Answer A is incorrect: 16.58% chose this answer, “The recommended time in range is >70% within 70–180 mg/dL. MT’s TIR is slightly below target and her time below range is above the recommended targets, indicating adjustments are needed to reduce hypoglycemia.” Answer A is incorrect. The answer uses non-pregnancy CGM target range of 70–180 mg/dL. Pregnancy target range for individuals with type 1 diabetes are lower, keep reading for the best answer.

Answer B is correct: 51% chose this answer, “The recommended time in range is >70% within 63–140 mg/dL; MT’s TIR is slightly below target and her time below and above range is above the recommended goal.” Answer B is correct. Based on the 2025 ADA Standards of Care the recommended time in range targets for individuals with type 1 diabetes during pregnancy is >70% between 63-140 mg/dL, < 4% under 63 mg/dL with < 1 % under 54 mg/dL, and < 25% over 140 mg/dL.

Answer C is incorrect: 19.55% chose this answer, “The recommended time in range is >80% within 63–140 mg/dL; MT’s TIR is below target, with fluctuations of hypo and hyperglycemia.” Answer C is incorrect. The time in range target is above the evidenced-based
minimum and MT is having frequent hypoglycemia in addition to hyperglycemia, both outside the goal ranges.

Answer D is incorrect: 12.87% chose this answer, “The recommended time in range is >80% within 70–180 mg/dL to prevent fetal
complications; MT’s TIR is significantly below the recommended Standard of Care target.” Answer D is incorrect. The recommended target range for individuals with type 1diabetes during pregnancy is 63-140 mg/dL as stated above.

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!

Answer A is incorrect: 15.69% chose this answer, “Next time, make sure to take your insulin and put it in the refrigerator for safekeeping.” This approach goes under the compliance model, where the healthcare professional only provides one way instruction without considering the individuals insights and problem solving skills. We want to work toward a person-centered collaborative approach to foster connection.

Answer B is correct: 63.10% chose this answer, “Before we dive into the diabetes stuff, tell me about your fishing trip.” Great job! This is the best answer. By asking RT about their fishing trip first, you let them know you are interested in their life experiences and this helps to establish a connection. After hearing about the trip, we might pivot and say something like, “Do you want to discuss strategies to bring your insulin on your next fishing trip?”

Answer C is incorrect: 9.27% chose this answer, “I’m worried that you’re going get complications due to high blood glucose levels.” Although this statement shows concern, it is unlikely that RT will get diabetes complications from not taking their insulin for a few days. This statement could lead to feelings of shame and failure, and may close the door to making a meaningful connection.

Answer D is incorrect: 11.94% chose this answer, “I’m just relieved you did not go into diabetes ketoacidosis.” This statement could evoke feelings of guilt and shame, that could close the door to future communication. And if RT has type 2 diabetes, the chance of DKA is minimal. Instead of focusing on the HCP feelings, let’s check in with RT and explore problem solving strategies for future trips that would work for them.

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!

Answer A is incorrect: 0% chose this answer, “Reassure Kyle that retinopathy is very common with type 2 diabetes. Encourage him to verify the CGM with his glucometer more frequently if that helps make him feel less anxious.” This is incorrect. Although diabetes retinopathy is a common complication of diabetes, it is not inevitable, and the risk can be reduced by maintaining optimal glycemic control. Additionally, verifying blood glucose levels with a glucometer when there appears to be no issue with his CGM will not alleviate his anxiety.

Answer B is incorrect: 0% chose this answer, “Educate Kyle that the CGM he is using cannot be calibrated and instruct him to stop using his glucometer, since the CGM is accurate.” This is incorrect. Though his particular CGM cannot be calibrated, fingerstick blood glucose readings are the gold standard when CGM readings are unexpectedly out of range.

Answer C is correct: 99.36% chose this answer, “Acknowledge Kyle’s fears about vision loss, screen for diabetes distress, and collaborate on strategies to reduce the emotional burden of CGM use, including referral to a behavioral health provider if indicated.” This is correct. Kyle is demonstrating symptoms of diabetes distress due to fear of ocular complications, perfectionism, and technology overwhelm. The ADA Standards of Care 2025 recommend routine screening for diabetes distress and other psychosocial concerns at least annually or when complications arise.

Answer D is incorrect: 0.64% chose this answer, “Adjust Kyle’s time in range target goal to >90% to meet his expectations and reduce his worry about complications.” This is incorrect: The time in range goal for most adults living with diabetes is >70%. Adjusting his time-in-range goal to >90% will not work to reduce his obsessive behavior.

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!