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Rationale of the Week | Weight-Inclusive Diabetes Care

For last week’s practice question, we quizzed participants on weight inclusive diabetes care. 85% 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 below: Answer Question 

Lightbulb and text: Rationale of the Week

Question:

How does weight-inclusive care improve clinical outcomes in diabetes management?

Answer Choices:

  1. It eliminates weight stigma, leading to enhanced engagement and collaboration.
  2. It reduces A1c only in those who experience weight loss.
  3. It leads to greater weight loss, which is the key factor in diabetes management.
  4. It removes the need for lifestyle modifications and focuses only on medication.

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 1 is correct. 85% chose this answer, “It eliminates weight stigma, leading to better patient engagement and adherence to treatment.” Studies suggest that weight stigma in healthcare leads to worse health outcomes, as patients in larger bodies are more likely to delay care or avoid medical visits altogether due to fear of judgment. A weight-inclusive approach fosters trust and encourages long-term behavior change, which ultimately improves glycemic control and patient well-being.

Answer 2 is incorrect. 2% of you chose this answer, “It reduces A1c only in patients who experience weight loss.” Research has consistently shown that health-promoting behaviors—like increasing fiber intake and engaging in regular movement—can improve blood sugar levels independent of weight loss.

Answer 3 is incorrect. About 10% of respondents chose this, “It leads to greater weight loss, which is the key factor in diabetes management.” While weight loss is often associated with improved health markers, the key drivers of better outcomes in diabetes care are sustainable habits, not weight change itself. Many individuals improve their metabolic health and blood sugar levels through consistent health behaviors, regardless of changes in body size. The focus should be on sustainable, evidence-based interventions rather than weight as an outcome.

Finally, Answer 4 is incorrect. 1% chose this answer, “It removes the need for lifestyle modifications and focuses only on medication.” Medications like metformin and GLP-1 receptor agonists are valuable tools in diabetes management, but they work best when combined with behavior-based interventions. A weight-inclusive model does not dismiss the role of medication; rather, it ensures that patients receive comprehensive, stigma-free care that includes sustainable lifestyle adjustments.

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!

by Jessica Jones, MS, RD, CDCES, CEO and Co-founder of Diabetes Digital, a virtual nutrition counseling platform for people with diabetes and prediabetes

Want to learn more about this question?

Enroll in our upcoming webinar led by Jessica Jones, MS, RD, CDCES

Weight-Inclusive Diabetes Care: Turning Compassion into Practical Tools

Join us live on June 5, 2025, at 11:30 am PST

This session provides healthcare providers with actionable strategies to integrate weight-inclusive care into diabetes management practices, focusing on improving outcomes through respect for body diversity and individual autonomy. Weight stigma is a well-documented barrier to effective care, contributing to poorer glycemic control, disordered eating, and care avoidance. By shifting from a weight-focused approach to one aligned with Health at Every Size (HAES®), providers can foster trust, enhance participant engagement, and support sustainable health behaviors.

Jessica Jones, MS, RD, CDCES, will share evidence-based insights on mitigating weight stigma and applying HAES-aligned strategies in practice. Participants will learn how to build rapport, set realistic nutrition goals, and implement interventions that prioritize blood sugar management, joyful movement, and intuitive eating. This session equips providers with tools to deliver compassionate, person-centered care, improving both clinical outcomes and the provider-participant relationship..

Course topics:

  1. Foundations of weight-inclusive diabetes care: overview and evidence
  2. Shifting perspectives: building trust and redefining success
  3. Practical tools for sustainable blood sugar management

Instructor: Jessica Jones, MS, RD, CDCES, CEO and Co-founder of Diabetes Digital

Woman smiling with laptop at desk

Jessica Jones, MS, RDN, CDCES, is a nationally recognized Registered Dietitian Nutritionist and Certified Diabetes Care & Education Specialist committed to making nutrition education accessible to everyone. As the CEO and co-founder of Diabetes Digital, Jessica has been pivotal in developing an innovative telehealth platform that provides tailored nutrition counseling for individuals with diabetes and prediabetes. Additionally, she co-hosts the Diabetes Digital Podcast, engaging listeners with thoughtful conversations on managing diabetes.

 With over a decade of clinical experience, Jessica has contributed significantly to the field through her co-authorship of the “28-Day Plant-Powered Health Reboot” cookbook and “A Diabetes Guide to Enjoying the Foods of the World.” She also wrote the Diabetes Chapter for the Food and Nutrition Care Manual Textbook and regularly shares her insights as a columnist for SELF magazine.

As a co-founder of Food Heaven, an online platform and podcast with more than 5 million downloads, she offers essential resources on cooking, intuitive eating, and embracing body respect. Jessica’s contributions have been celebrated in prominent publications, including Oprah Magazine, Women’s Health, The Food Network Magazine, SELF Magazine, the Huffington Post, and Bon Appetit. She lives in Sacramento, CA with her husband and “spirited” Maltese Shih Tzu puppy, Poppy.

Rationale of the Week | Triglyceride Management

For last week’s practice question, we quizzed participants on Triglyceride Management. 63% 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 below: Answer Question 

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JT is 58-years-old and has type 2 diabetes, hypertension, and BMI is 32 kg/m². Medications include metformin, lisinopril, and atorvastatin. Diet intake includes frequent highly processed foods, sugary beverages, no alcohol consumption, and minimal physical activity. Recent lab work indicates A1c: 7.2%, LDL:82 mg/dL, HDL: 38 mg/dL, triglycerides: 345 mg/dL, AST/ALT were both normal.

Given these findings, what is the recommended first-line intervention for managing his elevated triglycerides according to the 2025 ADA Standards of Care?

Answer Choices:

  1. Omega-3 fatty acids
  2. Lifestyle modification (nutrition, physical activity, and weight management)
  3. Start a Statin
  4. Start a Fenofibrate

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 1 is incorrect. 7.93% chose this answer, “Omega-3 fatty acid.” Icosapent ethyl, a refined omega-3 fatty acid, is typically considered when triglycerides ≥ 500 mg/dL to help lower levels and reduce pancreatitis risk, but they are not typically first-line for triglycerides at 345 mg/dL. For individuals with known cardiovascular risk consideration of additional of Icosapent ethyl could be added after maximizing statin therapy.

Answer 2 is correct. 63% of you chose this answer, “Lifestyle modification (nutrition, physical activity, and weight management.” The first-line recommendation for triglycerides 150-499 mg/dL is lifestyle modification. This may include dietary modifications (types of fats, reducing added sugars, refined carbohydrates, and alcohol), increasing physical activity, and weight loss, if applicable. If triglycerides remain elevated or reach ≥ 500 mg/dL, pharmacologic treatment such as icosapent ethyl or fibrates may be considered to reduce the risk of pancreatitis.

Answer 3 is incorrect. About 10% of respondents chose this, “Start a Statin.” JT is already taking a statin, atorvastatin. Although we can consider maximizing statin therapy as LDL is above 70 mg/dl, this is not the best answer. Statins may have a modest triglyceride-lowering effect, they are not the primary treatment for hypertriglyceridemia at this level.

Finally, Answer 4 is incorrect. 18.41% chose this answer, “Start a Fenofibrate.” Fenofibrate are typically recommended when triglycerides elevate greater than 500 mg/dL to reduce pancreatitis risk and addition could be
considered if lifestyle therapy does not indicate benefit.

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!

Ignite your passion & prepare for Diabetes Certification!​

Join our Expert Team at our dynamic Virtual DiabetesEd Training Conference April 16-18th, 2025

Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more! If you’re preparing for the CDCES or BC-ADM exam, this conference—paired with free bonus courses—serves as the ideal study companion!

With interactive co-teaching, we keep sessions engaging, relevant, and fun. Let’s learn and grow together!

Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun! The faculty includes:

  • Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES
  • Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
  • Christine Craig, MS, RD, CDCES
Registration Fee includes:
  • 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
  • 11 Bonus Online Courses: As a course attendee, you automatically receive a bonus online course bundle of 11 online courses valued at over

Rationale of the Week | Best approach: Fasting During Ramadan

For last week’s practice question, we quizzed participants on best approach: fasting during Ramadan . 74% 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 below: Answer Question 

Lightbulb and text: Rationale of the Week

Question:

JL observes Ramadan and fasts from sunrise to sunset. JL has type 2 diabetes and usually takes 4 units of bolus insulin three times a day with meals and 10 units of glargine (Rezvoglar) at bedtime.

What would be the best recommendation for JL?

Answer Choices:

  1. See if JL can get a note from your doctor to allow eating during the day.
  2. Take bolus insulin when JL eats a meal.
  3. Monitor urine ketones at least twice a day.
  4. Switch glargine to degludec to decrease risk of hypoglycemia.

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 1 is incorrect. 3% chose this answer, See if JL can get a note from your doctor to allow eating during the day. With careful planning and insulin adjustments, we can honor JL’s religious fast and cultural beliefs.

Answer 2 is correct. 76% of you chose this answer, Take bolus insulin when JL eats a meal. Yes, this is the BEST answer. If the basal insulin is dosed correctly, it won’t cause hypoglycemia while fasting. JL can hold bolus insulin during fasting, and take bolus insulin when eating.

Answer 3 is incorrect. About 9% of respondents chose this, Monitor urine ketones at least twice a day. There is no need to monitor ketones, since JL will be taking basal insulin daily and bolus insulin with meals, which will prevent ketosis.

Finally, Answer 4 is incorrect. 12% chose this answer, Switch glargine to degludec to decrease risk of hypoglycemia. There is no need to switch basal insulins. JL can stay on glargine, recognizing that it may need to be adjusted.

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!

Ignite your passion & prepare for Diabetes Certification!​

Join our Expert Team at our dynamic Virtual DiabetesEd Training Conference April 16-18th, 2025

Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more! If you’re preparing for the CDCES or BC-ADM exam, this conference—paired with free bonus courses—serves as the ideal study companion!

With interactive co-teaching, we keep sessions engaging, relevant, and fun. Let’s learn and grow together!

Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun! The faculty includes:

  • Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES
  • Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
  • Christine Craig, MS, RD, CDCES
Registration Fee includes:
  • 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
  • 11 Bonus Online Courses: As a course attendee, you automatically receive a bonus online course bundle of 11 online courses valued at over

Rationale of the Week | Based on ADA Standards, what is next med addition?

For last week’s practice question, we quizzed participants on ADA Standards & what is next med addition? 67% 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 below: Answer Question 

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Question:

JR has type 2 diabetes and takes Metformin 1000mg BID and sitagliptin (Januvia), A1C 8.1%. GFR 47, UACR 158mg/g. Recent diagnosis of congestive heart failure. These are the medications their insurance covers.

Of the following medications, which addition would most benefit JR?

Answer Choices:

  1. glipizide (Glucotrol)
  2. pioglitazone (Actos)
  3. semaglutide (Ozempic)
  4. dapagliflozin (Farxiga)

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.

For a helpful reference, please see our PocketCards for more information.

Answer 1 is incorrect. 5% chose this answer, “Glipizide (Glucotrol)”. Even though glipizide would help lower blood glucose, considering JL’s CHF and worsening kidney function, it is not the best choice.

Answer 2 is incorrect. 8% of you chose this answer,  “pioglitazone (Actos)”.  Even though pioglitazone would help lower blood glucose, considering JL’s CHF and worsening kidney function, it is not the best choice.

Answer 3 is incorrect. About 18% of respondents chose this, “Semaglutide (Ozempic)”. Even though semaglutide would help lower blood glucose and would address worsening kidney function, considering JL’s CHF and worsening kidney function, it is not the best choice.

Finally, Answer 4 is correct. 67% chose this answer,  “Dapagliflozin (Farxiga)”.  YES, GREAT JOB. Dapagliflozin is a SGLT-2i that will help lower blood glucose, address worsening kidney function and CHF. Plus, it is covered by insurance.  Considering JL’s health profile, it is the best choice.

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!

Ignite your passion & prepare for Diabetes Certification!​

Join our Expert Team at our dynamic Virtual DiabetesEd Training Conference April 16-18th, 2025

Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more! If you’re preparing for the CDCES or BC-ADM exam, this conference—paired with free bonus courses—serves as the ideal study companion!

With interactive co-teaching, we keep sessions engaging, relevant, and fun. Let’s learn and grow together!

Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun! The faculty includes:

  • Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES
  • Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
  • Christine Craig, MS, RD, CDCES
Registration Fee includes:
  • 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
  • 11 Bonus Online Courses: As a course attendee, you automatically receive a bonus online course bundle of 11 online courses valued at over

Rationale of the Week | 2025 ADA Standards: Key Nutrition Behaviors for Individuals with Diabetes

For last week’s practice question, we quizzed participants on. 79% 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 below: Answer Question.

Lightbulb and text: Rationale of the Week

 Question:

According to the 2025 ADA Standards of Care, which of the following nutrition behaviors are strongly encouraged for individuals with diabetes?

Answer Choices:

  1. Incorporate onions, garlic, celery, carrots and other vegetables for a base of homemade
    foods.
  2. Use herbs and spices to season foods instead of salt containing preparations.
  3. Water should be the primary beverage of choice.
  4. Include family or roommate in meal preparation.
  5. All of the above

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 1 is incorrect. 1.7% chose this answer, ” Incorporate onions, garlic, celery, carrots and other vegetables for a base of homemade foods.” Although this answer is true, it is not the best answer. Incorporate onions, garlic, celery, carrots, and other vegetables for a base of homemade foods. These foods can serve as a base to many dishes and incorporates flavor, fiber, vitamins, and minerals while encouraging vegetable consumption.

Answer 2 is incorrect. 4% of you chose this answer, “Use herbs and spices to season foods instead of salt containing preparations.” Although this answer is true, it is not the best answer. 90% of people in the US exceed the daily recommended limits for sodium.  Reducing salt intake is important for heart health, managing blood pressure and meeting dietary guidelines. Herbs and spices not only enhance flavor and may provide additional health benefits.

Answer 3 is incorrect. About 12% of respondents chose this, “Water should be the primary beverage of choice.”  Although this answer is true, it is not the best answer. The 2025 ADA Standards of Care have emphasized water as the primary beverage of choice.  Alternatives to plain water can include no calorie alternatives. Suggestions to add lemon, lime or cucumber to water, choose sparkling no calorie beverages and no-calorie carbonated beverages are also encouraged.

 Answer 4 is incorrect. 2% chose this answer, “Include family or roommate in meal preparation.” Although this answer is true, it is not the best answer. Engaging others in meal preparation can create a supportive environment, encourage healthier eating habits, and make cooking more enjoyable. Social support can be especially helpful in managing diabetes long-term.

 Answer 5 is correct. 79% chose this answer, “All of the above.” The 2025 ADA Standards of Care encourages all the above nutrition behaviors.

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!

Ignite your passion & prepare for Diabetes Certification!​

Join our Expert Team at our dynamic Virtual DiabetesEd Training Conference April 16-18th, 2025

Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more! If you’re preparing for the CDCES or BC-ADM exam, this conference—paired with free bonus courses—serves as the ideal study companion!

With interactive co-teaching, we keep sessions engaging, relevant, and fun. Let’s learn and grow together!

Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun! The faculty includes:

  • Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES
  • Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
  • Christine Craig, MS, RD, CDCES
Registration Fee includes:
  • 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
  • 11 Bonus Online Courses: As a course attendee, you automatically receive a bonus online course bundle of 11 online courses valued at over

Rationale of the Week | Action needed to prevent heart failure?

For last week’s practice question, we quizzed participants oAction needed to prevent heart failure. 41% 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 below: Answer Question 

Lightbulb and text: Rationale of the Week

Question:

Adults with diabetes are at increased risk for the development of asymptomatic or symptomatic heart failure.

According to the ADA 2025 Standards of care, what action is needed to facilitate prevention of heart failure?

Answer Choices:

  1. Recommend the DASH Diet.
  2. Measure natriuretic peptide (BNP or pro-BNP).
  3. Assess ankle circumference at each visit.
  4. Recommend echocardiography after age 55.

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 1 is incorrect. 27% chose this juicy answer. “Recommend the DASH Diet.” Although the DASH Diet with lower sodium content is helpful once someone is diagnosed with heart failure, this dietary approach alone won’t prevent heart failure. In order to prevent heart failure, it needs to first be diagnosed to determine best treatment plan.

Answer 2 is correct. 49% of you chose this answer. “Measure natriuretic peptide (BNP or pro-BNP).”  YES, Great JOB.  According to the ADA Standard on ASCVD, “Adults with diabetes are at increased risk for the development of asymptomatic cardiac structural or functional abnormalities (stage B heart failure) or symptomatic (stage C) heart failure. Consider screening adults with diabetes by measuring a natriuretic peptide (B-type natriuretic peptide [BNP] or N-terminal pro-BNP [NT-proBNP]) to facilitate prevention of stage C heart failure. In asymptomatic individuals with diabetes and abnormal natriuretic peptide levels, echocardiography is recommended to identify stage B heart failure.”

Answer 3 is incorrect. About 11% of respondents chose this. “Assess ankle circumference at each visit.” Although pedal edema and shortness of breath are both indicators of heart failure, the BNP or NT-proBNP lab test is more definitive.

Finally, Answer 4 is incorrect. 18% chose this answer. “Recommend echocardiography after age 55.” According to ADA standards, we would first check the BNP or NT-proBNP lab test. In asymptomatic individuals with diabetes and abnormal natriuretic peptide levels, echocardiography is then recommended to identify stage B heart failure.”

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!

Ignite your passion & prepare for Diabetes Certification!​

Join our Expert Team at our dynamic Virtual DiabetesEd Training Conference April 16-18th, 2025

Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more! If you’re preparing for the CDCES or BC-ADM exam, this conference—paired with free bonus courses—serves as the ideal study companion!

With interactive co-teaching, we keep sessions engaging, relevant, and fun. Let’s learn and grow together!

Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun! The faculty includes:

  • Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES
  • Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
  • Christine Craig, MS, RD, CDCES
Registration Fee includes:
  • 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
  • 11 Bonus Online Courses: As a course attendee, you automatically receive a bonus online course bundle of 11 online courses valued at over

Rationale of the Week | ADA 2025: Intensive Prevention for High-Risk Individuals with BMI >35 kg/m2

For last week’s practice question, we quizzed participants on what defines overbasalization according to 2025 ADA Standards? 60% 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 below: Answer Question 

Lightbulb and text: Rationale of the Week

Question:

According to ADA 2025 Standards, more intensive preventive approaches should be considered in individuals who are at particularly high risk of progression to diabetes, including individuals with BMI ≥35 kg/m2 who:

Answer Choices:

  1. Sit more than eight hours a day and have a sedentary lifestyle.
  2. Have a history of thyroid or celiac disease.
  3. Consume a diet with high amounts of simple carbohydrates.
  4. Have fasting plasma glucose of 110–125 or A1C ≥6.0%.

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 1 is incorrect. 25% chose this answer, “Sit more than eight hours a day and have a sedentary lifestyle”. Although the ADA Standards recommend getting up and moving every half-hour, they don’t specify that eight hours of sitting a day qualifies a person as higher risk to progressing to diabetes.

Answer 2 is incorrect. 7% of you chose this answer “Have a history of thyroid or celiac disease”.  These autoimmune conditions are more closely associated with immune mediated type 1 diabetes and do not place a person as higher risk for progression to type 2 diabetes.

Answer 3 is incorrect. About 9% of respondents chose this, “Consume a diet with high amounts of simple carbohydrates.” While eating foods rich in fiber and a variety of nutrients is important to decrease risk of diabetes, the ADA does not state that eating simple carbohydrates puts individuals in a higher risk category of progressing to diabetes.

Finally, Answer 4 is correct 60% chose this answer, “Have fasting plasma glucose of 110–125 or A1C ≥6.0%.”  Great job. This is the BEST answer. According to ADA 2025 Standards, “More intensive preventive approaches should be considered in individuals who are at particularly high risk of progression to diabetes, including individuals with BMI ≥35 kg/m2, those at higher glucose levels (e.g., fasting plasma glucose 110–125 mg/dL [6.1–6.9 mmol/L], 2-h post challenge glucose 173–199 mg/dL [9.6–11.0 mmol/L], and A1C ≥6.0% [≥42 mmol/mol]), and individuals with a history of gestational diabetes mellitus.”

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!

Ignite your passion & prepare for Diabetes Certification!​

Join our Expert Team at our dynamic Virtual DiabetesEd Training Conference April 16-18th, 2025

Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more! If you’re preparing for the CDCES or BC-ADM exam, this conference—paired with free bonus courses—serves as the ideal study companion!

With interactive co-teaching, we keep sessions engaging, relevant, and fun. Let’s learn and grow together!

Our expert team transforms complex diabetes science into clear, practical insights—keeping it real, engaging, and fun! The faculty includes:

  • Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES
  • Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
  • Christine Craig, MS, RD, CDCES
Registration Fee includes:
  • 3 Days: of critical information delivered by passionate speakers in an engaging and fun format!
  • 11 Bonus Online Courses: As a course attendee, you automatically receive a bonus online course bundle of 11 online courses valued at over

Rationale of the Week | What defines overbasalization according to 2025 ADA Standards?

For last week’s practice question, we quizzed participants on what defines overbasalization according to 2025 ADA Standards?. 52% 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 below: Answer Question 

Lightbulb and text: Rationale of the Week

Question: 

What defines overbasalization according to 2025 ADA Standards?

According to the new 2025 ADA Standards of Care, which of the following most accurately reflects overbasalization?

Answer Choices:

  1. basal insulin doses exceeding 0.5 units/kg/day
  2. significant bedtime-to-morning or postprandial-to-preprandial glucose differential
  3. low glycemic variability
  4. basal insulin dose exceeding 50 units twice per day

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 1 is incorrect. 25% chose this answer: basal insulin doses exceeding 0.5 units/kg/day. This year, the ADA Recommendation was revised to remove consideration of basal insulin doses exceeding 0.5 units/kg/day as evidence of overbasalization. Instead, signs of overbasalization including significant bedtime-to-morning or postprandial-to-preprandial glucose differential, occurrences of hypoglycemia (aware or unaware), and high glycemic variability should be used.

Answer 2 is correct. 52% of you chose this answer: significant bedtime-to-morning or postprandial-to-preprandial glucose differential.  GREAT JOB!  In the 2025 ADA Standards (9), they define overbasalization as significant bedtime-to-morning or postprandial-to-preprandial glucose differential, occurrences of hypoglycemia (aware or unaware), and high glycemic variability.

Answer 3 is incorrect. About 18% of respondents chose this: low glycemic variability, This is a juicy and tempting answer. However, high glycemic variability (lots of ups and downs) is more closely associated with hypoglycemia.

Finally, Answer 4 is incorrect 3% chose this answer: basal insulin dose exceeding 50 units twice per day. Overbasalization is not defined by the amount of insulin used, but by the glucose response including significant bedtime-to-morning or postprandial-to-preprandial glucose differential, occurrences of hypoglycemia (aware or unaware), and high glycemic variability

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!

Want to learn more about this question?

Enroll in our Level 3

Diabetes Mastery & Cert Readiness

Ready for your certification exams? Our Level 3 course series is the final step in your exam prep, complementing our Level 1, 2, or 4 bundles. Designed for healthcare professionals preparing for diabetes certification exams in 3-6 months, this master-level series covers key topics like pharmacology, technology, MNT, and person-centered care, all based on the latest ADA Standards of Care.

Each course includes a video, podcast, practice test, and additional resources—available immediately for one full year. Boost your knowledge and confidence to succeed in your certification!