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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
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:
- Recommend the DASH Diet.
- Measure natriuretic peptide (BNP or pro-BNP).
- Assess ankle circumference at each visit.
- Recommend echocardiography after age 55.
Getting to 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
- 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
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:
- Sit more than eight hours a day and have a sedentary lifestyle.
- Have a history of thyroid or celiac disease.
- Consume a diet with high amounts of simple carbohydrates.
- Have fasting plasma glucose of 110–125 or A1C ≥6.0%.
Getting to 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
- 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
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:
- basal insulin doses exceeding 0.5 units/kg/day
- significant bedtime-to-morning or postprandial-to-preprandial glucose differential
- low glycemic variability
- basal insulin dose exceeding 50 units twice per day
Getting to 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!
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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!
Rationale of the Week | ADA Standards identify another 1st Line med to treat kidney disease. Which one?
For last week’s practice question, we quizzed participants on ADA Standards identify another 1st line med to treat kidney disease. 63.39% 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
Question:
According to the ADA 2025 Standards, new clinical trials suggest that another diabetes medication (besides SGLT-2i) can be used as a first line agent to treat chronic kidney disease.
Which of the folowing diabetes meds is effective as a first-line agent for people with CKD?
Answer Choices:
- Afrezza inhaled insulin
- Semaglutize (Ozempic)
- Amylin (Pramlintide)
- Sitagliptin (Januvia)
Getting to the Best Answer
Answer 1 is incorrect. 2% chose the answer, Afrezza inhaled insulin. Insulin helps lower blood glucose levels, which contributes to improved overall vessel health. However, there are currently no specific studies supporting the use of Afrezza as a first-line treatment strategy for managing chronic kidney disease.
Answer 2 is correct. 63.39% of you chose this answer the best answer, semaglutide (Ozempic). GREAT JOB! According to the 2025 ADA Standards, “a recent clinical trial suggests that the GLP-1 RA semaglutide has a beneficial effect on CVD, mortality, and kidney outcomes among people with Chronic Kidney Disease (CKD), leading to the recommendation that semaglutide can be used as another first-line agent for people with CKD.”
Answer 3 is incorrect. About 12.34% of respondents chose Amylin (Pramlintide). Amylin is an injected hormone mimetic that helps lower blood glucose levels. However, there are currently no specific studies supporting the use of Amylin as a first-line treatment strategy for managing chronic kidney disease.
Finally, Answer 4 is incorrect. 22.38% chose this answer, Sitagliptin (Januvia). Sitagliptin helps lower A1C levels by 0.5-0.7%. However, there are currently no specific studies supporting the use of sitagliptin as a first-line treatment strategy for managing chronic kidney disease.
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 Standards of Care Course
This is our most popular course of the year, offering the perfect opportunity to immerse yourself in the essential content featured in this comprehensive 300-page clinical guidebook.
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Rationale of the Week | Diabetes & Malnutrition Risk
For last week’s practice question, we quizzed participants on Diabetes & Malnutrition Risk 74.26% 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
Question: The 2025 ADA Standards of Care have added recommendations for malnutrition screening.
According to these updated standards, who could be at risk for malnutrition?
Answer Choices:
- An individual with a BMI of 38 and 21% weight loss in the past 6 months.
- An individual on incretin therapy with intentional 18-pound weight loss in the past 2 months.
- An 86-year-old with type 1 diabetes and reported recent decline in activity and strength.
- All the above
Getting to the Best Answer
Answer 1 is incorrect. 10.54% chose this answer: “An individual with a BMI of 38 and 21% weight loss in the past 6 months”. Although Answer A is true, it is not the best answer. Malnutrition risk is not solely based on BMI. According to the 2025 ADA Standards of Care, individuals with diabetes experiencing significant weight loss, greater than 20%, may be at risk for malnutrition regardless of starting BMI.
Answer 2 is incorrect. 4.90% of you chose this answer: “An individual on incretin therapy with intentional 18-pound weight loss in the past 2 months.” This answer is also true, but there is a better answer. Even though the weight loss was intentional on incretin therapy, a rapid drop in weight, more than 4 kg/month, can still place an individual at risk for malnutrition. Monitoring nutrition status during weight loss pharmacotherapy is essential.
Answer 3 is incorrect About 10.29% of respondents chose this: “An 86-year-old with type 1 diabetes and reported recent decline in activity and strength”. This answer is true but not the best answer. Older adults, especially those with type 1 diabetes, are at greater risk for malnutrition, particularly when they experience declines in physical activity and strength. Malnutrition and sarcopenia, a loss of lean body mass, may develop simultaneously.
Finally, Answer 4 is correct. 74.26% chose this correct answer – GREAT JOB! All these scenarios indicate an increased risk of malnutrition and warrant additional screening. The ADA Standards of Care emphasize screening for malnutrition in individuals who have lost significant weight, especially individuals’ post-metabolic surgery, on incretin therapy, and individuals managing multiple chronic conditions who may experience an increased risk of developing sarcopenia and malnutrition. Check out the 2025 ADA Standards of Care Section 5 and Section 8 for the latest on malnutrition screening recommendations.
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?
Join us live on Jan. 30th for our
Standard of Care Course
Level 2
Diabetes Education Services Online University Courses are an excellent way to study for your exam anytime and anywhere that is convenient for you. You will have immediate access to your courses for 1 year after your purchase date. Each online course includes a: video presentation, podcast, practice test, and additional resources.
This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the annual updates to the American Diabetes Association’s (ADA) Standard of Medical Care in Diabetes & provides critical teaching points & content for healthcare professionals involved in diabetes care & education.
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Rationale of the Week | Best Meds to Treat MASH – 2025 Standards
For last week’s practice question, we quizzed participants on best meds to treat MASH. 64% 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
Question: In the 2025 ADA Standards, they have updated the term Non-Alcoholic Steatohepatitis (NASH) to Metabolic Associated Steatohepatitis (MASH). They also recommend pharmacologic agents along with lifestyle interventions to treat people with diabetes and MASH.
Which of the following are the recommended diabetes medications to treat MASH?
Answer Choices:
- Vitamin E and SGLT-2
- Pioglitazone and/or GLP-1 RA / GIP
- Fish oil supplements and statin
- Metformin and/or bolus insulin therapy
Getting to the Best Answer
Answer 1 is incorrect. 14.93% chose this answer. “Vitamin E and SGLT-2.” While SGLT-2’s will help lower glucose levels and may result in some weight loss, the ADA does not recognize it as a treatment for steatosis. As far as Vitamin E, according to the ADA 2025 Standards, “it may be beneficial for the treatment of MASH in people without diabetes. However, in people with type 2 diabetes, vitamin E monotherapy was found to be ineffective in a small RCT, and it did not seem to enhance pioglitazone’s efficacy when used in combination, as reported in an earlier trial in this population.
Answer 2 is correct. 63.81% of you chose this answer. “Pioglitazone and/or GLP-1 RA / GIP.” GREAT JOB, this is the best answer. According to the ADA Standards In adults with type 2 diabetes with biopsy-proven MASH or those at high risk for liver fibrosis (based on noninvasive tests), pioglitazone, a GLP-1 RA, or a dual GIP and GLP-1 RA is preferred for glycemic management because of potential beneficial effects on MASH.
Answer 3 is incorrect. About 12.69% of respondents chose this. “Fish oil supplements and statin.” Part of this answer is correct. Based on the 2025 ADA Standards, “Statin therapy is safe in adults with type 2 diabetes and compensated cirrhosis from MASLD and should be initiated or continued for cardiovascular risk reduction as clinically indicated. In people with decompensated cirrhosis, statin therapy should be used with caution, and close monitoring is needed, given limited safety and efficacy data. However, the ADA does not recommend fish oil supplements to treat MASH.
Finally, Answer 4 is incorrect. 8.58% chose this answer. “Metformin and/or bolus insulin therapy.” Although metformin therapy and insulin are effective at addressing insulin resistance and lower glucose levels, they are not first line recommended agents to treat MASH.
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?
Join us for this upcoming webinar!
Test Taking Practice Exam Toolkit
Jan. 13th @ 11:30am PST
You are invited to join Coach Beverly for this FREE Webinar. And, if you want to have access to an additional 220+ sample practice online questions, you can purchase the complete Test Taking Toolkit.
For many of us, taking the certification exam is a nerve-wracking process
During this webinar, Coach Beverly will help you transform your nervousness into focused energy that will help you succeed. She will provide test-taking tips based on her experience taking the certification exam six times.
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Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Rationale of the Week | What do the NEW 2025 ADA Standards Say?
For last week’s practice question, we quizzed participants on 2025 ADA Standards & hyperglycemic crises. 43% 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
Question: What do the NEW 2025 ADA Standards Say?
According to the Newly Published 2025 Standards of Care, which of the following statements reflect the latest guidelines to treat hyperglycemic crises?
Answer Choices:
- Administer low dose basal insulin analog in addition to intravenous insulin infusion to improve glucose management.
- If serum pH is below 7.4, administer IV bicarb, along with a glucose infusion to resolve severe acidosis.
- To differentiate between DKA and HHS, the most important lab indicators are the anion gap and glucose levels.
- Lactated Ringers is now the preferred intravenous solution for fluid resuscitation.
Getting to the Best Answer
Answer 1 is correct. 43.04% chose this answer. “Administer low dose basal insulin analog in addition to intravenous insulin infusion to improve glucose management.” YES, great job, this is the best answer. According to ADA Standard 16 on Hospital Care, “Studies have reported that the administration of a low dose of basal insulin analog in addition to intravenous insulin infusion may prevent rebound hyperglycemia without increased risk of hypoglycemia.”
Answer 2 is incorrect. 19.59% of you chose this answer. “If serum pH is below 7.4, administer IV bicarb, along with a glucose infusion to resolve severe acidosis.” Since this pH is in the normal range, this person is not in ketoacidosis. According to ADA Standard 16 on Hospital Care, “Several studies have shown that the use of bicarbonate in people with DKA made no difference in the resolution of acidosis or time to discharge, and its use is generally not recommended.”
Answer 3 is incorrect. About 20.10% of respondents chose this. “To differentiate between DKA and HHS, the most important lab indicators are the anion gap and glucose levels.” According to the 2024 Consensus Statement, to differentiate between the two conditions, the most decisive lab indicators are beta hydroxybutyrate or urine ketones to verify insulin deficiency along with pH levels to verify acidosis and osmolality to determine hydration status in HHS.
Finally, Answer 4 is incorrect. 17.27% chose this answer. “Lactated Ringers is now the preferred intravenous solution for fluid resuscitation.” According to the 2024 Consensus Statement, Normal saline or Ringer’s lactate are both accepted IV rehydration solutions.
You are invited to register for our Hyperglycemic Crises – New criteria and treatment guidelines for DKA, Euglycemic DKA and HHS | 1.25 CE – Recorded and Ready for Viewing.
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?
Join us live on Jan 30, 2025 for our
ADA Standards of Care
Level 2 | Standards of Care Intensive
This course, updated annually, is an essential review for anyone in the field of diabetes. Join Coach Beverly as she summarizes the annual updates to the American Diabetes Association’s (ADA) Standard of Medical Care in Diabetes & provides critical teaching points & content for healthcare professionals involved in diabetes care & education.
Objectives:
- A review of changes & updates to the annual ADA Standards of Medical Care in Diabetes.
- Identification of key elements of the position statement.
- Discussion of how diabetes educators can apply this information in their clinical setting.
Learning Outcome: Participants will identify updates and articulate recommendations from the 2024 ADA Standards of Care that can be applied to their practice.
Target Audience: This course is a knowledge-based activity designed for individuals or groups of diabetes professionals, including RNs, RDs/RDNs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other healthcare providers interested in staying up to date on current practices of care for people with prediabetes, diabetes, and other related conditions. The practice areas for RDs/RDNs for CDR reporting are healthcare, preventative care, wellness, and, lifestyle along with, education and research.
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For more information or any questions, please email [email protected].
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Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
Rationale of the Week | Low carb diets and SGLT-2’s a good mix?
For last week’s practice question, we quizzed participants on SGLT-2’s & low carb diets. 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
Question: ST is a 56-year-old presenting for MNT and diabetes education. Their last A1c was 7.4%, and they are currently taking 1000 mg of Metformin and 10 mg of empagliflozin daily for glucose management. They recently read that a very low-carbohydrate eating pattern can help individuals with type 2 diabetes reduce A1C and the need for additional medications and are motivated to implement diet changes.
What would be your primary considerations and guidance in response to ST?
Answer Choices:
- ST is motivated for change, encourage their desire to implement a very low-carbohydrate diet as it is safe for all individuals with diabetes.
- ST should avoid a very low-carbohydrate diet.
- A very low-carbohydrate diet may be appropriate if ST transitions off the SGLT2 inhibitor.
- ST should follow a fixed carbohydrate intake at each meal to align with their medication regimen.
Getting to the Best Answer
Answer 1 is incorrect. 10.61% chose this answer. “ST is motivated for change, encourage their desire to implement a very low-carbohydrate diet as it is safe for all individuals with diabetes.” While very-low-carbohydrate diets has evidence for reducing A1c and need for additional medications, they may not be universally safe for all individuals. Keep reading to learn more.
Answer 2 is incorrect. 12.77% of you chose this answer. “ST should avoid a very low-carbohydrate diet.” A very-low-carbohydrate diet is not inherently contraindicated for individuals with diabetes, but careful planning and potential discontinuation of the SGLT2 inhibitor is recommended to reduce the risk of euglycemic ketoacidosis.
Answer 3 is correct. About 59.53% of respondents chose this. “A very low-carbohydrate diet may be appropriate if ST transitions off the SGLT2 inhibitor.” Use SGLT2 inhibitors with caution when implementing a low carbohydrate diet and strong consideration should be made to cease this medication if implementing a very low carbohydrate diet, less than 50 grams of carbohydrate per day. Very low carbohydrate diets may increase the risk of euglycemic ketoacidosis by lowering insulin levels. After additional clinical review, a very-low-carbohydrate diet can be considered for ST if they transition off the SGLT2 inhibitor. Educating ST about the difference between physiological ketosis and pathological ketoacidosis may also be considered.
Finally, Answer 4 is incorrect. 17.09% chose this answer. “ST should follow a fixed carbohydrate intake at each meal to align with their medication regimen.” While fixed carbohydrate intake can sometimes simplify diabetes management, it does not align with ST’s interest in very-low-carbohydrate eating patterns. The current medication regimen does not necessarily require a fixed carbohydrate plan. Simply educating on this approach without additional shared decision making may not provide an individualized dietary intervention.
Reference: American Diabetes Association Professional Practice Committee; 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024. Diabetes Care 1 January 2024; 47 (Supplement_1): S77–S110. https://doi.org/10.2337/dc24-S005
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?
Check out these upcoming class offerings!
All hours earned count toward your CDCES Accreditation Information
Sign up for Diabetes Blog Bytes – we post weekly Blog Bytes that are informative and FREE! Every week we post one exam practice Question of the Week and Rationale of the Week. Sign up below!
The use of DES products does not guarantee the successful passage of the certification exam. CBDCE and ADCES do not endorse any preparatory or review materials for the CDCES or BC-ADM exams, except for those published by CBDCE & ADCES.
