Answer A is incorrect: 14.66% chose this answer, “Partner with CS to reduce missed boluses and reassess in 3 months.” While reducing missed boluses and optimizing insulin therapy are essential to support A1c reduction, this intervention alone does not address the likely underlying psychological barriers to self-management.

Answer B is incorrect: 31.1% chose this answer, “Simplify regimen to support current state of diabetes distress.” While simplifying insulin dosing may be supportive in some cases, without addressing the underlying diabetes distress it is unlikely to achieve sustained improvement.

Answer C is correct: 50.55% chose this answer, “Refer to a qualified behavioral health professional for evaluation and treatment.” The 2026 ADA Standards of Care recommends a referral to a qualified behavioral health professional for evaluation and treatment when diabetes distress, burnout, reduced engagement in diabetes management or other psychosocial factors are impacting self-care and glycemic targets. ¹

Answer D is incorrect: 3.7% chose this answer, “Recommend referral to MNT for a structured weight-loss program.” Focusing solely on weight loss does not address the primary psychosocial barriers and weight gain may be a symptom of underlying behavioral health needs. Evaluation and treatment from a behavioral health provider would be the most appropriate next step.

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: 12.89% chose this answer, “Turn on her CGM alarms but increase the high alarm so she doesn’t get as many
hyperglycemia related alerts.” Helping Katie turn on and increasing her high alarm will not help improve her glycemic management. 

Answer B is correct: 76.5% chose this answer, “Show her step-by-step how to use the app and how to troubleshoot the alerts and alarms.” Guiding Katie through the CGM app and its functions helps her ask questions, resolve issues, and better monitor her glycemic management.

Answer C is incorrect: 9.46% chose this answer, “Have the school nurse monitor her CGM trends when Katie is at school, since her mom monitors the CGM trends when she is at home.” Asking the school nurse to monitor CGM data while Katie is at school is not helping to improve Katie’s self-management skills.

Answer D is incorrect: 1.15% chose this answer, “Email Katie’s mother once a week for updates to make sure she is monitoring CGM
trends.” Emailing Katie’s mother does not help improve Katie’s CGM self-monitoring skills or her confidence level with the CGM app.

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: 14.85% chose this answer, “BMI and activity level.” This answer is incorrect but tempting. BMI level is used as a a screening tool for prediabetes and diabetes risk, but is not included as a factor contributing to secretory defects. According to the ADA, there are four factors related to insulin secretory defects in type 2 diabetes. They include; genetics, epigenetics, metabolic stress and inflammation.

Answer B is incorrect: 16.92% chose this answer, “Lifestyle and inflammation.” This juicy answer is incorrect.  Lifestyle is not a direct factor related to insulin secretory defects, but inflammation is a contributor. According to the ADA, there are four factors related to insulin secretory defects in type 2 diabetes. They include; genetics, epigenetics, metabolic stress and inflammation.

Answer C is incorrect: 25.75% chose this answer, “Genetics and visceral adipose distribution.” This answer is incorrect. Visceral adiposity is associated with an increased risk for diabetes, but does not contribute to insulin secretory defects. According to the ADA, there are four factors related to insulin secretory defects in type 2 diabetes. They include; genetics, epigenetics, metabolic stress and inflammation.

Answer D is correct: 42.48% chose this answer, “Epigenetics and metabolic stress.” This answer is correct, GREAT JOB! According to the ADA, there are four factors related to insulin secretory defects in type 2 diabetes. They include; genetics, epigenetics, metabolic stress and inflammation.

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!