CL is a 58-year-old individual with type 1 diabetes for 35 years. Their current therapy includes a CGM with an automated insulin delivery system, and they announce their meal 15-20 minutes before eating.
Last HgbA1c is 7.4%, but they report recent worsening, unpredictable glucose patterns. CGM data review shows Time in Range is 62% with 4% below 70 mg/dL.
Patterns note after breakfast, glucose drops from 110-130 mg/dL to 60-70 mg/dL within 1–2 hours, then rises to 220-280 mg/dL 3–4 hours later, and after dinner, glucose remains stable initially but rises to 240-280 mg/dL late in the evening. CL also reports an onset of bloating and occasional nausea.
What could be considered a potential contributor to this individual’s glucose variability?
- A. Inaccurate carbohydrate counting creating an increased variability in glucose patterns.
- B. Excess programmed basal insulin causing post-meal glucose fluctuations
- C. Delayed gastric emptying.
- D. A high-carbohydrate and high-fat dietary pattern causing prolonged glucose elevations after meals.
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