Remission of Type 2 Diabetes and Reversal of Insulin Resistance with Lifestyle Medicine

Physician/Doctor:
    Non-Members: $720 | ACLM Members: $540
Non-Doctoral Health Professional:
    Non-Members: $540 | ACLM Members: $405
Student/Trainee:

    Non-Members: $360 | ACLM Members: $270

Credits
18 CME/CE Credits 

Course Description

This course is led by John Kelly, MD, MPH, LM Intensivist, FACLM, founding ACLM president and ABLM certified LM Intensivist. It reviews the epidemiology, risk factors, and current medical approach to preventing and treating all forms of diabetes.

Throughout the course, expert faculty in the fields of diabetes and lifestyle medicine address the scientific literature that supports the treatment, remission, and prevention of type 2 diabetes and insulin resistance.

Most importantly, the application of lifestyle medicine methods, guidelines, tools, and monitoring standards are explained, enabling healthcare practitioners to successfully apply lifestyle medicine techniques to treat, prevent, and achieve remission of type 2 diabetes and reversal of insulin resistance for their patients.

Learning Objectives

  • Discuss the role of nutrition and particularly whole food plant-based nutrition in the prevention, treatment, and remission of type 2 diabetes and reversal of insulin resistance
  • Discuss the role of physical activity, sleep and other essential factors in the prevention, treatment and remission of type 2 diabetes and reversal of insulin resistance
  • Review the key metabolic disturbances and pathophysiology of type 2 diabetes, insulin resistance, type 1 diabetes, and latent autoimmune diabetes in adults (LADA)
  • Review the current literature and considerations around medication de-prescribing for type 2 diabetes remission and reversal of insulin resistance.
  • Review the definitions and success rates of remission of type 2 diabetes and reversal of insulin resistance

Remission of Type 2 Diabetes Is Possible

Studies have demonstrated that a lifestyle medicine approach to the treatment of type 2 diabetes can not only improve patient outcomes, compared to other treatment regimens, but can reduce or even eliminate the need for prescription medication treatments, including insulin.

Course Format

Course Format

The course is composed of 20 lectures within 17 modules and is 18 hours in length. The course is completed online via the ACLM Learning Management System. Users are able to click through the voice-over module slides at their own pace and complete a corresponding quiz. Interactive scenarios, images and case studies have been added to enhance the experience.
Course Outline

There are 20 lectures within 17 modules included in this course:

  • Course Overview & Introduction to Diabetes Remission as the Goal of Type 2 Diabetes Treatment | John Kelly, MD, MPH, LM Intensivist, FACLM | Caroline B. Trapp, DNP, ANP-BC, CDCES, DipACLM, FAANP
  • Module 2: Key Metabolic Disturbances in the Pathophysiology of Type 2 Diabetes and Insulin Resistance | George Guthrie, MD, MPH, CDCES, FAAFP, FACLM, DipABLM
  • Module 3: Insulin Resistance in Type 1 Diabetes, Latent Autoimmune Diabetes in Adults (LADA), and Type 2 Diabetes | Kylie Buckner, MSN, RN
  • Module 4: Treatment and Reversal of Insulin Resistance in Type 1 Diabetes and Latent Autoimmune Diabetes in Adults (LADA) | Kylie Buckner, MSN, RN
  • Module 5: Insulin Resistance and Cognitive Impairment | Dean Sherzai, MD, MAS, MPH, PhD(c) | Ayesha Sherzai, MD, MAS
  • Module 6: Effective Modalities for the Reversal of Insulin Resistance and Remission of Type 2 Diabetes | Scott Stoll, MD, FABPMR
  • Module 7: Lifestyle Medicine Treatment for the Reversal of Insulin Resistance and Remission of Type 2 Diabetes | Scott Stoll, MD, FABPMR
  • Module 8: Dietary Plans for the Reversal of Insulin Resistance and Remission of Type 2 Diabetes (Parts 1-3) | Brenda Davis, RD
  • Module 9: The Role of Plant-Based Diets in Type 2 Diabetes Management | Neal Barnard, MD, FACC
  • Module 10: The Impact of Fasting on the Reversal of Insulin Resistance and Remission of Type 2 Diabetes | George Guthrie, MD, MPH, CDCES, FAAFP, FACLM, DipABLM
  • Module 11: The Role of Physical Activity in the Reversal of Insulin Resistance and Remission of Type 2 Diabetes | Jonathan Bonnet, MD, MPH, CAQSM, FAAFP, FACLM, DipABLM
  • Module 12: The Role of Sleep in the Reversal of Insulin Resistance and Remission of Type 2 Diabetes | Scott Stoll, MD, FABPMR
  • Module 13: Medication Deprescribing – Lifestyle Medicine Considerations for Medications Commonly Used by People with Diabetes (Parts 1-2) | Jeni Shull Clayton, MD, MPH, DipABLM | Denise Fields, PharmD, BC-ADM, FASHP, DipACLM
  • Module 14: Helping Patients Change Their Diets | Neal Barnard, MD, FACC
  • Module 15: Expected Success Rates for the Reversal of Insulin Resistance and Remission of Type 2 Diabetes | John Kelly, MD, MPH, LM Intensivist, FACLM
  • Module 16: Facilitating Behavior Change | Caroline B. Trapp, DNP, ANP-BC, CDCES, DipACLM, FAANP
  • Module 17: Key Steps and Processes in Establishing an Effective Lifestyle Medicine Program for Reversal of Insulin Resistance and Remission of Type 2 Diabetes | John Kelly, MD, MPH, LM Intensivist, FACLM
Faculty

John Kelly, MD, MPH, LM Intensivist, FACLM

Lead Faculty, Remission of Type 2 Diabetes and Reversal of Insulin Resistance with Lifestyle Medicine
Co-author, ACLM Lifestyle Medicine Board Review Course 3rd edition
President, Lifestyle Health Education Inc.

Dr. Kelly is trained in Biochemistry, Molecular Biology, Medicine, Epidemiology and Information Technology (IT). He completed studies at Loma Linda University in Preventive and Lifestyle Medicine and has done funded research in Lifestyle Medicine, was founding President of ACLM, co-authored the Board Review Course in LM, and was founding Chair for the Expert LM Panel. He received the AMA excellence in medicine award in 2004 for his work in establishing the American College of Lifestyle Medicine. He practices LM and teaches clinicians LM around the world. Dr. Kelly established and conducts lifestyle medicine training programs, and serves as adjunct faculty at two medical schools.

 

Caroline B. Trapp, DNP, ANP-BC, CDCES, DipACLM, FAANP

Senior Reviewer, Remission of Type 2 Diabetes and Reversal of Insulin Resistance with Lifestyle Medicine
Adjunct Clinical Instructor, University of Michigan School of Nursing – Dept. of Health Behavior and Biological Sciences
Scientific Advisory Board, Physicians Committee for Responsible Medicine
Nutrition Research Consultant, Northern Arizona University Dept. of Health Sciences

Dr. Trapp has long been committed to changing the way diabetes is treated; advocating for safe, affordable, and effective lifestyle interventions over medications and surgery, through clinical practice, writing for publications, and developing extensive professional and public education programming. She is the former director of diabetes education & care of the Physicians Committee for Responsible Medicine. She is board certified in Adult Primary Care Nursing, Diabetes Care and Education, and Lifestyle Medicine. She completed her Doctor of Nursing Practice degree in 2015. Her work has taken her to China, the Marshall Islands, The Republic of Northern Macedonia, and to many cities and Native Nations across the U.S. She was honored to be inducted as a Fellow in the American Association of Nurse Practitioners.

 

George Guthrie, MD, MPH, CDCES, FAAFP, FACLM, DipABLM

Assistant Director, Advent Health Winter Park Family Medicine Residency
Past President, American College of Lifestyle Medicine

George Guthrie received his MD from Loma Linda University in 1981. After completing his Family Medicine Residency, he joined a multispecialty medical group on the island of Guam in Micronesia. The high incidence of type 2 diabetes in his patients triggered his interest in the effective treatment of the disease through lifestyle changes.

Dr. Guthrie returned to Loma Linda University in 1992 and earned a master’s degree in Public Health with a focus on nutrition. He then joined the faculty at the LLU’s School of Medicine and the LLU School of Public Health’s Nutrition Department, where he taught graduate and medical students how lifestyle impacts the cause and treatment of disease. In 1994, he moved to a rural practice in northern California.

While serving as medical director at Lifestyle Center of America in Sulphur, Oklahoma from 2002 to 2007, Dr. Guthrie enjoyed helping people who really wanted to make lifestyle changes to treat their lifestyle-related diseases such as type 2 diabetes, hypertension, obesity and coronary heart disease.

In 2007, he joined Florida Hospital’s Family Practice residency, where he guides medical residents in family and lifestyle medicine and pilots innovative ways of incorporating lifestyle medicine into office and hospital practice.

Dr. Guthrie has helped to develop or pilot several community-focused lifestyle change programs, including the Complete Health Improvement Project (CHIP), the Wellspring Diabetes Program and the CREATION Health program. This work has allowed him to share lifestyle medicine presentations with audiences in the U.S. and other countries. His most recent accomplishments have been the writing chapters and editing a section for Rippe’s 3rd edition of Lifestyle Medicine textbook, publishing his experience in peer reviewed literature, and the recent release of a book for the popular press entitled Eat Plants, Feel Whole.

Kylie Buckner, MSN RN

Director of Lifestyle Change, Lifestyle Transition Coach
Mastering Diabetes

I have a background as a nurse and educator working in women’s health (OBGYN, Labor and Delivery, NICU, and pediatrics). Since 2017 I have worked as a coach and the Director of Lifestyle Change for Mastering Diabetes. I understand the challenges of adopting a whole food, plant based lifestyle and work to find long term solutions for the clients I serve.

I work directly with clients living with T1, LADA, T2, pre diabetes, and gestational diabetes to help them achieve their best insulin sensitivity utilizing the tools in the Mastering Diabetes Method. Using the evidence-based principles of Lifestyle Medicine, the tools in the method include adopting a low-fat, plant-based, whole-food diet, strategically adding intermittent fasting, exercise, and mindfulness techniques to improve health outcomes, reduce long term health risks, and overall quality of life for people living with diabetes.

I have been a passionate coach, educator, and advocate for the benefits of a plant-based approach for reversing insulin resistance and supporting those who wish to achieve their best health, regardless of their diabetes diagnosis.

I work side by side with my husband and Mastering Diabetes Co-Founder, Cyrus Khambatta, PhD, who has been living with T1 diabetes for more than 20 years. For more information, visit www.masteringdiabetes.org

Dean Sherzai, MD, MAS, MPH, PhD(c)  |  Ayesha Sherzai, MD, MAS

Co-directors, Alzheimer’s Prevention Program
Loma Linda University

Dean Sherzai trained in neurology at Georgetown University School of Medicine and completed fellowships in neurodegenerative diseases and dementia at the National Institutes of Health and UC San Diego. He also holds a PhD in healthcare leadership with a focus on empowering communities achieve their optimal brain health, and two masters degrees; one in Public Health on the subject of lifestyle and epidemiology and a second in advanced research methodology. He is currently the co-director of the Alzheimer’s Prevention program at Loma Linda University and president of the international non-profit, Healthy Minds initiative, which hopes to empower communities to take control of their own brain health.  

Ayesha Sherzai leads the Lifestyle Program for the Prevention of Neurological Diseases. She completed a dual training in preventative medicine and neurology at Loma Linda University, a masters in clinical research at UCSD, and a fellowship in vascular neurology and epidemiology at Columbia University. She is also a trained plant-based culinary artist. Ayesha is currently the co-director of the Alzheimer’s Prevention program at Loma Linda University, and lead researcher at the Healthy Minds Initiative. 

Scott Stoll, MD, FABPMR

Co-founder, The Plantrician Project

Dr. Stoll is board certified physician specializing in sports and musculoskeletal medicine and is a recognized as an international leader in lifestyle medicine and whole food plant-based nutrition. He is the co-founder of the Plantrician Project, the International Plant Based Nutrition Healthcare Conference, the International Journal of Disease Reversal and Prevention, and the Regenerative Health Institute, a unique collaborative project with the Rodale Institute that integrates a regenerative vision of human health, agriculture, and the environment. He was a member of the 1994 Olympic Bobsled team and served as a team physician for the United States Bobsled and Skeleton Team and Lehigh University. Dr. Stoll served as a member of the Whole Foods scientific and medical advisory board and consults with healthcare organizations globally to integrate lifestyle medicine solutions.

Every year Dr. Stoll hosts the very popular one-week total health immersions in Florida and helps attendees recover lost health, overcome addictions, and restore emotional balance. In addition to authoring numerous books, scientific articles and speaking internationally, Dr. Stoll has appeared on a wide variety of national shows including the Dr. Oz show, hosting a 2018 PBS special Food As Medicine, and numerous documentaries including The Game Changers, Eating You Alive, Disease Reversal Hope, and Plantwise.

Brenda Davis, RD

Nutrition Consultant, Author, Speaker
Private Practice

Brenda Davis, registered dietitian, is a world leading plant-based pioneer and an internationally acclaimed speaker. Brenda has been a featured speaker at medical, nutrition, and dietetic conferences in 25 countries on 6 continents.
As a prolific nutrition writer, Brenda has authored/co-authored 12 books with nearly a million copies in print in 15 languages. She has just completed a 13th book, Plant-Powered Protein, which is due out in the spring of 2023. Her most recent works include Nourish: The Definitive Plant-based Nutrition Guide for Families (Shah and Davis, 2020), Kick Diabetes Essentials (Davis, 2019), The Kick Diabetes Cookbook (Davis and Melina, 2018), Becoming Vegan: Comprehensive Edition (Davis and Melina, 2014) and Becoming Vegan: Express Edition (Davis and Melina, 2013). Nourish won gold in the 2020 Nautilus Book Awards and was also a Canada Book Award winner. Becoming Vegan: Comprehensive Edition won a 2014 REAL Best of 2014 Book Award and Becoming Vegan: Express Edition won the Canada Book Award and was a finalist and received honorable mention in the Foreward Book of the Year Award. Becoming Vegan: Comprehensive and Express Editions have also received a star rating by the American Library Association as the “go-to books” on plant-based nutrition. Brenda has also authored and co-authored numerous professional and lay articles and is a past chair of the Vegetarian Nutrition Dietetic Practice Group of the American Dietetic Association.
Brenda is passionate about lifestyle medicine. She worked with Dr. John Kelly in a diabetes research project in the Marshall Islands and in a lifestyle medicine demonstration project in Lithuania. As the lead dietitian in the Marshall Islands, Brenda spent many months establishing and implementing the program. On her last trip (November 2017), she developed a nutrition education curriculum for kindergarten through grade 6 and trained teachers in all public schools

Neal Barnard, MD, FACC

Adjunct Professor of Medicine
George Washington University School of Medicine
President, Physicians Committee for Responsible Medicine

Neal Barnard is an Adjunct Professor of Medicine at the George Washington University School of Medicine in Washington, DC, and President of the Physicians Committee for Responsible Medicine.

Dr. Barnard has led numerous research studies investigating the effects of diet on diabetes, body weight, and chronic pain, including a groundbreaking study of dietary interventions in type 2 diabetes, funded by the National Institutes of Health, that paved the way for viewing type 2 diabetes as a potentially reversible condition for many patients. Dr. Barnard has authored more than 90 scientific publications and 20 books for medical and lay readers, and is the editor in chief of the Nutrition Guide for Clinicians, a textbook made available to all U.S. medical students.

As president of the Physicians Committee, Dr. Barnard leads programs advocating for preventive medicine, good nutrition, and higher ethical standards in research. His research contributed to the acceptance of plant-based diets in the Dietary Guidelines for Americans. In 2015, he was named a Fellow of the American College of Cardiology. In 2016, he founded the Barnard Medical Center in Washington, DC, as a model for making nutrition a routine part of all medical care.

Working with the Medical Society of the District of Columbia and the American Medical Association, Dr. Barnard has authored key resolutions, now part of AMA policy, calling for a new focus on prevention and nutrition in federal policies and in medical practice. In 2018, he received the Medical Society of the District of Columbia’s Distinguished Service Award. He has hosted four PBS television programs on nutrition and health.

Originally from Fargo, North Dakota, Dr. Barnard received his M.D. degree at the George Washington University School of Medicine and completed his residency at the same institution. He practiced at St. Vincent’s Hospital in New York before returning to Washington to found the Physicians Committee.

Jeni Shull Clayton, MD, MPH, DipABLM

Jeni Shull Clayton, M.D., M.P.H., is a Family and Preventive Medicine Physician, a Diplomat of the American and International Board of Lifestyle Medicine, and a Fellow of the American College of Lifestyle Medicine. Dr. Clayton graduated from Indiana University School of Medicine. She attended Loma Linda University’s Family and Preventive Medicine residency, served as chief resident, and completed her Master’s in Population Health. She was awarded Resident Teacher of the Year and the Will Alexander Whole Person Care Award. Under Dr. John Kelly, founder of the American College of Lifestyle Medicine (ACLM), she became the first Lifestyle Medicine Fellow at the Black Hills Health and Education Center. She is a co-author of the Foundations of Lifestyle Medicine Board Review Manual and Course. Currently, Dr. Clayton enjoys making lifestyle medicine the foundation of her primary care practice in Indiana. She lives in the country with her husband and 3 cats and enjoys time outdoors, gardening, and cooking.

Denise Fields, PharmD, BC-ADM, FASHP, DipACLM

Ambulatory Care Pharmacist, Evernorth

Denise Fields became a Diplomate of the American College of Lifestyle Medicine and the International Board of Lifestyle Medicine in 2018. She currently works as a Lifestyle Pharmacist at the Cummins LiveWell Center in Columbus, IN. Dr. Fields received her B.S. in Pharmacy from Butler University and her PharmD from Purdue University. She holds conventional medicine certifications in Immunization Delivery, Diabetes Care, Anticoagulation, Medication Therapy Management, Pain Management and Pharmacogenomics. She is also board certified in Advanced Diabetes Management.

Dr. Fields began her Lifestyle Medicine Journey as a CHIP facilitator and now participates in the training of new CHIP facilitators at the Cummins LiveWell Center. She has also completed Dr. McDougall’s Starch Solution Certification Course for Professionals.

Dr. Fields has experience in various pharmacy practice sites including community (independent and chain), hospital (critical access to teaching-sized hospitals), and managed care. She has fulfilled such roles as clinical pharmacist, informatics pharmacist, medication safety pharmacist, and Director of Pharmacy.

Dr. Fields is a former co-chair of the Pharmacist Member Interest Group within the American College of Lifestyle Medicine. She is a Past President of the Indiana Pharmacists Association (2018-2020), Past President of the Indiana Society of Health System Pharmacists (2015), and Past President of the Indiana Academy of Non-Traditional Pharmacists (2017). Dr. Fields has served on the Board of Directors for both the Indiana Pharmacists Association and the Indiana Rural Health Association. She served on Section Advisory Groups for the American Society of Health-System Pharmacists for 7 years. She served as Chair of the Indiana Pharmacy Practice Advancement Initiative Task Force from 2014-2015.

Dr. Fields is a Certified Zumba Instructor, and also enjoys kickboxing at her local gym. She discovered a new love of hiking after a trip to Havasu Falls in 2018 to celebrate her 50th birthday and spends much of her free time hiking now that she and her husband became empty nesters in 2022. She climbed to the top of the infamous Angel’s Landing in 2021 and is preparing for a rim-to-rim hike in March of 2023 at the Grand Canyon.

Frequently Asked Questions

What are the credentials of the curriculum authors?

The authors are clinical subject matter experts in their fields, including faculty who are board-certified in Preventive Medicine, Family Medicine, Lifestyle Medicine and more. They have achieved professional clinical degrees and have substantially contributed to the research and advancement of the lifestyle medicine profession.

What does it mean that the curriculum is evidence based?

The curriculum is a collection of the national guidelines for each content area. For example, the course reviews the work of those who have received the highest scientific achievement by the American Diabetes Association – the Banting Medal for Scientific Achievement. Course scientific evidence comes from journals such as the Journal of the American Medical Association (JAMA), the American Diabetes Association (ADA) Diabetes Care, the American Journal of Clinical Nutrition, Annals of Internal Medicine, and more. Additionally, the recommendations of national professional societies are incorporated, as well as the core peer-reviewed journal articles that contribute to the evidence base in this field.

Who will benefit from this 18-hour course?

This program is designed to provide in-depth education on the use of lifestyle medicine for type 2 diabetes and insulin resistance reversal and is applicable to physicians, physician assistants, registered nurses, nurse practitioners, pharmacists, registered dietitians, certified diabetes educators, and others involved in providing coordinated care for patients with type 2 diabetes and insulin resistance. It is intended for those who are familiar with the field of lifestyle medicine and would like to learn specific lifestyle medicine interventions for those with type 2 diabetes and insulin resistance. The modules cover both basic and more advanced concepts, providing a thorough foundation of the underlying elements of both academic and clinical lifestyle medicine.

What is the format of the content?

The course is composed of 20 lectures within 17 modules and is 18 hours in length. The course is completed online via the ACLM Learning Management System. Users are able to click through the voice-over module slides at their own pace and complete a corresponding quiz. Interactive scenarios, images and case studies have been added to enhance the experience.

Is this content accredited for CME?

Yes, this 18-hour course is accredited to provide 18 AMA PRA Category 1 Credits TM. Additionally, this course also provides Maintenance of Certification (MOC) for the American Board of Lifestyle Medicine (ABLM) and the American College of Lifestyle Medicine (ACLM) certification.

Will I receive a certificate of completion?

Yes, all participants who complete the full 18-hour course and pass the post-module evaluation will be eligible to receive an online CME/CE certificate of completion.

I’m a registered nurse, registered dietitian, physician assistant, physical therapist, occupational therapist, respiratory therapist, social worker, speech therapist or audiologist; may I receive credit for this content?

Yes!

How recent is the content?

The program was just developed and launched November 2022. The content reflects the recent work in this field. It also describes the foundational studies that showed the evidence base for the treatment and reversal of type 2 diabetes and insulin resistance. Faculty will be updating the content on a regular basis, and enrollees have 1-year access to the program.

Will additional CME content, or updates to this content, be available soon?

Yes, updates to the training program will be made on an ongoing basis.

How long do I have access to the content?

Course purchasers will have access to the online course for one year.

 

If you’re interested in more information about Lifestyle Medicine or Lifestyle Medicine training, contact education@lifestylemedicine.org

Accreditation

In support of improving patient care, Rush University Medical Center is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

For Medicine: Rush University Medical Center designates enduring material for a maximum of 18.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.  

For Nursing: Rush University Medical Center designates this enduring material for a maximum of 18.00 nursing contact hour(s).  

For Pharmacy: Rush University Medical Center designates this knowledge-based enduring material for a maximum of 18.00 contact hour(s) for pharmacists.  

For Psychologists: Rush University Medical Center designates this enduring material for 18.00 CE credits in psychology.  

For Dietitians: This enduring material has been approved by the Commission on Dietetic Registration for 18.00 CPEUs.  

For Social Work: As a Jointly Accredited Organization, Rush University Medical Center is approved to offer social work continuing education buy the Association of Social Work Boards (ASWB) Approved continuing education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 18.00 general continuing education credits.  

For physical therapy or occupational therapy: Rush University is an approved provider for physical therapy/occupational therapy by the Illinois Department of Professional Regulation. Rush University designates this enduring material for a maximum of 18.00 continuing education credits for physical therapists/ occupational therapists.  

ABIM MOC: Successful completion of this activity, which includes participation in the evaluation component, enables the participant to earn up to 18.00 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participation completion information to ACCME for the purpose of granting ABIM MOC credit. 

AAFP Prescribed Credits: The AAFP has reviewed Remission of Type 2 Diabetes and Reversal of Insulin Resistance with Lifestyle Medicine and deemed it acceptable for up to 18.00 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval is from 11/10/2022 to 11/10/2023. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 
 
ABLM MOC: The American Board of Lifestyle Medicine has approved 18.0 maintenance of certification credits for this learning activity. 
 
For NBC-HWCs: The National Board for Health and Wellness Coaching (NBHWC) has approved 18 continuing education credits for this learning activity: CEA-000127-2