Was ist das eigentlich? Cyberrisiken verständlich erklärt

Es wird viel über Cyberrisiken gesprochen. Oftmals fehlt aber das grundsätzliche Verständnis, was Cyberrisiken überhaupt sind. Ohne diese zu verstehen, lässt sich aber auch kein Versicherungsschutz gestalten.

Beinahe alle Aktivitäten des täglichen Lebens können heute über das Internet abgewickelt werden. Online-Shopping und Online-Banking sind im Alltag angekommen. Diese Entwicklung trifft längst nicht nur auf Privatleute, sondern auch auf Firmen zu. Das Schlagwort Industrie 4.0 verheißt bereits eine zunehmende Vernetzung diverser geschäftlicher Vorgänge über das Internet.

Anbieter von Cyberversicherungen für kleinere und mittelständische Unternehmen (KMU) haben Versicherungen die Erfahrung gemacht, dass trotz dieser eindeutigen Entwicklung Cyberrisiken immer noch unterschätzt werden, da sie als etwas Abstraktes wahrgenommen werden. Für KMU kann dies ein gefährlicher Trugschluss sein, da gerade hier Cyberattacken existenzbedrohende Ausmaße annehmen können. So wird noch häufig gefragt, was Cyberrisiken eigentlich sind. Diese Frage ist mehr als verständlich, denn ohne (Cyber-)Risiken bestünde auch kein Bedarf für eine (Cyber-)Versicherung.

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Nursing CBDCE-CDCES : CBDCE Certified Diabetes Care and Education Specialist Practice Tests

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Exam Number : CBDCE-CDCES
Exam Name : CBDCE Certified Diabetes Care and Education Specialist
Vendor Name : Nursing
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CBDCE-CDCES test Format | CBDCE-CDCES Course Contents | CBDCE-CDCES Course Outline | CBDCE-CDCES test Syllabus | CBDCE-CDCES test Objectives

Number of Questions: Approximately 200 multiple-choice questions.
Exam Duration: 4 hours (240 minutes).
Exam Name: CBDCE Certified Diabetes Care and Education Specialist (CDCES) Exam
Certifying Body: Certification Board for Diabetes Care and Education (CBDCE)

- Diabetes Pathophysiology
- Types of Diabetes:
- Type 1
- Type 2
- Gestational Diabetes
- LADA (Latent Autoimmune Diabetes in Adults)
- MODY (Maturity-Onset Diabetes of the Young)
- Insulin Physiology:
- Insulin secretion
- action and resistance
- Glucose Metabolism:
- Glycolysis
- gluconeogenesis
- glycogenolysis
- Hormonal Regulation:
- Role of glucagon
- amylin
- incretins (GLP-1, GIP), and other hormones
- Complications:
- Acute (hypoglycemia, DKA, HHS)
- chronic (microvascular and macrovascular complications)

- Clinical Practice Guidelines
- ADA Standards of Medical Care in Diabetes: Annual updates and key recommendations
- AACE/ACE Guidelines: Comprehensive type 2 diabetes management algorithm
- International Guidelines:
- IDF (International Diabetes Federation)
- NICE (National Institute for Health and Care Excellence)
- Individualized Care: Tailoring treatment plans based on patient-specific factors (age, comorbidities, lifestyle)

- Medication Management
- Insulin Therapy:
- Types of insulin
- rapid-acting
- short-acting
- intermediate-acting
- long-acting
- ultra-long-acting
- insulin regimens
- injection techniques, and devices
- Non-Insulin Therapies:
- Metformin
- sulfonylureas
- DPP-4 inhibitors
- SGLT2 inhibitors
- GLP-1 receptor agonists
- thiazolidinediones
- Combination Therapies: Rationale for combining medications
- Medication Adherence: Strategies to Boost adherence, addressing barriers

- Nutrition Therapy
- Medical Nutrition Therapy (MNT): Evidence-based nutrition interventions
- Carbohydrate Counting:
- Basic and advanced carbohydrate counting
- glycemic index/load
- Meal Planning:
- Plate method
- portion control
- balanced meals
- Special Diets:
- Low-carb
- ketogenic
- Mediterranean
- DASH diet
- vegetarian/vegan diets
- Nutritional Supplements:
- Role of vitamins
- minerals
- herbal supplements

- Physical Activity
- Practice Physiology: Effects of exercise on glucose metabolism
- Practice Prescription:
- Aerobic
- resistance
- flexibility exercises
- Safety Considerations:
- Hypoglycemia prevention
- foot care
- cardiovascular risks
- Behavioral Strategies: Motivating patients to increase physical activity

- Psychosocial Aspects
- Diabetes Distress: Identification and management
- Behavioral Change Theories:
- Stages of Change
- Motivational Interviewing
- Cognitive Behavioral Therapy
- Cultural Competence: Providing culturally sensitive care
- Support Systems: Role of family, community, and support groups

- Self-Management Education
- DSME/S (Diabetes Self-Management Education and Support): National Standards for DSME/S
- Patient Empowerment: Encouraging active participation in care
- Health Literacy: Assessing and addressing health literacy levels
- Technology in Diabetes Care: Use of apps, telemedicine, and online resources

- Monitoring and Use of Data
- Blood Glucose Monitoring:
- SMBG (Self-Monitoring of Blood Glucose)
- CGM (Continuous Glucose Monitoring)
- Data Interpretation: Understanding glucose patterns, trend analysis
- A1C Testing: Correlation with average glucose, limitations
- Other Biomarkers:
- Fructosamine
- ketone testing

- Acute Complications
- Hypoglycemia:
- Causes
- symptoms
- treatment
- prevention
- Diabetic Ketoacidosis (DKA):
- Pathophysiology
- management
- prevention
- Hyperglycemic Hyperosmolar State (HHS):
- Pathophysiology
- management
- prevention

- Chronic Complications
- Microvascular Complications:
- Retinopathy
- nephropathy
- neuropathy
- Macrovascular Complications:
- Cardiovascular disease
- stroke
- peripheral arterial disease
- Foot Care:
- Risk exam
- preventive measures
- management of foot ulcers
- Screening and Prevention:
- Regular screening for complications
- preventive strategies

- Special Populations
- Pediatrics: Unique considerations in children and adolescents
- Elderly:
- Managing diabetes in older adults
- polypharmacy
- frailty
- Pregnancy:
- Preconception care
- gestational diabetes management
- postpartum care
- Ethnic and Racial Disparities: Addressing disparities in diabetes care

- Technology in Diabetes Management
- Insulin Pumps:
- Types
- benefits
- challenges
- CGM Systems:
- Real-time vs. intermittent scanning
- integration with insulin pumps
- Digital Health Tools:
- Apps
- wearable devices
- remote monitoring
- Emerging Technologies:
- Artificial pancreas
- closed-loop systems

- Professional Issues
- Ethical Considerations:
- Confidentiality
- informed consent
- patient autonomy
- Legal Issues:
- Scope of practice
- documentation
- liability
- Interprofessional Collaboration: Working with other healthcare providers
- Continuing Education: Staying current with advancements in diabetes care

- Research and Evidence-Based Practice
- Interpreting Research:
- Understanding study designs
- statistical significance
- Applying Evidence: Translating research findings into practice
- Quality Improvement: Implementing QI projects to Boost diabetes care outcomes

- Patient-Centered Care
- Individualized Care Plans: Tailoring interventions to meet individual needs
- Shared Decision Making: Involving patients in care decisions
- Communication Skills:
- Effective communication techniques
- active listening

- Healthcare Systems and Reimbursement
- Reimbursement Policies:
- Understanding Medicare
- Medicaid
- private insurance coverage for diabetes care
- Healthcare Delivery Models:
- PCMH (Patient-Centered Medical Home)
- ACO (Accountable Care Organizations)
- Cost-Effectiveness: Balancing cost and quality in diabetes care

- Prevention and Public Health
- Diabetes Prevention Programs (DPP): Lifestyle interventions to prevent or delay type 2 diabetes
- Community Resources: Accessing local resources for diabetes care and education
- Public Health Initiatives: National and global efforts to reduce diabetes prevalence

- Emerging Trends and Future Directions
- New Medications: Latest advancements in diabetes pharmacotherapy
- Technological Innovations: Advances in diabetes technology
- Personalized Medicine:
- Tailoring treatment based on genetic
- biomarker
- other individual factors

- A1C: Glycated hemoglobin, a measure of long-term glucose control
- Basal-Bolus Therapy: Insulin regimen that mimics natural insulin secretion
- Carbohydrate Counting: Method of tracking carbohydrate intake to manage blood glucose levels
- Diabetic Ketoacidosis (DKA): Acute complication characterized by high blood glucose, ketones, and acidosis
- Euglycemia: Normal blood glucose levels
- Glycemic Variability: Fluctuations in blood glucose levels
- Hyperglycemia: High blood glucose levels
- Hypoglycemia: Low blood glucose levels
- Incretins: Hormones that enhance insulin secretion
- Ketones: Byproducts of fat metabolism, elevated in DKA
- Microalbuminuria: Early sign of diabetic nephropathy
- Peripheral Neuropathy: Nerve damage affecting the extremities
- Postprandial Glucose: Blood glucose levels after eating
- Retinopathy: Diabetes-related eye disease
- Sulfonylureas: Class of oral diabetes medications that stimulate insulin secretion
- Titration: Adjusting medication doses based on blood glucose levels

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Warum sind Cyberrisiken so schwer greifbar?

Als mehr oder weniger neuartiges Phänomen stellen Cyberrisiken Unternehmen und Versicherer vor besondere Herausforderungen. Nicht nur die neuen Schadenszenarien sind abstrakter oder noch nicht bekannt. Häufig sind immaterielle Werte durch Cyberrisiken in Gefahr. Diese wertvollen Vermögensgegenstände sind schwer bewertbar.

Obwohl die Gefahr durchaus wahrgenommen wird, unterschätzen viele Firmen ihr eigenes Risiko. Dies liegt unter anderem auch an den Veröffentlichungen zu Cyberrisiken. In der Presse finden sich unzählige Berichte von Cyberattacken auf namhafte und große Unternehmen. Den Weg in die Presse finden eben nur die spektakulären Fälle. Die dort genannten Schadenszenarien werden dann für das eigene Unternehmen als unrealistisch eingestuft. Die für die KMU nicht minder gefährlichen Cyberattacken werden nur selten publiziert.

Aufgrund der fehlenden öffentlichen Meldungen von Sicherheitsvorfällen an Sicherheitsbehörden und wegen der fehlenden Presseberichte fällt es schwer, Fakten und Zahlen zur Risikolage zu erheben. Aber ohne diese Grundlage fällt es schwer, in entsprechende Sicherheitsmaßnahmen zu investieren.

Erklärungsleitfaden anhand eines Ursache-Wirkungs-Modells

Häufig nähert man sich dem Thema Cyberrisiko anlass- oder eventbezogen, also wenn sich neue Schadenszenarien wie die weltweite WannaCry-Attacke entwickeln. Häufig wird auch akteursgebunden beleuchtet, wer Angreifer oder Opfer sein kann. Dadurch begrenzt man sich bei dem Thema häufig zu sehr nur auf die Cyberkriminalität. Um dem Thema Cyberrisiko jedoch gerecht zu werden, müssen auch weitere Ursachen hinzugezogen werden.

Mit einer Kategorisierung kann das Thema ganzheitlich und nachvollziehbar strukturiert werden. Ebenso hilft eine solche Kategorisierung dabei, eine Abgrenzung vorzunehmen, für welche Gefahren Versicherungsschutz über eine etwaige Cyberversicherung besteht und für welche nicht.

Die Ursachen sind dabei die Risiken, während finanzielle bzw. nicht finanzielle Verluste die Wirkungen sind. Cyberrisiken werden demnach in zwei Hauptursachen eingeteilt. Auf der einen Seite sind die nicht kriminellen Ursachen und auf der anderen Seite die kriminellen Ursachen zu nennen. Beide Ursachen können dabei in drei Untergruppen unterteilt werden.

Nicht kriminelle Ursachen

Höhere Gewalt

Häufig hat man bei dem Thema Cyberrisiko nur die kriminellen Ursachen vor Augen. Aber auch höhere Gewalt kann zu einem empfindlichen Datenverlust führen oder zumindest die Verfügbarkeit von Daten einschränken, indem Rechenzentren durch Naturkatastrophen wie beispielsweise Überschwemmungen oder Erdbeben zerstört werden. Ebenso sind Stromausfälle denkbar.

Menschliches Versagen/Fehlverhalten

Als Cyberrisiken sind auch unbeabsichtigtes und menschliches Fehlverhalten denkbar. Hierunter könnte das versehentliche Veröffentlichen von sensiblen Informationen fallen. Möglich sind eine falsche Adressierung, Wahl einer falschen Faxnummer oder das Hochladen sensibler Daten auf einen öffentlichen Bereich der Homepage.

Technisches Versagen

Auch Hardwaredefekte können zu einem herben Datenverlust führen. Neben einem Überhitzen von Rechnern sind Kurzschlüsse in Systemtechnik oder sogenannte Headcrashes von Festplatten denkbare Szenarien.

Kriminelle Ursachen

Hackerangriffe

Hackerangriffe oder Cyberattacken sind in der Regel die Szenarien, die die Presse dominieren. Häufig wird von spektakulären Datendiebstählen auf große Firmen oder von weltweiten Angriffen mit sogenannten Kryptotrojanern berichtet. Opfer kann am Ende aber jeder werden. Ziele, Methoden und auch das Interesse sind vielfältig. Neben dem finanziellen Interesse können Hackerangriffe auch zur Spionage oder Sabotage eingesetzt werden. Mögliche Hackermethoden sind unter anderem: Social Engineering, Trojaner, DoS-Attacken oder Viren.

Physischer Angriff

Die Zielsetzung eines physischen Angriffs ist ähnlich dem eines Hackerangriffs. Dabei wird nicht auf die Tools eines Hackerangriffs zurückgegriffen, sondern durch das physische Eindringen in Unternehmensgebäude das Ziel erreicht. Häufig sind es Mitarbeiter, die vertrauliche Informationen stehlen, da sie bereits den notwendigen Zugang zu den Daten besitzen.

Erpressung

Obwohl die Erpressung aufgrund der eingesetzten Methoden auch als Hackerangriff gewertet werden könnte, ergibt eine Differenzierung Sinn. Erpressungsfälle durch Kryptotrojaner sind eines der häufigsten Schadenszenarien für kleinere und mittelständische Unternehmen. Außerdem sind auch Erpressungsfälle denkbar, bei denen sensible Daten gestohlen wurden und ein Lösegeld gefordert wird, damit sie nicht veröffentlicht oder weiterverkauft werden.

Ihre Cyberversicherung sollte zumindet folgende Schäden abdecken:

Cyber-Kosten:

Soforthilfe und Forensik-Kosten (Kosten der Ursachenermittlung, Benachrichtigungskosten und Callcenter-Leistung)
Krisenkommunikation / PR-Maßnahmen
Systemverbesserungen nach einer Cyber-Attacke
Aufwendungen vor Eintritt des Versicherungsfalls

Cyber-Drittschäden (Haftpflicht):

Befriedigung oder Abwehr von Ansprüchen Dritter
Rechtswidrige elektronische Kommunikation
Ansprüche der E-Payment-Serviceprovider
Vertragsstrafe wegen der Verletzung von Geheimhaltungspflichten und Datenschutzvereinbarungen
Vertragliche Schadenersatzansprüche
Vertragliche Haftpflicht bei Datenverarbeitung durch Dritte
Rechtsverteidigungskosten

Cyber-Eigenschäden:

Betriebsunterbrechung
Betriebsunterbrechung durch Ausfall von Dienstleister (optional)
Mehrkosten
Wiederherstellung von Daten (auch Entfernen der Schadsoftware)
Cyber-Diebstahl: elektronischer Zahlungsverkehr, fehlerhafter Versand von Waren, Telefon-Mehrkosten/erhöhte Nutzungsentgelte
Cyber-Erpressung
Entschädigung mit Strafcharakter/Bußgeld
Ersatz-IT-Hardware
Cyber-Betrug

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Cyber-Kosten:

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