For last week’s practice question, we quizzed participants on what the next step should be for too much weight loss. 87% 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 is a 68-year-old with type 2 diabetes who started semaglutide (Ozempic) 5 months ago and now takes 2.0mg weekly. Their A1C has decreased from 8.2% to 6.4%, and they have lost 24 pounds (11% of their initial body weight). JR is pleased with their improved glucose levels but concerned about their declining strength and lack of appetite.
Which of the following is the most appropriate next step for the diabetes care and education specialist?
- A. Explain that muscle loss is expected with GLP-1 therapy and encourage JR to continue their current eating pattern with a focus on protein intake.
- B. Recommend increasing fluid and carbohydrate intake to prevent further weight loss while maintaining the current semaglutide dose.
- C. Suggest discontinuing semaglutide immediately and initiating basal insulin to prevent further muscle loss.
- D. Collaborate with JR and provider to reassess GLP-1 therapy and refer JR to an RDN for MNT.
Getting to the Best Answer
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. 8.85% chose this answer: “Explain that muscle loss is expected with GLP-1 therapy and encourage JR to continue their current eating pattern with a focus on protein intake.”
Although some lean body mass loss may accompany weight reduction, clinically meaningful muscle weakness and functional decline is not acceptable or inevitable consequences of GLP-1 therapy. JR’s symptoms warrant prompt assessment and intervention to prevent further loss of strength, mobility, and independence.
Answer B is incorrect. 1.77% of you chose this answer, “Recommend increasing fluid and carbohydrate intake to prevent further weight loss while maintaining the current semaglutide dose.”
Increasing carbohydrate intake alone does not adequately address JR’s nutritional deficiencies or declining muscle function. The focus should be on sufficient total energy, high-quality protein, and nutrient-dense foods. The current medication regimen should also be reassessed in light of JR’s reduced appetite and functional decline.
Answer C is incorrect. 2.21% of respondents chose this: “Suggest discontinuing semaglutide immediately and initiating basal insulin to prevent further muscle loss.”
Automatically discontinuing GLP-1 therapy and replacing it with insulin is not an evidence-based strategy for treating sarcopenia. JR’s glucose management has improved, and semaglutide may continue to provide important cardiometabolic benefits. The healthcare team should assess the severity of nutritional compromise, consider dose adjustment or discontinuation when clinically indicated, and implement interventions to improve muscle health. Insulin does not directly treat sarcopenia.
Finally, Answer D is correct. 87.17% chose this answer, “Collaborate with JR and provider to reassess GLP-1 therapy and refer JR to an RDN for MNT.” Great job, this is the best answer!
Although GLP-1 receptor agonists can provide substantial glycemic and cardiometabolic benefits, reduced appetite and early satiety may contribute to inadequate energy and protein intake. Rapid or substantial weight loss can include loss of lean body mass, particularly in older adults. The priority is to preserve muscle strength and function while maintaining the benefits of diabetes treatment. A comprehensive approach includes assessing nutritional adequacy, referring to an RDN for individualized energy and protein recommendations, incorporating progressive resistance training as tolerated, and collaborating with the prescribing provider to evaluate whether the current GLP-1 dose remains appropriate.
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?
Join Dr. Marie Frazzitta on November 12th, 2026, at 11:30 am PST
Leading the Digital Quality Transformation: Advanced Strategies for Diabetes Professionals
The U.S. healthcare system is rapidly shifting toward digital quality reporting, transforming how diabetes outcomes are measured, reimbursed, and improved.
In this 1-hour and 15-minute program. Dr. Marie Frazzitta, DNP, FNP‑C, PMHNP, CDCES, MBA, explores how national quality initiatives are modernizing diabetes metrics, including the integration of CGM-derived indicators and the upcoming measure that will track CGM adoption. We’ll also highlight the operational realities of digital reporting and show how DCESs can leverage these trends to expand their impact, strengthen care equity, and become strategic partners in quality improvement and population health.
