According to the 2026 ADA Standards of Care, what individuals should be recommended to have a bone density evaluation using dual-energy X-ray absorptiometry to evaluate for bone loss?

JR is hospitalized with influenza. They have a history of prediabetes but now have persistent glucose readings between 220–260 mg/dL and are started on basal-bolus insulin.

JR is upset and states: “I’ve been reading that pancreatic parasites can cause of diabetes. No one is treating my infection.”

What is the BEST response?

After the initial assessment JM is scheduled for an individual visit instead of a group DSMES class.

According to Medicare guidelines, which of the following would NOT justify providing individual DSMES instead of group DSMES?

JZ is proud of their Time of Range of 89%. You notice their time below range is 7%. JZ uses a rapid-acting insulin pen 4–6 times daily to keep glucose in target range and occasionally increases the glargine dose when evening glucose is elevated.

What is your primary concern?

Maria, a 52‑year‑old woman with type 2 diabetes for 8 years, attends a follow‑up visit. Her A1C has risen from 7.8% to 9.2% over the past year. She reports feeling “overwhelmed” and says she didn’t want to start the medication her clinician recommended at the last visit. She explains, “I’m scared of side effects, and I feel like needing medication means I failed.”

Which of the following responses is the least appropriate (i.e., the WRONG thing to say) to Maria?

A 32-year-old with newly discovered diabetes is brought to the emergency department with polyuria and lethargy. They have been sleeping more than usual.

Initial labs show:

• Plasma glucose: 680 mg/dL
• Potassium 3.7 mEq/L
• Serum osmolality: 335 mOsm/kg

Based on the following labs, which feature most strongly supports a diagnosis of hyperosmolar hyperglycemic state (HHS) rather than diabetes ketoacidosis (DKA)?

KC has type 2 diabetes, diagnosed 5 years ago. They report low physical activity, frequent sugar-sweetened beverage intake, and high stress related to work. Last A1c was 8.2%. KC reports previous advice to “exercise more and drink less soda,” but reports making minimal changes. They express interest in improving health but feels overwhelmed by where to start.

Which of the following responses best aligns with the 2026 ADA Standards of Care recommendations for facilitating positive health behavior change?