This week on The Huddle, we're resharing a discussion with current ADCES President, Veronica Brady, PhD, FNP-BC, BC-ADM, CDCES, FADCES. Veronica discussed the concept of unconscious bias, how it shows up in our everyday lives and in working as health care professionals, and how we can practice cultural humility to better serve the needs of people with and at risk for diabetes. 

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.

In the first episode in a multi-part diabetes technology series, Kathryn Evans Kreider DNP, FNP-BC, BC-ADM, FAANP, joins The Huddle to discuss integrating diabetes technology into primary care. She talks about the importance of embracing digital technology in primary care and how health care professionals in primary care can take tangible steps to better utilize the technology available to them.

Learn about the latest advances in diabetes technology on danatech:  Diabetes technology for healthcare professionals | Danatech

Check out the two-part Integrating Diabetes Technology into Primary Care course here: 

• Part 1: Integrating Diabetes Technology into Primary Care Part 1: Overview and Clinical Scenarios
• Part 2: Integrating Diabetes Technology into Primary Care Part 2: Interactive Case Studies

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.

Michael See MS, ACSM-CEP, NBCHWC, CDES joins the Huddle to share his expertise and experiences in bringing physical activity to people with type 2 diabetes who also have physical limitations. He covers topics like how to assess physical limitations, their prevalence in people with type 2 diabetes, and how to use a motivational interviewing approach in conversations with your clients. This episode was made possible with support from Lilly, A Medicine Company.

Learn more about this topic in our latest patient/client handout (support for the development of this handout was provided by Lilly, A Medicine Company): adces_tipsheet_physical_activity2.pdf

References

American Diabetes Association Professional Practice Committee; 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024. Diabetes Care 1 January 2024; 47 (Supplement_1): S77–S110.

Ahmad E, Sargeant JA, Yates T, Webb DR, Davies MJ. Type 2 Diabetes and Impaired Physical Function: A Growing Problem. Diabetology. 2022; 3(1):30-45. https://doi.org/10.3390/diabetology3010003

Angulo, J., Assar, M. E., Álvarez-Bustos, A., & Rodríguez-Mañas, L. (2020). Physical activity and exercise: Strategies to manage frailty. Redox Biology, 35. https://doi.org/10.1016/j.redox.2020.101513

Colberg SR, Sigal RJ, Yardley JE, et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065-2079. doi:10.2337/dc16-1728

O'Neill D, Forman DE. The importance of physical function as a clinical outcome: Assessment and enhancement. Clin Cardiol. 2020;43(2):108-117. doi:10.1002/clc.23311

Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports. 2015;25 Suppl 3:1-72. doi:10.1111/sms.12581

36-Item Short form survey instrument (SF-36). Available at: https://www.rand.org/content/dam/rand/www/external/health/surveys_tools/mos/mos_core_36item_survey.pdf (Accessed: 21 October 2024). 

Physical activity vital sign. Available at: https://www.exerciseismedicine.org/wp-content/uploads/2021/04/EIM-Physical-Activity-Vital-Sign.pdf (Accessed: 21 October 2024). 

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.

Eileen Egan, DNP, FNP-C, BC-ADM, CDCES, FADCES joins The Huddle to share her expertise about the interplay between weight and glycemic management in people with Type 2 diabetes, the importance of meeting glycemic and weight goals early after a Type 2 diabetes diagnosis, as well as best practices for helping people stay motivated and engaged. This episode was made possible with support from Lilly, A Medicine Company.

Learn more about this topic in this accompanying patient/client handout (support for the development of this handout was provided by Lilly, A Medicine Company): adces_tipsheet_early_control2.pdf

References:

American Diabetes Association. Obesity and weight management for the prevention and treatment of type 2 diabetes: standards of care in diabetes- 2024. Diabetes Care, 47(1): S145-S157.

Center for Disease Control and Prevention. Adult overweight and obesity. https://www.cdc.gov/obesity/basics/adult-defining.html

DCCT/EDIC study research group. Intensive Diabetes Treatment and Cardiovascular Outcomes in Type 1 Diabetes: The DCCT/EDIC Study 30-Year Follow-up. Diabetes Care. 2016;39(5):686-693. 

Gregg E, Jakicic J, Blackburn G, et al. Association of the magnitude of weight loss and changes in physical fitness with long-term cardiovascular disease outcomes in overweight or obese people with type 2 diabetes: a post hoc analysis of the Look AHEAD randomized clinical trial. Lancet Diabetes Endocrinol. 2016; 4(11): 913-921.

Gutiérrez-Cuevas J, Santos A, Armendariz-Borunda J. Pathophysiological Molecular Mechanisms of Obesity: A Link between MAFLD and NASH with Cardiovascular Diseases. Int J Mol Sci. 2021. 27;22(21):11629.

Howard BV, Ruotolo G, Robbins DC. Obesity and dyslipidemia. Endocrinol Metab Clin North Am. 2003;32(4):855-867. 

Jin X, et al. Pathophysiology of obesity and its associated diseases. Acta Pharm Sin B. 2023;13(6):2403-2424.  

Laiteerapong N, Ham SA, Gao Y, et al. The legacy effect in type 2 diabetes: impact of early glycemic control on future complications (The Diabetes & Aging Study). Diabetes Care. 2019;42(3):416-426.

Lean MEJ, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial.Lancet Diabetes Endocrinol. 2019;7(5):344-355.

Lingvay I, Sumithran P, Cohen RV, le Roux CW. Obesity management as a primary treatment goal for type 2 diabetes: time to reframe the conversation. Lancet. 2022 Jan 22;399(10322):394-405. doi: 10.1016/S0140-6736(21)01919-X. Epub 2021 Sep 30. Erratum in: Lancet. 2022 Jan 22;399(10322):358. PMID: 34600604

Rachel G. Miller, Trevor J. Orchard; Understanding Metabolic Memory: A Tale of Two Studies. Diabetes 1 March 2020; 69 (3): 291–299. https://doi.org/10.2337/db19-0514

Ross, R., Neeland, I.J., Yamashita, S. et al. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol16, 177–189 (2020). https://doi.org/10.1038/s41574-019-0310-7

Thom G, McIntosh A, Messow CM, et al. Weight loss-induced increase in fasting ghrelin concentration is a predictor of weight regain: Evidence from the Diabetes Remission Clinical Trial (DiRECT). Diabetes Obes Metab. 2021;(23):711-719.

Tsai AG, Bessesen DH. Obesity. Ann Intern Med. 2019;170(5):ITC33-ITC48.

Wing RR, Bolin P, Brancati FL, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369(2):145-154.

World Health Organization. Obesity. https://www.who.int/health-topics/obesity#tab=tab_1

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.

On our latest episode of The Huddle, Sheetal Shah, founder of MettaHealth Partners discusses the evolving realm of AI, the role DCESs and other health care professionals can play in embracing and adopting AI technology, and the importance of keeping a human element in the technology.

Learn more about MettaHealth Partners here: MettaHealth Partners

Learn more about the National Institute of Standards and Technology (NIST) here: National Institute of Standards and Technology

Stay up to date on all things related to diabetes technology on danatech: Diabetes technology for healthcare professionals | Danatech

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.

During a special episode of The Huddle recorded live at our 2024 annual meeting, we sat down with incoming ADCES President Veronica Brady, PhD, FNP-BC, BC-ADM, CDCES, FADCES. Veronica discussed the impact she wants to leave behind as President this coming year, as well as the concept of unconscious bias, how it shows up in our everyday lives and in working as health care professionals, and how we can practice cultural humility to better serve the needs of people with and at risk for diabetes. 

Please note: since the recording of this episode, Kirsten Yehl has since moved on from ADCES to pursue another professional opportunity.

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.

Lucia Novak MSN, ANP-BC, BC-ADM joined The Huddle to discuss the role of basal insulin in type 2 diabetes, when to initiate it, and how to have discussions about basal insulin with your clients that make them feel comfortable, informed and empowered.

This episode was made possible with support from Lilly, A Medicine Company.

Resources: 

American Diabetes Association Professional Practice Committee; 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2024. Diabetes Care 1 January 2024; 47 (Supplement_1): S158–S178. https://doi.org/10.2337/dc24-S009

Look AHEAD (Action for Health in Diabetes) study. Look AHEAD (Action for Health in Diabetes)

Pantalone KM, Misra-Hebert AD, Hobbs TM, et al. Clinical inertia in type 2 diabetes management: evidence from a large, real-world data set. Diabetes Care. 2018;41(7): e113-e114.

Find a DSMES program near you here: Find an Accredited Diabetes Education Program

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.

People with diabetes who are newly starting insulin may have concerns and fears, many of which are caused by beliefs about insulin that may not be accurate. Susan Guzman, PhD, joined The Huddle to talk about the potential fears that may come up when someone is starting insulin, and how diabetes care and education specialists can address these fears and provide support so that people feel comfortable and informed when taking insulin.  

This episode was made possible with support from Lilly, A Medicine Company.

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.

Having elevated cortisol levels can lead to a variety of side effects, and it may impact people with diabetes in a number of ways. Natalie J. Bellini DNP, FNP-BC, BC-ADM, CDCES joined The Huddle to talk about hypercortisolism, how it is diagnosed, and its potential effects on type 2 diabetes management. This episode is sponsored by Corcept.

Learn more about Corcept here: Corcept Therapeutics

View a recorded webinar that dives deeper into cortisol levels and diabetes management (sponsored by Corcept): A Closer Look at Difficult-to-Manage Diabetes – Is Cortisol at Play?

Learn more about the CATALYST study: Corcept Announces Presentation of Results From Prevalence Phase of CATALYST Clinical Trial at American Diabetes Association’s Scientific Sessions – Corcept Therapeutics, Incorporated

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.

Diabetes-related foot conditions like ulcers and amputations can be very serious, but these complications are preventable when comprehensive foot exams are prioritized. Podiatrist Dr. Mark Hinkes joined The Huddle to talk about the importance of foot health and comprehensive foot exams for people with diabetes, and how we can use data collected from these foot exams to predict potential future risk. 

Learn more about the International Working Group on the Diabetic Foot here: Home - IWGDF Guidelines

View Mark's book "Healthy Feet for People with Diabetes" here: Healthy Feet for People With Diabetes: Hinkes DPM, Dr. Mark: 9780985628604: Books - Amazon.ca

Learn more about diabetes-related foot complications:

• Foot Complications | ADA
• Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer | Journal of Foot and Ankle Research | Full Text

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.