 2019. "Using the Avocado to Test the Satiety Effects of a Fat-Fiber Combination in Place of Carbohydrate Energy in a Breakfast Meal in Overweight and Obese Men and Women: A Randomized Clinical Trial" Nutrients 11, no. 5: 952. https://doi.org/10.3390/nu11050952

Resources:

• Avocado nutrition 101
• How to choose and prepare an avocado
• How to cut, slice, peel and pit an avocado
• How to ripen avocados faster
• How to store avocados
• Accredited Podcast: Avocados, Satiety and Mindful Eating in Diabetes with Erin Palinski-Wade, MS, RDN, CDE
• Educational Handout: Effects of avocado on LDL cholesterol
• Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Dr. David Klonoff and Dr. David Kerr are authors of a recent study that introduces a new practical metric, the glycemic risk index. They join the Huddle to talk about the practicalities of this emerging metric and share how it can be used by clinicians to quickly assess a person’s glycemic risk. It’s a fascinating conversation that will leave you with a tool to easier leverage CGM-generated data and produce improved health outcomes for your patients. 

Resources

• Klonoff, David C., et al. “A Glycemia Risk Index (GRI) of Hypoglycemia and Hyperglycemia for Continuous Glucose Monitoring Validated by Clinician Ratings.” Journal of Diabetes Science and Technology, Mar. 2022, doi:10.1177/19322968221085273
• GRI web-based calculator: https://www.diabetestechnology.org/gri/
• GRI Excel File to calculate multiple tracings: https://www.diabetestechnology.org/gri/gri-calculator.xlsx?ver=2
• Diabetes Digital Health book:  https://www.elsevier.com/books/diabetes-digital-health/klonoff/978-0-12-817485-2
• Diabetes Digital Health and Telehealth book: https://www.elsevier.com/books/diabetes-digital-health-and-telehealth/klonoff/978-0-323-90557-2

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

We caught Jane K. Dickinson PhD, RN, CDCES at ADCES22 in Baltimore, MD after she finished hosting a panel discussion. The panel showcased Julie K. Heverly at the DiaTribe Foundation, Mary Jane Roche from the College Diabetes Network, and T’ara Smith from Beyond Type 1. All three are individuals live with diabetes and took the stage to share their perspectives and experiences with DCESs. Jane joins us today to share the highlights of that discussion, along with some insights into how the DCES and other healthcare professionals can further support the needs of their patients.

Resources

• ADCES22 On-Demand Session available until October 24, 2022 at ADCES22.org.

 

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Maria Bustamante and Megan Martinez are involved in the diabetes care and prevention programs at the National Center for Farmworker Health (NCFH) and join us today to share some of the work they’re doing to improve health outcomes for the vital workforce of agricultural workers. While the topic may sound niche at first, you are likely to recognize the challenges faced by agricultural workers in your own patent populations, especially if you are working within immigrant communities, in rural, agricultural settings, or with men with physically demanding jobs. You’ll hear how Megan and Maria’s teams developed resources to meet people with prediabetes or diabetes where they are—and we’ll tell you how you can access these tools for your own practice! 

Resources

• Diabetes & U.S. Agricultural Workers Data: http://www.ncfh.org/diabetes-fact-sheet.html
• Ag worker access campaign: http://www.ncfh.org/ag-worker-access.html
• NCFH Diabetes Resource Hub: http://www.ncfh.org/diabetesresourcehub.html
• Jeopardy game: http://www.ncfh.org/uploads/3/8/6/8/38685499/jeopardy_guide-final_eng.pdf
• NCFH Diabetes Webinar Archive: http://www.ncfh.org/archived-webinars.html#diabetes_webinars
• NCFH Health Information and Referral Hotline: http://www.ncfh.org/callforhealth.html
• Telehealth readiness worksheet: http://www.ncfh.org/uploads/3/8/6/8/38685499/final_patient_telehealth_readiness_tool_.pdf
• Resource for being active for men who are already physically active: https://www.diabeteseducator.org/docs/default-source/living-with-diabetes/tip-sheets/aade7/adces-men-health-being-active-v1.pdf
• Resource for reducing risks: https://www.diabeteseducator.org/docs/default-source/living-with-diabetes/tip-sheets/aade7/adces-reducing-risk-english-final.pdf?sfvrsn=84c39758_2

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Dr Jane Jeffrie Seley, MPH, MSN, NP, RN, APRN, BC-ADM, CDCES, FADCES, brings us the top highlights from the technology seen at the ADCES22 conference in Baltimore this year. She’s talking about what’s new and what’s next in CGM, BGM, insulin delivery, connected devices, and more.  Jane references specific of devices and manufacturers here, but keep in mind that these references are for educational purposes and do not represent an endorsement from ADCES.

Show Notes

• ADCES22 sessions on demand: ADCES22.org
• Learn more about the latest diabetes technology: Danatech.org

 

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Alexis Skelley, LISW-CP/S, LCSW, CDCES, and Kersti Spjut, PhD, join The Huddle to talk about the dangers of perfectionism in diabetes. You’ll learn the risks and signs of unhealthy perfectionism in diabetes or prediabetes management and get practical steps to help these individuals develop a more flexible approach. You’ll even get some pearls of wisdom you can use yourself. 

Resources:

• ADCES22 sessions on demand: ADCES22.org
• Kersti's website: DrKerstiSpjut.com
• Kersti's Instagram (@drkerstispjut): instagram.com/drkerstispjut
• South Carolina AHAC: scahec.net
• Alexis’ Instagram (@Diabetes_Therapist): instagram.com/diabetes_therapist
• Dr. Kristin Neff's website and book: https://self-compassion.org/
• How to Keep House While Drowning (book) by KC Davis: https://www.strugglecare.com/book
• Research article on self-compassion and exercise:
  Rapoport, O., Bengel, S., Möcklinghoff, S., & Neidhardt, E. (2022). Self-compassion moderates the influence of procrastination on postponing sporting activity. Personality and Individual Differences, 185, 111242. https://doi.org/10.1016/j.paid.2021.111242
• Summary of the research on weight cycling and weight stigma: 
  What Is Weight Cycling? — Christy Harrison - Intuitive Eating Dietitian, Anti-Diet Author, & Certified Eating Disorders Specialist
  What Is Weight Stigma? — Christy Harrison - Intuitive Eating Dietitian, Anti-Diet Author, & Certified Eating Disorders Specialist

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Quisha Umemba, MPH, BSN, RN, CDCES, joins us to discuss the serious impact of stress on people with cardiometabolic conditions like diabetes and prediabetes. You’ll hear how chronic stress can complicate self-management and care, and how a person’s behaviors in response to stress can either hinder or help their health. Tune in for practical tips and resources to help you identify signs of toxic stress in your patients and improve their healthy coping skills.

Resources

• Diversity in Diabetes Website: https://www.diversityindiabetes.org/
• American Psychological Association Fact Sheet on Health Disparities and Stress: https://www.apa.org/topics/racism-bias-discrimination/health-disparities-stress
• Chronic Stress and Healthy Coping Handout: healthy-coping-patient-flyer-v-1-(002).pdf (diabeteseducator.org)

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDCES and Michelle Magee, MD, MB, BCh, LRCPSI join us to talk about the importance of preparation, risk mitigation, and treatment of hypoglycemia for school-age children. We want to thank our sponsor, Lilly Diabetes, for their support of this episode. VV-MED-124888 © 2022 Lilly USA, LLC. All rights reserved.Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast. Learn more about ADCES and the many benefits of membership at adces.org/join.

Lisa Letourneau-Freiberg, MPH, RD, LDN, a Research Manager at the University of Chicago Kovler Diabetes Center, joins us for a practical conversation on monogenic diabetes, a rare and atypical form of diabetes that may be hindering the treatment and health outcomes of the people with diabetes in your practice. Understand monogenic diabetes, signs healthcare professionals can look out for and the next steps you can take to help the individual better understand their diagnosis.

Resources:

• University of Chicago Monogenic Diabetes Registry: https://monogenicdiabetes.uchicago.edu
• RADIANT: https://www.atypicaldiabetesnetwork.org
• University of Chicago free virtual professional education CME on monogenic diabetes. Register for the webinar on Friday 7/22 at https://cme.uchicago.edu/CMM2022.

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Resources:

• The Role of the Diabetes Care and Education Specialist in the Hospital Setting. The Science of Diabetes Self-Management and Care. 2022;48(3):184-191. doi:10.1177/26350106221094332

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Resources:

• Galloway, Nicholas, et al. “Exploring the Role of Precision Medicine in Diabetes Diagnoses.” ADCES in Practice, vol. 10, no. 1, Jan. 2022, pp. 26–32, doi:10.1177/2633559X211060849.

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.