For last week’s practice question, we quizzed test takers on JR’s fear of hypoglycemia. 85% of respondents chose the best answer. GREAT JOB. We want to 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
Question:
JR is 26 years old with type 1 diabetes for over a decade. JR keeps missing appointments and when you finally get a hold of them on the phone, they start crying and say “I am afraid my blood sugars will go too low, so I stopped using my bolus insulin”. They explain that they were too embarrassed to come in and have their data downloaded.
Based on this information, what would be the most helpful approach?
Answer Choices:
- Provide reassurance and recognize that JR is dealing with childhood trauma.
- Encourage JR to start using half their usual dose of bolus insulin to get started.
- Recognize JR’s effort to prevent low blood sugars and explore their feelings.
- Remind JR that all of the downloaded data and reports are confidential.
Getting to the Best Answer
Answer 1 is incorrect. 5.15% chose this answer, “Provide reassurance and recognize that JR is dealing with childhood trauma.” While there is a real possibility that JR experienced childhood trauma, there is no information to support that assumption in the question. However, providing JR with reassurance and helping with problem solving would be very helpful.
Answer 2 is incorrect. 5.36% of you chose this answer, “Encourage JR to start using half their usual dose of bolus insulin to get started.” Although taking half of the usual dose of bolus insulin is certainly better than taking no insulin, it is not a person centered approach. We need to engage JR in determining the best approach.
Answer 3 is correct. 85.84.% of respondents chose this answer, “Recognize JR’s effort to prevent low blood sugars and explore their feelings.” YES, great job, this is the best answer. We want to use a strength based approach and acknowledge that JR is making a big effort to prevent hypoglycemia and stay safe. We also want to recognize JR’s big emotions around hypoglycemia and explore them more closely. Finally, we will encourage JR to identify next steps.
Finally, Answer 4 is incorrect. 3.65% chose this answer, “Remind JR that all of the downloaded data and reports are confidential.” Not the best answer, but it is true that many people may have access to JR’s reports, which can add even more pressure to make sure everything looks good. When we look at JR’s report, we want to make sure we acknowledge the periods where things are going well before we dive into the troubled spots.
Thank you so much for reading this “Rationale of the Week”.
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Speakers Interviews – Learn more about the ReVive 5 Team
What is the Biggest Takeaway when Addressing Diabetes Distress? – Dr. Susan Guzman
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