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Rationale| COVID & Diabetes Treatment

Our November 17th Question of the week quizzed test takers on COVID-19 and diabetes. Less than half, 48% of respondents, chose the best answer, We thought that this was an important topic to discuss further, so we can pass on correct info to people living with diabetes.

Join us for FREE Covid & Diabetes Webinar. Click here to view>>

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

Question: COVID cases are surging throughout the United States. Providing the best care for people with diabetes is especially important during this crisis. Which of the following statements regarding diabetes and COVID is most accurate?

Answer Choices:

  1. Avoid use of ACE inhibitors during illness, especially during the critical phase.
  2. Administration of sitagliptin (Januvia) during hospitalization may be associated with improved outcomes.
  3. Steroid use during acute illness should be avoided to prevent hypoglycemic or hyperglycemic crisis.
  4. Supine positioning during the acute phase is associated with improved oxygen saturation.

As shown above, the most common choice was option 2, the second most common answer was option 1, then option 4, and finally option 3.

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. 20.04% chose this answer. “Avoid use of ACE inhibitors during illness, especially during the critical phase.” Since the corona virus enters the body via ACE2 receptors, some early recommendations included stopping ACE inhibitors in those with COVID-19. However, scientists quickly discovered that stopping ACE inhibitors did NOT improve outcomes and that ACE inhibitors should be continued.

Answer 2 is correct. 47.61% of you chose this answer. “Administration of sitagliptin (Januvia) during hospitalization may be associated with improved outcomes.” YES. New research demonstrates that people with diabetes and COVID-19 started sitagliptin (Januvia) on hospital admission, experience dramatic decreases mortality and improved outcomes.

See our Blog Post Sitagliptin Improves Outcomes here

Answer 3 is incorrect. About 12.87% of respondents chose this. “Steroid use during acute illness should be avoided to prevent hypoglycemic or hyperglycemic crisis.” It is true that steroids can contribute to hyperglycemia in people with diabetes. However, since steroids have been shown to be lifesaving for very ill people with COVID, with or without diabetes, research supports administering the steroid while managing resultant hyperglycemia with insulin therapy.

Finally, Answer 4 is incorrect. 19.49% chose this answer. “Supine positioning during the acute phase is associated with improved oxygen saturation.” Research has shown that “prone” positioning (laying on belly) can improve alveolar oxygenation and outcomes. More info here.

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!


COVID & Diabetes Update – Navigating a Crisis

Purchase recording of our Live Webinar on December 2 | Earn 1.5 CE | $19

With the surge in new COVID cases, what is the essential information health care professionals and Diabetes Specialists need to navigate this overwhelming crisis?

What are the best practices to care for people with diabetes and COVID-19 in the outpatient and hospital setting?

Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM, has completely updated this critical presentation, to bring health care professionals up-to-date on the current state of COVID and its impact on diabetes care. She summarizes key information including critical teaching points and management strategies for people with diabetes who develop a COVID-19 infection.

Topics Include:

  1. Discuss the current state of diabetes in the United States.
  2. Describe the relationship between COVID and health care disparities 
  3. Explore the impact of COVID infection on those with pre-existing diabetes.
  4. Discuss treatment strategies for COVID and diabetes, including new vaccines.
  5. List critical teaching points for people with diabetes and COVID.

If you miss the live version, your registration guarantees access to the recorded version.

Join us to learn critical information about Diabetes and COVID Management

Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF and Touro University and a nationally recognized diabetes expert.


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AccreditationDiabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*  

The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.

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The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.

**To satisfy the requirement for renewal of certification by continuing education for the Certification Board for Diabetes Care & Education (CBDCE), continuing education activities must be applicable to diabetes and approved by a provider on the CBDCE List of Recognized Providers (www.cbdce.org). CBDCE does not approve continuing education. Diabetes Education Services is accredited/approved by the Commission of Dietetic Registration which is on the list of CBDCE Recognized Providers.

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