For last week’s practice question, we quizzed participants on the role of diabetes HCPs in addressing psychosocial needs. 95% 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 by clicking here.
A 45 year old man with type 2 diabetes is referred to a CDCES with a persistently elevated A1c (9.4%). He has missed multiple follow-up appointments and reports inconsistent medication use. During the visit, he shares that he recently lost his job, is staying intermittently with friends, and often skips meals due to limited food access. He reports feeling “constantly stressed” and “burned out” with diabetes management. A Diabetes Distress Scale (DDS) score indicates moderate distress, and a PHQ-9 score is 4 (minimal depressive symptoms). He denies suicidal ideation.
Which of the following is the most appropriate next step for the diabetes healthcare professional?
- A. Refer immediately to a psychiatrist for evaluation of and initiate pharmacologic treatment.
- B. Provide structured problem-solving support, address social needs, and coordinate with appropriate team members.
- C. Delay intervention until glycemia improves, then reassess psychosocial concerns.
- D. Focus primarily on intensifying glucose monitoring and medication adherence strategies
Getting to the Best Answer
Answer A is incorrect. 1.52% chose this answer, “Refer immediately to a psychiatrist for evaluation of and initiate pharmacologic treatment.” This answer is incorrect. The patient’s PHQ-9 score of 4 indicates minimal depressive symptoms, which does not warrant psychiatric referral or pharmacologic treatment.
Answer B is correct. 95.45% of you chose this answer, “Provide structured problem-solving support, address social needs, and coordinate with appropriate team members.” This answer is correct. This patient has moderate diabetes distress, minimal depressive symptoms (PHQ-9 = 4), and significant social barriers including food insecurity and housing instability.
Answer C is incorrect. About 0.76% of respondents chose this: “Delay intervention until glycemia improves, then reassess psychosocial concerns.” This answer is incorrect. Psychosocial factors and social barriers are contributing directly to this patient’s hyperglycemia, not as a result of it. Delaying intervention ignores key root causes of poor glycemic management. Addressing these factors is essential to improving outcomes.
Finally, Answer D is incorrect. 2.27% chose this answer, “Focus primarily on intensifying glucose monitoring and medication adherence strategies.” While important, this approach does not address food insecurity, housing instability, or emotional distress and burnout. Intensifying monitoring or adherence strategies alone is unlikely to be effective. Effective CDCES care prioritizes context and coordination, not just education or adherence.”
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!
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