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January 1 st always brings with it a feeling of a clean slate. This is definitely true of this New Year! The “Fresh-Start Effect” can be a powerful motivator for creating a new goal or getting back to some healthy habits. The downside to this can be making resolutions based in fear and punishment for some over-indulging that happened over the holidays or throughout quarantine. Having a restrictive or scarcity mind-set commonly leads to failure. Setting goals with the attitude of self-compassion instead of self-flagellation can lead to more fulfilling, sustainable change. Let’s empower those we work with to begin thinking “what can I add?” instead of ...
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Let’s make 2021 the year of getting back to basics. As CDCESs we get consumed with trying to be the best we can be for our patients and start taking on more than we can manage. Over time we become overwhelmed and frustrated in which we start to withdraw from committees, organizations, and volunteering. Over the weekend ADCES held their yearly Leadership Forum which started out on day 1 stressing that we need to get back to basics and start small again. We need to sit down and start small to do something well and not just belonging to numerous activities and committees. As I go into 2021 as the Chair for WPLNG, I am going to look at changing how we ...
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October is national breast cancer awareness month and we all know how early detection saves lives. The ADA originated the standards of care in 1988, and they have been evolving ever since, providing clinicians, patients, researchers, payers and other interested individuals with the components of diabetes care. These standards of care provide the treatment goals and tools to evaluate the quality of care in an effort to improve management for those with diabetes. While reading a recent article, a New York Times analysis of CDC data found that in New York and New Jersey alone from March 15 to May 2, 800 more people died of diabetes than would have been expected ...
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Highlight from ADCES20

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Many of us attended the national meeting, ADCES20, this year. If you haven’t joined all of the sessions there remains time to do so. One of my favorite sessions that definitely worth viewing is SO5- Liver Disease: An Overlooked Complication of Diabetes . The 30 minute session provided a nice over view of NASH- including the incidence and outcomes for liver disease in glucose intolerance and diabetes. The information provided on the strategies to improve client outcomes and cope with liver disease was excellent. Management Guidelines: Screening for T2DM and CV disease Lifestyle interventions (weight loss; exercise) Treatment of dyslipidemia statin ...
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Many of us were excited to hear CMS was changing the requirements for Medicare patients to qualify for a continuous glucose monitor during Covid times. Unfortunately, the adjustments weren’t as significant as we were hoping. Here is an update on how the CGM companies and distributors are interpreting the new guidelines: Telehealth video appointments are now accepted Medicare is paying the provider the same rate for a telehealth appointment as they would an in-person appointments Patients who have tested positive for Covid-19 do not have to meet the requirements (4+ BG/day and 3+ injections/day or a pump) to receive a Dexcom. However, to continue ...
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ADCES 2020 is certainly one for the History books! This year there were a lot of firsts. First virtual meeting, first opportunity to view ALL of the speakers/sessions, education theatres, vendor chats, hands-on sessions and posters at your convenience. Lots of outstanding information and CEs for one incredibly low price and plenty of time to fit into your schedule. As a person who does not identify as being “Tech Savvy” I found that ADCES made the transition to the virtual experience seamless, and that I was well prepared, to download the App, do the System check, experience the tutorial and the CE follow-up. Navigating through the Virtual platform was smooth ...
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The new implications and guidelines put in place recently due to current pandemic has changed the way we practice in the outpatient setting drastically. I am currently a nurse practitioner in an outpatient endocrinology practice where I specialize in diabetes technology. Majority of my patients utilize continuous subcutaneous insulin infusion or insulin pumps and continuous glucose monitoring for their diabetes management. My practice is located in the hospital so early on, as the COVID-19 cases were increasing we had limited our in-person visits and transitioned to tele-medicine. This learning curve came along with a new EHR system as well! My patients ...
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As things spiral into a new realm with covid-19, we are reminded even more of our responsibility to care for ourselves and the people around us. In Philadelphia, we have a mandate to stay home to help reduce the spread of a virus. I’ve heard of people developing symptoms and being gone in such a short time. It’s too fast. Every story I hear reminds me of our fragility as humans. We depend on each other to survive. I am so thankful for the healthcare team, the grocery store clerk, the truck drivers. These essentials I took for granted; I’m reminded now is a privilege. I am being provided for in big and small ways. Once you notice this, I think it’s easier ...
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As a Diabetes Care and Education Specialist, motivational interviewing (MI) becomes an important part of a skill set when working with people with diabetes. Making behavior changes can be a struggle for everyone. Diabetes Care and Education Specialists can refine their skills to help participants by eliciting change talk by using MI strategies in their education sessions. The Acronym OARS can be utilized in the following ways. O – Open-ended questions help establish a comfortable environment while exploring and understanding your participant's world. Example: “What makes working on your eating regimen important to you?” A – Affirmations help build a ...
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Sacrifice-Preparing for the season of Lent My experience in working with people with diabetes who also struggle with chronic dieting, disordered eating or an eating disorder reminds me to assist them in preparing to participate in observation of the Lenten season. As I read my February copy of the Catholic Light a publication of the Diocese of Scranton, I realized that some who read the Regulations for Lent may find them triggering for disordered eating behaviors regarding food. The obligation of fasting and or abstinence can be stressful for those struggling or in recovery. I would like to offer acceptable options that correlate with the faithful followers ...
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Telehealth for Diabetes Educators Tomorrow Solutions Available Today Emerging technological advances have the potential to improve quality of care and increase access to healthcare services for patients with diabetes. The telehealth communication with patients has been used by provider, but can this platform be used by diabetes educators? Telehealth communication has great potential to change the way diabetes is managed by improving efficiency of care and enhancing quality of treatment You are invited to come to my presentation that will take place at the AADE PA CB annual meeting on May 8 th and learn how you the diabetes educator can: Change ...
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The 5 Whys

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The 5 Whys I blogged last month about my recent thoughts about goal setting. I also talked about a challenging part of diabetes education is helping a patient set meaningful goals. I mentioned an approach used in the corporate world called the 5 Whys and said that I would discuss that in this month’s blog. The 5 Whys is an approach that allows a general goal to become more specific by getting to the root cause of the problem. You do that by simply asking “why.” Here is an example: I want to lose weight. Why? Because I weight too much. Why do you care about that? I’m afraid that that my excess weight will lead to more health problems. Why do you ...
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Thoughts about Goal Setting I’ve been thinking a lot about goals lately. It started when I was flipping through Facebook posts of my “friends” and the following enticed me to stop and read. A Dream Written Down with a Date Becomes a Goal A Goal Broken Down into Steps Becomes a Plan A plan Backed by Action Makes Your Dreams Come True. How true. I thought of all of the goals that I had set in my life, some reached and others not so much. Every year we all set New Year’s Goals, but those are the worst for me. I rarely got beyond March with those ...
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Patients consistently ask for a meal plan and a specific list of “good foods” for them to choose. For years, we have avoided such structured recommendations, as we realize a “one-size-fits-all” approach isn’t appropriate or realistic for our patients. The American Diabetes Association Medical Nutrition Therapy Consensus Report 2019 continues to support this theory. The 2019 guidelines highlight evidence that there is not an ideal percentage of calories from carbohydrates, protein and fat for all people with diabetes. Macronutrient distribution should be tailored to the individuals eating patterns, preferences and weight goals. So, continue your efforts to ...
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Chronic Care Management (CCM) may be one of the hottest new opportunities out there for diabetes educators. CCM is a Medicare funded program since 2015, and more recently by some commercial insurers. It targets the highest risk demographic of an internal medicine or primary care practice, namely those with at least two chronic diseases including diabetes, hypertension, COPD, cancer and depression. Rarely, would you find someone with only one of these conditions at a time. While medication management is not a chronic disease, it is also included in this list, as it frequently results in hospital admissions and readmissions for someone whose medication financial ...
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During education on foot care I hear that providers are not completing this standard of care annually. As educators do we just question if it is practiced? I see the topic of foot care documented in follow up visits. Do we need to question about foot problems earlier? In life we show affection when kissing those sweet baby feet. As we grow older and walk daily we begin to hide our feet if bunions, callous, foot and toe deformities appear. The ever present obesity epidemic is creating additional foot risks for young and old. We can begin evaluating for foot risk when patients walk into our inpatient/outpatient settings. Yes, you can observe their gait, shoe ...
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We are all aware that the Month of November is the month that we focus a little more on our patients living with diabetes, and most of us increase our outreach efforts a little more this month. I want to share our hospital’s outreach efforts. Clarion Hospital is a very small rural hospital facility located in Clarion County, PA. Our landscape is rich with farmland and small towns and communities. We have tried to continually improve our Diabetes Care each year enhancing our efforts from the previous year. This year it started early in the morning on November 2 nd , from 6 AM – 10AM. Our hospital organizes a Multiphasic Screening Event that is sponsored ...
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Wow, that’s a loaded question. It can mean so many different things to so many different people. What’s the best diet for a person living with diabetes? How many of you have been asked this at least once in the past week? If we teach our patients to carb count, that’s good enough, right? Which is healthier; low-carb, low-fat or vegan? Probably depends on whose research you are looking at and the sponsors of the study. Sometimes I get overwhelmed with these discussions. It makes me think back to all the changes and hot topics I have seen with what once was considered a “diabetic diet.” Back in the early 90s, when I first worked in a hospital as a dietitian, most ...
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Now that it is o fficially Brussels sprouts season! For many people, eating healthy is a chore. When the world is filled with glorious pastas, breads, the cheesiest of pizzas, and layers of cake, why in the world would we ever bother eating a salad? Well, it's because not only is it a good idea for us to eat a vegetable every now in then, but also eating healthy is actually delicious -- no lie Michael Greger, MD. wrote a book How Not to Die inspiring more people to eat better and a more healthier life. He encourages eating more vegetables include cabbage, cauliflower, and Brussels sprouts. They contain tons of nutrients and fiber, ...
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Empathy and Compassion in Diabetes Education, How to Open the Gate By Kim Campbell, MPH, RD, LDN, CDE As an RD for over half of my lifetime, and a CDE for over 20 years, I always thought I had enough empathy for my patients. I was moved by the stories people told me about their diabetes, their lives, and their difficulties with managing their complex health demands. I cared, I was kind, I listened, I did my best to help with the education and ideas I had been trained to provide. I have said things like, “I understand”, “I know this sucks”, and “What can I do to help you?” I try to incorporate concepts of motivational interviewing into my visits with people ...
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