For last week’s practice question, we quizzed participants on what assessments are the most important. 40% 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.
CJ is a 13-year-old teenager with type 1 diabetes diagnosed less than a week ago. You are seeing CJ and their parents for the first DSME visit.
Based on CJ’s recent diagnosis, which of the following would be most important to assess?
- A. Since CJ is newly diagnosed and still in the honeymoon phase, they will need low doses of insulin.
- B. Has anyone mentioned teplizumab (Tzield) therapy as an option to slow beta cell destruction?
- C. Do you know to be aware of any signs of gluten intolerance or thyroid issues?
- D. Did you know that most teenagers experience significant diabetes distress during the first year of diagnosis?
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 A is incorrect. 22.72% chose this answer: “Since CJ is newly diagnosed and still in the honeymoon phase, they will need low doses of insulin.”
The honeymoon phase, or partial clinical remission, occurs when remaining pancreatic beta cells temporarily produce enough insulin to reduce exogenous insulin requirements. However, not everyone experiences this phase, and its onset, duration, and degree of insulin production vary. Since CJ was diagnosed less than a week ago, it would be premature to assume they are experiencing the honeymoon phase. Insulin dosing should be individualized based on glucose patterns, carbohydrate intake, insulin sensitivity, and clinical assessment.
Answer B is correct. 40.23% of you chose this answer, “Has anyone mentioned teplizumab (Tzield) therapy as an option to slow beta cell destruction?” Great job! This is the correct answer.
Teplizumab (Tzield) is a CD3-directed monoclonal antibody that received FDA accelerated approval in June 2026 to delay the decline in endogenous insulin production in children and adolescents ages 8–17 with recently diagnosed stage 3 type 1 diabetes. Treatment must be initiated within 8 weeks of diagnosis. Since CJ is 13 years old and was diagnosed less than a week ago, discussing teplizumab and referring CJ for an eligibility evaluation would be appropriate. Eligibility requires at least one positive pancreatic islet autoantibody and evidence of residual insulin production, including a stimulated peak C-peptide of at least 0.2 pmol/mL. The PROTECT trial demonstrated that teplizumab significantly slowed the decline in beta cell function compared with placebo over 78 weeks. Although teplizumab does not eliminate the need for insulin therapy, it represents an important disease-modifying treatment option for eligible youth with newly diagnosed type 1 diabetes.
Answer C is incorrect. 10.42% of respondents chose this: “Do you know to be aware of any signs of gluten intolerance or thyroid issues?”
Children and adolescents with type 1 diabetes have an increased risk of developing autoimmune thyroid disease and celiac disease. Screening for these conditions is an important component of comprehensive diabetes care. However, given CJ’s very recent diagnosis, discussing the potential benefits of teplizumab is a more time-sensitive priority because treatment must begin within 8 weeks of diagnosis. Screening and education about associated autoimmune conditions should still be included in CJ’s ongoing diabetes management.
Finally, Answer D is incorrect. 26.63% chose this answer, “Did you know that most teenagers experience significant diabetes distress during the first year of diagnosis?”
Adolescents with type 1 diabetes are at increased risk for diabetes distress and other psychosocial challenges, especially as they adjust to a new diagnosis. However, stating that most teenagers experience significant distress during the first year is an overgeneralization that may unnecessarily alarm CJ and their parents. A more appropriate approach would be to ask open-ended questions about how CJ and their family are coping, normalize a range of emotional responses, and offer psychosocial support as needed.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Test You Knowledge Tuesday and participate in this fun learning activity!
Want to Learn More about this Question?
Join Dr. Marie Frazzitta on Nov. 12th for the
Digital Quality Reporting Toolkit: Advanced Strategies for Diabetes Professionals webinar
The U.S. healthcare system is rapidly shifting toward digital quality reporting, transforming how diabetes outcomes are measured, reimbursed, and improved.
In this 1-hour and 15-minute program. Dr. Marie Frazzitta, DNP, FNP‑C, PMHNP, CDCES, MBA, explores how national quality initiatives are modernizing diabetes metrics, including the integration of CGM-derived indicators and the upcoming measure that will track CGM adoption. We’ll also highlight the operational realities of digital reporting and show how DCESs can leverage these trends to expand their impact, strengthen care equity, and become strategic partners in quality improvement and population health.
