Answer A is incorrect: 1% chose this answer, “Stress with R.S. the importance of never missing his meal time lispro to prevent diabetes-related complications.” R.S. is aware that his glycemic control is important, and he is already aware of the risk of diabetes-related complications. Counseling him on this would not help him be successful with his insulin management.  

Answer B is correct: 96% chose this answer, “Using open-ended questions, explore R.S.’s routine, stressors, and support systems to understand the barriers to his insulin use.” R.S. is struggling with barriers to successful insulin management.  A holistic approach would be to ask open-ended questions about his current routine, stressors, and support systems to gain a better understanding of these barriers. This information can lead to a personalized plan of care to help improve glycemic control. 

Answer C is incorrect: 2% chose this answer, “Recommend R.S. switch to another non-insulin medication to make his regimen easier for him to manage.” He has already attempted other non-insulin therapies, and these were either ineffective or not tolerated. Changing his regimen would not be successful at improving his glycemic control and quality of life.

Answer D is incorrect: 1% chose this answer, “Since it appears R.S. did not understand how to take his insulin lispro, write out step-by-step instructions on how to take the insulin.” R.S. appears to understand how to take his insulin lispro at meals. Writing out the instructions would not improve his situation. It is not a lack of knowledge, but the multiple barriers in his life that are keeping him from being able to implement this new medication regimen.  

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: % chose this answer, “It is recommended that insulin is always stored and kept refrigerated. Can you make
sure you pack your insulin with your lunch cooler pack?” While refrigeration is ideal for insulin storage, insulin does not always need to be refrigerated. Once in use, most insulins, including degludec, are stable at room temperature (below 86F or 30 C). Advising refrigeration may create unnecessary barriers and does not reflect degludec’s stability profile.

Answer B is incorrect: % chose this answer, “Consider storing insulin in your freezer to allow it to be kept cold and protected when
refrigeration is less reliable.” Freezing damages insulin molecules, making the insulin ineffective and unsafe to use. This option contradicts manufacturer and clinical safety guidance.

Answer C is correct: % chose this answer, “If bringing your insulin with you every day helps you remember to take it, it should be
okay to leave the pen you’re using in your workbag when at the office or at home.” Insulin degludec is stable at room temperature below 86°F (30°C) for up to 56 days (8 weeks) once opened. If SJ’s work bag is not exposed to excessive heat or freezing, keeping the pen there is acceptable and may in fact support consistent dosing. We can also calculate SJ’s monthly insulin pen usage (15 units per day + 2 unit prime per injection = 510 units per month or 2 pens per month), knowing he will easily use more insulin than open insulin pen stability time window.

Answer D is incorrect: % chose this answer, “Once open, insulin pens can be stored and used at room temperature for up to 28 days, you should be okay with bringing it with you in your work bag.” While it is correct that insulin does not always require refrigeration once in use, the specific duration varies by insulin type; degludec lasts longer than 28 days.

To learn more, check out our Insulin Storage Cheat Sheet.

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: % chose this answer, “Discuss the insulin pump options that connect with the Dexcom G7 CGM. This will help simplify her transition to pump therapy by minimizing the learning curve when starting an AID system.” Although some insulin pumps are compatible with the Dexcom CGM, switching to a different CGM supplier should not restrict clients from selecting the insulin pump that best suits their needs.

Answer B is incorrect: % chose this answer, “Acknowledge Grace’s interest in insulin pump technology and recommend that she wait until more advanced insulin pump algorithms are available that are easier to use.” Automated insulin delivery systems offer advanced automation. Waiting for future technology will not help Grace improve glycemic control now.

Answer C is incorrect: % chose this answer, “Recommend that Grace use a tubeless pump as it will suit her better due to her work as a nurse and active lifestyle. This will help to avoid tubing issues or the insertion site becoming dislodged.” The type of pump, with or without tubing, is a personal decision and is not based solely on occupation.

Answer D is correct: % chose this answer, “Review with Grace the details of all the available insulin pumps, algorithms, and compatible CGMs so she can make a personalized decision based on her preferences and lifestyle.” Choosing the right insulin pump is a highly personalized decision. Each insulin pump has different variables and CGM connectivity that must be considered. Grace will need to be educated on the available options so she can determine which insulin pump will work best for her.

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: % chose this answer, “Drink sugar-free cranberry juice a few times a week.” Scientific studies have yielded mixed and inconsistent results regarding the effectiveness of cranberry juice for prevention. MS needs an intervention that will provide ongoing relief.

Answer B is correct: % chose this answer, “Apply topical vaginal estrogen cream.” Vaginal estrogen cream can help prevent recurrent urinary tract infections (UTIs) in postmenopausal women by restoring the health of vaginal and urinary tissues. Estrogen helps restore a healthy vaginal pH, increases beneficial bacteria, and improves circulation, creating an environment that is less hospitable to uropathogens. It is a non-antibiotic option recommended by medical societies and is associated with a significant reduction in rUTIs.

Answer C is incorrect: % chose this answer, “Get A1C below 7% by adding basal insulin.” Getting A1C to target can reduce risk of infections, but MS A1C is already close to target. They need an effective treatment for their frequent UTI’s.

Answer D is incorrect: % chose this answer, “Evaluate MS for autoimmune conditions.” Frequent UTIs are not usually associated with autoimmune conditions. MS needs an effective treatment for their frequent UTI’s.

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!

Learn more about HRT and UTIs in our blog “Hormone Replacement Therapy (HRT) – What You Need to Know”