SW is a 52-year-old living with type 2 diabetes. Over the past year, A1C increased from 7.1% to 8.2%, and blood pressure during their visit was 146/88 mmHg. They report increased fatigue, daytime sleepiness, difficulty concentrating, and waking up several times during the night. SW works rotating night shifts at a manufacturing plant.
Which of the following responses would best align with the 2026 ADA Standards of Care?
- A. Reassure SW that the sleep complaints are a normal consequence of shift work and focus the visit on intensifying glucose-lowering and antihypertensive medications to address the rising A1C and elevated blood pressure.
- B. Recommend SW take an over-the-counter melatonin supplement nightly, intensify glucose-lowering medications, and schedule a follow-up in 3 months to reassess A1C and blood pressure.
- C. Screen for sleep health and disorders and refer to a sleep medicine specialist or other qualified specialist, as indicated.
- D. Discuss with SW the impacts of night shift work, consider changing to a day shift to improve diabetes self-management, A1c and reduce blood pressure.
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Airs June 23rd, 2026
Solve common glucose mysteries and optimize time-in-range for people with type 2 diabetes.
Why are glucose levels elevated in the morning? When should insulin be started? What is the next step to get A1c to target? During this course Coach Beverly addresses each of these glucose mysteries and more, using a person-centered approach. She describes a stepwise approach to evaluate glucose patterns and correct common issues encountered by people living with type 2 diabetes.
Course Topics:
- Describe common glucose mysteries encountered by people with type 2 diabetes
- Discuss assessment strategies to determine a realistic dosing strategy using national guidelines
- Use a stepwise approach to evaluate factors affecting glucose patterns
- State interventions to increase time-in-range and improve quality of life
Course Objectives
Upon completion of this activity, participants will be able to:
- Apply current standards of care and evidence-based guidelines to develop and adjust individualized treatment plans in complex diabetes cases.
- Calculate and fine-tune insulin dosing using advanced pattern management strategies in patients with fluctuating needs, including those using pumps or those hospitalized.
