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Rationale of the Week | What defines overbasalization according to 2025 ADA Standards?

For last week’s practice question, we quizzed participants on what defines overbasalization according to 2025 ADA Standards?. 52% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question 

Lightbulb and text: Rationale of the Week

Question: 

What defines overbasalization according to 2025 ADA Standards?

According to the new 2025 ADA Standards of Care, which of the following most accurately reflects overbasalization?

Answer Choices:

  1. basal insulin doses exceeding 0.5 units/kg/day
  2. significant bedtime-to-morning or postprandial-to-preprandial glucose differential
  3. low glycemic variability
  4. basal insulin dose exceeding 50 units twice per day

Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.

Answer 1 is incorrect. 25% chose this answer: basal insulin doses exceeding 0.5 units/kg/day. This year, the ADA Recommendation was revised to remove consideration of basal insulin doses exceeding 0.5 units/kg/day as evidence of overbasalization. Instead, signs of overbasalization including significant bedtime-to-morning or postprandial-to-preprandial glucose differential, occurrences of hypoglycemia (aware or unaware), and high glycemic variability should be used.

Answer 2 is correct. 52% of you chose this answer: significant bedtime-to-morning or postprandial-to-preprandial glucose differential.  GREAT JOB!  In the 2025 ADA Standards (9), they define overbasalization as significant bedtime-to-morning or postprandial-to-preprandial glucose differential, occurrences of hypoglycemia (aware or unaware), and high glycemic variability.

Answer 3 is incorrect. About 18% of respondents chose this: low glycemic variability, This is a juicy and tempting answer. However, high glycemic variability (lots of ups and downs) is more closely associated with hypoglycemia.

Finally, Answer 4 is incorrect 3% chose this answer: basal insulin dose exceeding 50 units twice per day. Overbasalization is not defined by the amount of insulin used, but by the glucose response including significant bedtime-to-morning or postprandial-to-preprandial glucose differential, occurrences of hypoglycemia (aware or unaware), and high glycemic variability

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

Want to learn more about this question?

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Diabetes Mentorship Program Kicks-Off in Northern Cal

Dignity Health Mercy Medical Center Redding Steps Up with a Diabetes Mentorship Program!

We are thrilled to announce the launch of the Diabetes Mentorship Program at Mercy Medical Center in Redding, designed to support and guide the next generation of diabetes educators. This unique opportunity is tailored for eight motivated mentees who are eager to gain hands-on experience in diabetes care, all while learning from Janelle Revnak, MS, RDN, CDCES, an experienced diabetes care and education specialist, with 10 years practicing as an RDN and 5 years as a CDCES. Janelle is passionate about sharing her expertise with the next generation of diabetes professionals. Her extensive background in both outpatient and inpatient diabetes education will ensure that mentees receive comprehensive training and valuable insights into the world of diabetes care.  

Over the course of the program, mentees will attend monthly educational sessions led by Janelle, coupled with didactic learning sessions and job shadowing, providing an immersive experience in the inpatient setting. As part of our mentoring partnership, the trainees will also have access to our Diabetes Boot Camp series. Janelle decided to start this program after realizing that the need for diabetes education in her rural community was larger than what one person could realistically deliver. She reached out and identified colleagues in her hospital who were interested upping their diabetes knowledge and improving care.

“I alone cannot change the world, but I can cast a stone across the waters to create many ripples.” – Mother Teresa

Increasing Demand for Diabetes Care and Education Specialists

As the number of people living with diabetes continues to rise, the demand for skilled diabetes educators is paramount. According to the latest CDC Data, the prevalence of diabetes has increased dramatically over the past decade, with more than 37 million Americans now living with diabetes—an increase of nearly 30% over the past 10 years. This growing population needs more than just medical care; they require specialized education and support to effectively manage their condition. Current diabetes care and education specialists (DCES) are uniquely positioned to assist in equipping future professionals with the knowledge and experience needed to meet the needs of this expanding patient population.

The mentorship program will be held once a month and is designed to create a balanced approach to learning. Mentees will dive deep into didactic topics, such as advanced diabetes management, behavior change strategies, and innovative approaches to diabetes care. In addition to classroom-style learning, they will have the opportunity to job-shadow Janelle, gaining firsthand experience in how diabetes education is applied in real-world inpatient clinical settings. This combination of theory and practice ensures mentees are well-equipped to make an impact in the field.

Participants will also have the chance to engage with a wide range of diabetes-related cases during their job shadowing. From inpatient diabetes clinical management to individualized patient education, they will develop a well-rounded understanding of the crucial role diabetes educators play in improving care outcomes while helping individuals feel emotionally supported through this challenging disease. This hands-on approach allows for active learning and real-time feedback, which is vital for shaping confident and competent DCES.

The mentorship program is not just about learning—it’s about making connections, fostering growth and building a community of passionate diabetes care professionals. We are excited to offer this incredible opportunity to those who are committed to advancing their skills and knowledge in diabetes education. Together, we can make a real difference in the lives of those living with diabetes. In the spirit of Mother Teresa, it is not one person alone that can impact the growing population affected by diabetes, but working together, we can achieve meaningful change.

If you have questions, you can reach Janelle at [email protected].  


Are you Interested in Starting a Mentorship Program?

As part of our Bridge Program, Coach Beverly wants to support YOUR efforts to mentor a new generation of Diabetes Care and Education Specialists. If you are a mentor, we are offering significant discounts off of our Diabetes Boot Camp or Virtual 3 Day Program for groups of mentees who are practicing in underserved regions of our country.  Please email us for more information at [email protected]

Want more expert insights & hands-on learning?           

A perfect program for healthcare professionals entering the field of diabetes!

Join us for our 2025 Virtual Conference!!!

🎉 Join Our Virtual DiabetesEd Training Conference! 🎉

🗓️ Date:April 16th-18th, 2025
Time: 8:00am PST

Get ready for 2.5 days of engaging sessions on the latest in person-centered diabetes care, covering ADA Standards, medications, technology, and more! Learn from Diana Isaacs, Coach Beverly, and other experts.

💡 Can’t attend live? Access recordings, podcasts, and resources for 1 full year.

🎉 Special Offer: Register 3 or more and save $50 each!

Register now and take your diabetes expertise to the next level!