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For last week’s practice question, we quizzed participants on how many pens are needed per month. 48% 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.
JR needs to inject 70 units of degludec (Tresiba) a day and says he keeps running out of this basal insulin. The diabetes healthcare professional suggests changing the insulin concentration from U-100 to U-200, so his supplies last longer.
How many degludec U-200 insulin pens would JR need a month based on his current insulin dose? (You can check out our Insulin Dosing and Storage Sheet for more info)
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. 13.58% chose this answer: “7 Pens.”
Seven pens would be approximately the number needed if the pens contained only 300 units each. Tresiba U-200 contains 600 units per 3-mL pen, so fewer pens are required than with a U-100 formulation.
Answer B is correct. 47.80% of you chose this answer, “4 Pens.” Great job! This is the correct answer.
JR requires approximately 2,100 units per month. Each U-200 pen contains 600 units, so 2,100 ÷ 600 = 3.5 pens. Since a partial pen cannot meet the full monthly requirement, JR would need 4 pens. Calculation: JR uses 70 units/day × 30 days = 2,100 units/month. Each Tresiba U-200 pen contains 600 units (3 mL × 200 units/mL). Therefore, 2,100 ÷ 600 = 3.5 pens, which must be rounded up to 4 pens per month.
Answer C is incorrect. 28.04% of respondents chose this: “3.5 Pens”
Mathematically, JR will use the equivalent of 3.5 pens during a 30-day period. However, pens are dispensed as whole pens, not partial pens. Therefore, the quantity must be rounded up to 4 pens to ensure JR has enough insulin for the entire month. Three U-200 pens provide only 1,800 units (600 × 3) and since we can’t add in a half a pen, this approach wouldn’t work.
Finally, Answer D is incorrect. 10.58% chose this answer, “5 Pens”
Five pens would provide 3,000 units (600 units x 5) substantially more than JR’s calculated 30-day requirement of 2,100 units. Four pens provide 2,400 units and are sufficient for the month.
Clinical Pearl: The advantage of U-200 degludec is that the same insulin dose is delivered in a smaller volume, and each pen contains more total units. Please use our Insulin Dosing and Storage Sheet as a helpful resource for insulin calculations and the latest information. Our FREE Cheat sheets are also available on our CDCES Coach App for Easy Reference.
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!
🌟Updated Schedule: ADA Boot Camp, Tech, MNT & More
Live in Beautiful San Diego – Oct 22-23, 2026
Re-Ignite your Passion & Prepare for Diabetes Certification Exams
🎓 Earn 30+ CEs: AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
📅
2-Day Conference
Oct 22–23, 2026
⏱️
15.5 Live CEs
+ 17 bonus CEs
🏅
CDCES & BC-ADM
Exam Prep + Renewal
📍
San Diego, CA
1.7 mi from airport
The field of diabetes care is expanding and evolving rapidly. This unique training conference will keep you on the cutting edge plus prepare you for certification exams. It also fulfills the Standards of Care renewal requirement. Join us for two days of intensive education that is fun and inspiring. Add on the optional Day 3 (Engaging the Disengaged), to complete your conference exeperience.
Coach Beverly and Diana Isaacs, PharmD, BC-ADM, CDCES co-lead an exciting day that brings the ADA and AACE Standards to life. Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. After attending, you will be empowered to share the latest in diabetes care with your colleagues and the people in your care.
Take your knowledge to the next level with this intensive deep-dive into insulin therapy, dosing and pattern management with Dr. Diana Isaacs. Next, stay for the diabetes tech show-and-tell as Diana demonstrates the specs of the latest pumps and sensors. After lunch, nutrition whiz Christine Craig, MS, RDN, CDCES expertly details the latest in MNT and provides real strategies on translating this content to your clinical practice. You will have a chance to put it all together as Coach Beverly leads you through a series of case studies that integrates content from Day 1 and Day 2.
On Saturday, join this exceptional day-long program led by William H. Polonsky, PhD, CDCES & Susan Guzman, PhD (Behavioral Diabetes Institute) that reveals psychosocial forces behind diabetes self-management — tools to break through resistance and inspire change.
Read more below
📜 Essentials
Registration
+ Printed Syllabus
$559.00
🌟 Deluxe
Essentials
+ ADA Standards Book
$589.00
🏆 Complete – Best Value!
Deluxe
+ ADCES Review Guide e-Book
$669.00
Transform how you engage patients with diabetes — master behavior change, reduce distress, and overcome medication hesitancy.
Why do so many patients know what they should do — but still struggle to do it?
The answer lies in the psychology of diabetes.
In this transformative full-day course, world-renowned experts William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, from the Behavioral Diabetes Institute reveal the hidden psychosocial forces that drive — or derail — diabetes self-management.
You’ll walk away with a completely new toolkit for breaking through patient resistance, dissolving medication hesitancy, and creating clinical encounters that actually inspire change!
For last week’s practice question, we quizzed participants on the latest nutritional guidelines. 66% 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.
Which of the following best reflects the ADA’s current nutrition guidance for people with diabetes?
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. 19.28% chose this answer: “Choose a Mediterranean or low-carbohydrate diet, because these approaches are superior for diabetes management.”
The ADA does not recommend one specific eating pattern for everyone with diabetes. Mediterranean, DASH, low-carbohydrate, vegetarian, vegan, and other eating patterns can be appropriate when individualized to the person’s preferences, needs, and goals.
Answer B is incorrect. 3.14% of you chose this answer, “Focus primarily on carbohydrate quantity and recommend limiting fruit, legumes, and whole grains because they contain carbohydrate.”
Carbohydrate quality matters, not simply the amount of carbohydrate. The ADA encourages minimally processed, nutrient-dense, high-fiber carbohydrate sources. Fruit and whole grains do not need to be routinely eliminated simply because they contain carbohydrate.
Answer C is incorrect. 66.37% of respondents chose this: “Emphasize nonstarchy vegetables, whole fruits, legumes, whole grains, nuts and seeds, lean proteins, and low-fat dairy or nondairy alternatives while minimizing red meat, sugar-sweetened beverages, sweets, refined grains, and processed and ultra-processed foods.”
Great job! This is the correct answer. The 2026 ADA Standards of Care recommend eating patterns that emphasize key nutrition principles, including consumption of non-starchy vegetables, whole fruits, legumes, lean proteins, whole grains, nuts and seeds, and low-fat dairy or nondairy alternatives, while minimizing red meat, sugar-sweetened beverages, sweets, refined grains, and processed and ultraprocessed foods.
Finally, Answer D is incorrect. 30% chose this answer, “Focus on a carbohydrate-controlled meal plan, primarily eliminating added sugar and saturated fat.”
The ADA encourages a food-based approach that considers the overall eating pattern rather than focusing solely on individual nutrients. Added sugars and saturated fat are important considerations, but guidance goes beyond individual nutrients. It emphasizes the overall quality of the eating pattern, including increasing nutrient-dense foods while minimizing refined grains, sugar-sweetened beverages, and ultra-processed foods.
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!
🌟Updated Schedule: ADA Boot Camp, Tech, MNT & More
Live in Beautiful San Diego – Oct 22-23, 2026
Re-Ignite your Passion & Prepare for Diabetes Certification Exams
🎓 Earn 30+ CEs: AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
📅
2-Day Conference
Oct 22–23, 2026
⏱️
15.5 Live CEs
+ 17 bonus CEs
🏅
CDCES & BC-ADM
Exam Prep + Renewal
📍
San Diego, CA
1.7 mi from airport
The field of diabetes care is expanding and evolving rapidly. This unique training conference will keep you on the cutting edge plus prepare you for certification exams. It also fulfills the Standards of Care renewal requirement. Join us for two days of intensive education that is fun and inspiring. Add on the optional Day 3 (Engaging the Disengaged), to complete your conference exeperience.
Coach Beverly and Diana Isaacs, PharmD, BC-ADM, CDCES co-lead an exciting day that brings the ADA and AACE Standards to life. Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. After attending, you will be empowered to share the latest in diabetes care with your colleagues and the people in your care.
Take your knowledge to the next level with this intensive deep-dive into insulin therapy, dosing and pattern management with Dr. Diana Isaacs. Next, stay for the diabetes tech show-and-tell as Diana demonstrates the specs of the latest pumps and sensors. After lunch, nutrition whiz Christine Craig, MS, RDN, CDCES expertly details the latest in MNT and provides real strategies on translating this content to your clinical practice. You will have a chance to put it all together as Coach Beverly leads you through a series of case studies that integrates content from Day 1 and Day 2.
On Saturday, join this exceptional day-long program led by William H. Polonsky, PhD, CDCES & Susan Guzman, PhD (Behavioral Diabetes Institute) that reveals psychosocial forces behind diabetes self-management — tools to break through resistance and inspire change.
Read more below
📜 Essentials
Registration
+ Printed Syllabus
$559.00
🌟 Deluxe
Essentials
+ ADA Standards Book
$589.00
🏆 Complete – Best Value!
Deluxe
+ ADCES Review Guide e-Book
$669.00
Transform how you engage patients with diabetes — master behavior change, reduce distress, and overcome medication hesitancy.
Why do so many patients know what they should do — but still struggle to do it?
The answer lies in the psychology of diabetes.
In this transformative full-day course, world-renowned experts William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, from the Behavioral Diabetes Institute reveal the hidden psychosocial forces that drive — or derail — diabetes self-management.
You’ll walk away with a completely new toolkit for breaking through patient resistance, dissolving medication hesitancy, and creating clinical encounters that actually inspire change!
For last week’s practice question, we quizzed participants on if AACE recommends medications to treat prediabetes. 90% 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.
A 36-year-old has an A1C of 6.2%, BMI of 36, hypertension, and a strong family history of type 2 diabetes. Despite sustained nutrition and physical activity interventions, they can’t seem to lower their A1C. They ask whether medication could help reduce their risk of developing type 2 diabetes.
Which approach is MOST consistent with American Association of Clinical Endocrinology (AACE) recommendations?
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. 5.10% chose this answer: “Avoid pharmacologic treatment until the A1C or FPG reaches the diagnostic threshold for diabetes.”
This may have been true in the past, but both the ADA and AACE now recommend considering pharmacologic treatment in the prediabetes phase to delay or prevent a future diabetes diagnosis.
Answer B is correct. 89.80% of you chose this answer, “Consider pharmacotherapy, including metformin or GLP-1–based therapy to reduce metabolic risk.” Great job! This is the correct answer.
Prediabetes provides an opportunity for active intervention rather than watchful waiting. AACE recommends addressing excess adiposity and associated metabolic complications as part of diabetes prevention. For an individual with obesity and prediabetes, evidence-based obesity pharmacotherapy may be considered alongside nutrition, physical activity, behavioral support, and management of cardiovascular risk factors. Current AACE guidance takes a patient-centered, complication-focused approach to obesity/adiposity-based chronic disease rather than relying on BMI or glucose alone.
Answer C is incorrect. 3.06% of respondents chose this: “Initiate a sulfonylurea to improve beta-cell function and prevent progression to type 2 diabetes.”
Is not the best answer since sulfonylureas aren’t recommended as diabetes-prevention therapy and carry risks including hypoglycemia and weight gain.
Finally, Answer D is incorrect. 2.04% chose this answer, “Initiate basal insulin to preserve pancreatic beta-cell function and lower A1C.”
Not the best answer since insulin is not routinely used to delay progression from prediabetes to type 2 diabetes.
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!
🌟Updated Schedule: ADA Boot Camp, Tech, MNT & More
Live in Beautiful San Diego – Oct 22-23, 2026
Re-Ignite your Passion & Prepare for Diabetes Certification Exams
🎓 Earn 30+ CEs: AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
📅
2-Day Conference
Oct 22–23, 2026
⏱️
15.5 Live CEs
+ 17 bonus CEs
🏅
CDCES & BC-ADM
Exam Prep + Renewal
📍
San Diego, CA
1.7 mi from airport
The field of diabetes care is expanding and evolving rapidly. This unique training conference will keep you on the cutting edge plus prepare you for certification exams. It also fulfills the Standards of Care renewal requirement. Join us for two days of intensive education that is fun and inspiring. Add on the optional Day 3 (Engaging the Disengaged), to complete your conference exeperience.
Coach Beverly and Diana Isaacs, PharmD, BC-ADM, CDCES co-lead an exciting day that brings the ADA and AACE Standards to life. Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. After attending, you will be empowered to share the latest in diabetes care with your colleagues and the people in your care.
Take your knowledge to the next level with this intensive deep-dive into insulin therapy, dosing and pattern management with Dr. Diana Isaacs. Next, stay for the diabetes tech show-and-tell as Diana demonstrates the specs of the latest pumps and sensors. After lunch, nutrition whiz Christine Craig, MS, RDN, CDCES expertly details the latest in MNT and provides real strategies on translating this content to your clinical practice. You will have a chance to put it all together as Coach Beverly leads you through a series of case studies that integrates content from Day 1 and Day 2.
On Saturday, join this exceptional day-long program led by William H. Polonsky, PhD, CDCES & Susan Guzman, PhD (Behavioral Diabetes Institute) that reveals psychosocial forces behind diabetes self-management — tools to break through resistance and inspire change.
Read more below
📜 Essentials
Registration
+ Printed Syllabus
$559.00
🌟 Deluxe
Essentials
+ ADA Standards Book
$589.00
🏆 Complete – Best Value!
Deluxe
+ ADCES Review Guide e-Book
$669.00
Transform how you engage patients with diabetes — master behavior change, reduce distress, and overcome medication hesitancy.
Why do so many patients know what they should do — but still struggle to do it?
The answer lies in the psychology of diabetes.
In this transformative full-day course, world-renowned experts William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, from the Behavioral Diabetes Institute reveal the hidden psychosocial forces that drive — or derail — diabetes self-management.
You’ll walk away with a completely new toolkit for breaking through patient resistance, dissolving medication hesitancy, and creating clinical encounters that actually inspire change!
For last week’s practice question, we quizzed participants on which response BEST supports sustainable medication-taking. 68% 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 living with type 1 diabetes and calls the diabetes-education clinic, recently learning she is 7-weeks gestation. CJ uses a hybrid closed-loop (automated insulin delivery or AID) insulin pump system with continuous glucose monitoring that is set to a target to 110 mg/dl. The Ambulatory Glucose Profile report was reviewed for the past 2 weeks and findings show increasing postprandial hyperglycemia, with average post-meal readings of 170–220 mg/dL. Time in Range (TIR) is 72% (70-180 mg/dl) with 1% of Time below Range. The total daily insulin dose has increased approximately 10% over the same period. And CJ reports no significant changes to diet, activity, or carbohydrate intake. CJ asks if any modifications are need to the diabetes therapy plan?
What can we tell CJ?
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. 9.65% chose this answer: “Reassure her that increasing insulin resistance is expected as pregnancy progresses and suggest an increase in her basal insulin by 10-20%.”
Although we will anticipate an increase in insulin needs as pregnancy progresses, we do not yet have enough information to increase the basal rate. The pattern identified above was post-prandial hyperglycemia, making a recommendation for basal increase without additional information inappropriate.
Answer B is incorrect. 5.26% of you chose this answer, “Discontinue the AID system and transition her to manual mode pump therapy since, since AID systems are not intended for use in pregnancy.”
Pregnancy is not, by itself, a reason to discontinue AID. The use of AID during pregnancy is an evolving area, and the appropriateness of continued use depends on the specific system and its regulatory status, capabilities, and glucose targets. In April 2026, the FDA cleared Tandem’s Control-IQ+ technology1 for use during pregnancy in people with type 1 diabetes. Other AID systems may have different indications or may be used off-label. Additional assessment is recommended before AID discontinuation.
Answer C is incorrect. 16.67% of respondents chose this: “Time is Range is over 70%, meeting the ADA Standard of Care targets, however, due to post-prandial hyperglycemia recommend a lower (more aggressive) insulin-to-carbohydrate ratio.”
A lower (more aggressive) insulin-to-carbohydrate ratio may ultimately be appropriate for persistent postprandial hyperglycemia, but the initial TIR reported uses the standard 70–180 mg/dL range and does not adequately assess pregnancy-specific glycemic targets. For pregnant individuals with type 1 diabetes, the recommended CGM target range is 63–140 mg/dL, with a goal of spending >70% of time in this range. Additional goals include <4% time below 63 mg/dL, <1% below 54 mg/dL, and <25% above 140 mg/dL.2
Finally, Answer D is correct. 68.42% chose this answer: “Confirm her current AID system and review pregnancy specific glucose targets, capabilities, settings and limitations before recommending any changes.”
Great job! You chose the best answer. The first step is to confirm the specific AID system and review its pregnancy-specific indications, glucose targets (as stated in rationale answer C), algorithm capabilities, and current settings. CJ’s postprandial readings of 170–220 mg/dL are above pregnancy-specific glucose targets, but the appropriate intervention depends on the system and the pattern identified on the updated AGP report. Further assessment may include meal and bolus timing, carbohydrate entries, insulin-to-carbohydrate ratios, correction settings, and other system-specific parameters. Any insulin adjustments should be made in collaboration with her diabetes and pregnancy care team.
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!
🌟Updated Schedule: ADA Boot Camp, Tech, MNT & More
Live in Beautiful San Diego – Oct 22-23, 2026
Re-Ignite your Passion & Prepare for Diabetes Certification Exams
🎓 Earn 30+ CEs: AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
📅
2-Day Conference
Oct 22–23, 2026
⏱️
15.5 Live CEs
+ 17 bonus CEs
🏅
CDCES & BC-ADM
Exam Prep + Renewal
📍
San Diego, CA
1.7 mi from airport
The field of diabetes care is expanding and evolving rapidly. This unique training conference will keep you on the cutting edge plus prepare you for certification exams. It also fulfills the Standards of Care renewal requirement. Join us for two days of intensive education that is fun and inspiring. Add on the optional Day 3 (Engaging the Disengaged), to complete your conference exeperience.
Coach Beverly and Diana Isaacs, PharmD, BC-ADM, CDCES co-lead an exciting day that brings the ADA and AACE Standards to life. Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. After attending, you will be empowered to share the latest in diabetes care with your colleagues and the people in your care.
Take your knowledge to the next level with this intensive deep-dive into insulin therapy, dosing and pattern management with Dr. Diana Isaacs. Next, stay for the diabetes tech show-and-tell as Diana demonstrates the specs of the latest pumps and sensors. After lunch, nutrition whiz Christine Craig, MS, RDN, CDCES expertly details the latest in MNT and provides real strategies on translating this content to your clinical practice. You will have a chance to put it all together as Coach Beverly leads you through a series of case studies that integrates content from Day 1 and Day 2.
On Saturday, join this exceptional day-long program led by William H. Polonsky, PhD, CDCES & Susan Guzman, PhD (Behavioral Diabetes Institute) that reveals psychosocial forces behind diabetes self-management — tools to break through resistance and inspire change.
Read more below
📜 Essentials
Registration
+ Printed Syllabus
$559.00
🌟 Deluxe
Essentials
+ ADA Standards Book
$589.00
🏆 Complete – Best Value!
Deluxe
+ ADCES Review Guide e-Book
$669.00
Transform how you engage patients with diabetes — master behavior change, reduce distress, and overcome medication hesitancy.
Why do so many patients know what they should do — but still struggle to do it?
The answer lies in the psychology of diabetes.
In this transformative full-day course, world-renowned experts William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, from the Behavioral Diabetes Institute reveal the hidden psychosocial forces that drive — or derail — diabetes self-management.
You’ll walk away with a completely new toolkit for breaking through patient resistance, dissolving medication hesitancy, and creating clinical encounters that actually inspire change!
For last week’s practice question, we quizzed participants on which response BEST supports sustainable medication-taking. 77% 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.
Jordan is a 52-year-old person living with type 2 diabetes whose provider recently added a second daily medication after their A1C rose from 7.6% to 9.1%. Jordan works alternating shifts and cares for an aging parent. At a follow-up visit, Jordan reports consistently taking their morning dose but missing the evening dose “more nights than not.”
Jordan says, “My schedule’s never the same two days in a row. By the time I remember, I’ve already gone to bed.”
Which response by the diabetes care and education specialist best supports sustainable medication-taking?
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. 10.67% chose this answer: “Missing doses can raise your glucose and increase your risk of complications. Let’s set a daily 8 PM phone alarm so you don’t forget, and I’ll check your adherence at the next visit.”
This response is clinically accurate about the risks of missed doses, but it jumps to a fixed, externally chosen solution, a specific alarm time, without first understanding why the current routine isn’t working. A rotating shift schedule makes a single fixed time an unreliable anchor from the start, and framing the follow-up as adherence “checking” rather than problem-solving together can heighten shame rather than support change.
Answer B is correct. 81.33% of you chose this answer, “What types of movement have you enjoyed in the past, and who might you enjoy doing them with?”
Great job! This is the correct answer. This response explores Jordan’s actual daily rhythm before proposing anything, and it reframes an unpredictable schedule as a legitimate constraint to design around rather than a compliance problem. It supports the three psychological needs described in Self-Determination Theory.
Answer C is incorrect. 5.33% of respondents chose this: “Since mornings are working well, let’s move you to a pill organizer with both doses pre-sorted by day, so you can just take whatever’s next whenever you think of it.”
A pre-sorted pill organizer is a reasonable adherence tool in general, but this response solves the packaging problem while leaving the timing problem—the actual barrier Jordan described —unaddressed. “Whenever you think of it” doesn’t give Jordan a reliable cue any more than the current routine does. As with option A, a plausible-sounding tool is offered before the clinician has understood what’s actually failing.
Finally, Answer D is incorrect. 2.67% chose this answer: “Would it help if your parent reminded you each evening? Having someone else keep track might take the pressure off you.”
Involving a family member can be appropriate, but only when the person wants that kind of support. Jordan didn’t raise their parent as a source of help; they described their parent as someone they care for, which may make an added caregiving-adjacent responsibility unwelcome or even reverse the relatedness this response is trying to invoke. SDT’s relatedness means Jordan feels understood and supported on their own terms, not that responsibility is redistributed without checking first.
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?
People living with diabetes are often well informed about actions needed to shift into a “healthy lifestyle”, yet often struggle to sustain health behaviors over time. This webinar introduces a positive psychology lens for diabetes care, showing how clinicians can help individuals with diabetes build lifestyles that feel psychologically nourishing, not just medically correct. Rather than focusing solely on risk and problem-solving, we’ll explore how to weave well-being, motivation, and strengths into everyday diabetes education and support.
Drawing on the PERMA framework—Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment—participants will learn practical strategies to enhance motivation, resilience, and self-management. We’ll examine how PERMA aligns with key behavior-change principles such as autonomy, connection, and confidence-building, and translate these ideas into simple questions, reframes, and counseling approaches that can be used immediately in healthcare professionals’ practice.
For last week’s practice question, we quizzed participants on how glycemic control can be documented. 37% 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.
A 62‑year‑old woman with type 2 diabetes is being followed in a value‑based care program. She uses a continuous glucose monitor (CGM) that provides detailed glucose data, which she electronically shares with her care team.
At her follow‑up visit, her provider notes that her most recent laboratory A1c is unavailable due to a missed lab draw. However, her CGM report shows a Glucose Management Indicator (GMI) of 7.2%. The care team wants to ensure her glycemic status is captured for quality reporting under updated HEDIS® measures.
Which statement best reflects how her glycemic control can be documented?
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 correct. 37.12% chose this answer: “GMI from CGM data can be used in place of hemoglobin A1c for quality reporting.” Great job! This is the correct answer. The updated HEDIS® Glycemic Status Assessment for Patients With Diabetes measure accepts either a laboratory A1c or a GMI calculated from CGM data. Therefore, her GMI of 7.2% can be documented for quality reporting and meets the measure’s glycemic-status threshold of less than 8.0%.
Answer B is incorrect. 24.49% of you chose this answer, “GMI is useful for patient education but cannot be used for official quality measures.” GMI supports patient education and clinical decision-making while also serving as an accepted glycemic-status result under the updated HEDIS® measure.
Answer C is incorrect. 21.72% of respondents chose this: “GMI should only be used if time‑in‑range data are also reported.” Time in Range provides valuable information about glucose patterns, but a GMI result can independently document glycemic status for HEDIS® quality reporting.
Finally, Answer D is incorrect. 16.67% chose this answer, “GMI is not recognized by HEDIS® and must be converted to estimated A1c.” The updated HEDIS® measure directly recognizes GMI as a glycemic-status result. GMI is the current term derived from CGM data and requires no conversion to “estimated A1c.”
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?
Did you know that YOU are practicing in a healthcare system where the traditional fee for service model is giving way to value-based diabetes care, and how essential YOU are in that shift?
For last week’s practice question, we quizzed participants on unpredictable glucose patters with bloating and nausea. 76% 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.
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?
Answer A is incorrect. 4.93% chose this answer: “Inaccurate carbohydrate counting creating an increased variability in glucose patterns.” While carbohydrate counting errors can contribute to glucose variability, CL reports consistent meal announcement and insulin dosing before meals. The CGM pattern is also not typical of carbohydrate-counting challenges alone. A decline followed by a delayed rise several hours after eating suggests that the timing of glucose absorption may not align with insulin action.
Answer B is incorrect. 5.91% of you chose this answer, “Excess programmed basal insulin causing post-meal glucose fluctuations.” Excess basal insulin can contribute to hypoglycemia, but it typically causes a glucose decline independent of meals, and depending on the AID system, basal rate adjustments may not be a factor. CL’s pattern of an early post-meal glucose drop followed by a delayed glucose rise suggests a mismatch between insulin activity and nutrient absorption rather than simply excessive basal insulin.
Answer C is correct. 75.86% of respondents chose this: “Delayed gastric emptying resulting in a mismatch between insulin action and glucose absorption. Consider a referral for a gastric emptying study.” Great job! This is the correct answer. Based on the information we have, CL’s long duration of type 1 diabetes increases the risk for autonomic neuropathy, which can affect gastric motility. The pattern of early post-meal hypoglycemia followed by delayed hyperglycemia 3–5 hours later is characteristic of delayed carbohydrate absorption. New symptoms of bloating and nausea further support the consideration of gastroparesis. Referral for evaluation and possible gastric emptying testing may be appropriate.
Finally, Answer D is incorrect. 13.30% chose this answer, “A high-carbohydrate and high-fat dietary pattern causing prolonged glucose elevations after meals.” This is not the best answer. While it is possible that meals high in carbohydrate and fat can delay gastric emptying and contribute to prolonged post-meal glucose elevations, the early glucose drop followed by a delayed rise, combined with new gastrointestinal symptoms and long-standing type 1 diabetes, makes delayed gastric emptying a more likely primary contributor.
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!
🌟Updated Schedule: ADA Boot Camp, Tech, MNT & More
Live in Beautiful San Diego – Oct 22-23, 2026
Re-Ignite your Passion & Prepare for Diabetes Certification Exams
🎓 Earn 30+ CEs: AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
📅
2-Day Conference
Oct 22–23, 2026
⏱️
15.5 Live CEs
+ 17 bonus CEs
🏅
CDCES & BC-ADM
Exam Prep + Renewal
📍
San Diego, CA
1.7 mi from airport
The field of diabetes care is expanding and evolving rapidly. This unique training conference will keep you on the cutting edge plus prepare you for certification exams. It also fulfills the Standards of Care renewal requirement. Join us for two days of intensive education that is fun and inspiring. Add on the optional Day 3 (Engaging the Disengaged), to complete your conference exeperience.
Coach Beverly and Diana Isaacs, PharmD, BC-ADM, CDCES co-lead an exciting day that brings the ADA and AACE Standards to life. Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. After attending, you will be empowered to share the latest in diabetes care with your colleagues and the people in your care.
Take your knowledge to the next level with this intensive deep-dive into insulin therapy, dosing and pattern management with Dr. Diana Isaacs. Next, stay for the diabetes tech show-and-tell as Diana demonstrates the specs of the latest pumps and sensors. After lunch, nutrition whiz Christine Craig, MS, RDN, CDCES expertly details the latest in MNT and provides real strategies on translating this content to your clinical practice. You will have a chance to put it all together as Coach Beverly leads you through a series of case studies that integrates content from Day 1 and Day 2.
On Saturday, join this exceptional day-long program led by William H. Polonsky, PhD, CDCES & Susan Guzman, PhD (Behavioral Diabetes Institute) that reveals psychosocial forces behind diabetes self-management — tools to break through resistance and inspire change.
Read more below
📜 Essentials
Registration
+ Printed Syllabus
$559.00
🌟 Deluxe
Essentials
+ ADA Standards Book
$589.00
🏆 Complete – Best Value!
Deluxe
+ ADCES Review Guide e-Book
$669.00
Transform how you engage patients with diabetes — master behavior change, reduce distress, and overcome medication hesitancy.
Why do so many patients know what they should do — but still struggle to do it?
The answer lies in the psychology of diabetes.
In this transformative full-day course, world-renowned experts William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, from the Behavioral Diabetes Institute reveal the hidden psychosocial forces that drive — or derail — diabetes self-management.
You’ll walk away with a completely new toolkit for breaking through patient resistance, dissolving medication hesitancy, and creating clinical encounters that actually inspire change!
For last week’s practice question, we quizzed participants on bolus insulin after meals. 65% 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.
JR tells you they inject 4-6 units of bolus insulin after meals based on how high the sensor readings go post meals. JR also takes 18 units basal insulin every morning. JR is 78 with type 2 diabetes for over 20 years and is very proud of their A1C of 6.9%.
What is the best action by the diabetes healthcare professional?
Answer A is incorrect. 4.98% chose this answer: “Discuss transitioning to an insulin pump to make managing their diabetes easier.” This is not the best answer. An insulin pump may be beneficial for some individuals requiring intensive insulin therapy, but there is insufficient information to justify recommending one. JR appears comfortable with the current regimen, is using relatively small bolus doses, and there is no indication of difficulty with injections, significant glucose variability, or frequent hypoglycemia. Recommending advanced technology wouldn’t be the best step before assessing JR’s individual needs and preferences.
Answer B is incorrect. 20.25% of you chose this answer, “Encourage JR to take bolus insulin before meals to improve glucose levels.” This answer is tempting. Administering bolus insulin before meals is generally recommended because it better matches postprandial glucose excursions and often results in improved glucose control. However, immediately advising this change overlooks the need to understand why JR doses after meals. Older adults may intentionally dose afterward because of unpredictable appetite, gastroparesis, or concerns about hypoglycemia if they do not finish a meal. Exploring these factors should occur before recommending changes.
Answer C is incorrect. 9.66% of respondents chose this: “Calculate insulin-to-carb ratio to help fine-tune bolus insulin dosing.” Another tempting answer. Determining an insulin-to-carbohydrate ratio can optimize mealtime insulin dosing, but there is no evidence that JR is counting carbohydrates or interested in this level of diabetes self-management. Many older adults with type 2 diabetes successfully use fixed-dose or simplified insulin regimens. Before introducing a more complex dosing strategy, the healthcare professional should assess JR’s goals, health literacy, meal patterns, and willingness to make changes.
Finally, Answer D is correct. 65.11% chose this answer, “Explore how JR thinks this management strategy is working.” Great job, you chose the correct answer! This best answer because it reflects person-centered care, shared decision-making, and assessment before making recommendations.
The scenario provides several clues that the healthcare professional should first understand why JR is using this strategy before suggesting changes.
The first step is to understand JR’s perspective and goals. Although taking rapid-acting insulin after meals is generally less effective than premeal dosing, JR has maintained an A1C of 6.7% and expresses pride in their management. At age 78 with a 20-year history of type 2 diabetes, an A1C below 7% may be tighter than necessary depending on comorbidities, functional status, and hypoglycemia risk.
Before recommending changes, the diabetes care professional needs to explore JR’s reasoning, assess for hypoglycemia, review CGM metrics (particularly time in range and time below range), and determine whether postmeal dosing is intentional (e.g., due to unpredictable intake or fear of hypoglycemia). This approach aligns with person-centered care and avoids making assumptions.
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!
🌟Updated Schedule: ADA Boot Camp, Tech, MNT & More
Live in Beautiful San Diego – Oct 22-23, 2026
Re-Ignite your Passion & Prepare for Diabetes Certification Exams
🎓 Earn 30+ CEs: AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
📅
2-Day Conference
Oct 22–23, 2026
⏱️
15.5 Live CEs
+ 17 bonus CEs
🏅
CDCES & BC-ADM
Exam Prep + Renewal
📍
San Diego, CA
1.7 mi from airport
The field of diabetes care is expanding and evolving rapidly. This unique training conference will keep you on the cutting edge plus prepare you for certification exams. It also fulfills the Standards of Care renewal requirement. Join us for two days of intensive education that is fun and inspiring. Add on the optional Day 3 (Engaging the Disengaged), to complete your conference exeperience.
Coach Beverly and Diana Isaacs, PharmD, BC-ADM, CDCES co-lead an exciting day that brings the ADA and AACE Standards to life. Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. After attending, you will be empowered to share the latest in diabetes care with your colleagues and the people in your care.
Take your knowledge to the next level with this intensive deep-dive into insulin therapy, dosing and pattern management with Dr. Diana Isaacs. Next, stay for the diabetes tech show-and-tell as Diana demonstrates the specs of the latest pumps and sensors. After lunch, nutrition whiz Christine Craig, MS, RDN, CDCES expertly details the latest in MNT and provides real strategies on translating this content to your clinical practice. You will have a chance to put it all together as Coach Beverly leads you through a series of case studies that integrates content from Day 1 and Day 2.
On Saturday, join this exceptional day-long program led by William H. Polonsky, PhD, CDCES & Susan Guzman, PhD (Behavioral Diabetes Institute) that reveals psychosocial forces behind diabetes self-management — tools to break through resistance and inspire change.
Read more below
📜 Essentials
Registration
+ Printed Syllabus
$559.00
🌟 Deluxe
Essentials
+ ADA Standards Book
$589.00
🏆 Complete – Best Value!
Deluxe
+ ADCES Review Guide e-Book
$669.00
Transform how you engage patients with diabetes — master behavior change, reduce distress, and overcome medication hesitancy.
Why do so many patients know what they should do — but still struggle to do it?
The answer lies in the psychology of diabetes.
In this transformative full-day course, world-renowned experts William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, from the Behavioral Diabetes Institute reveal the hidden psychosocial forces that drive — or derail — diabetes self-management.
You’ll walk away with a completely new toolkit for breaking through patient resistance, dissolving medication hesitancy, and creating clinical encounters that actually inspire change!
