CS is a 42-year-old with type 1 diabetes for just over 18 years. In the past year, their A1C changed from 7.4% to 9.1%, and weight increased by 20 pounds. Review of CGM data suggests missed insulin boluses more than 7 times per week, and discussion with CS reveals missed clinic visits due to feeling “burned out”. They score in the moderate range on the Diabetes Distress Scale.
Based on the ADA 2026 Standards of Care, which of the following is the most appropriate next step?
- Partner with CS to reduce missed boluses and reassess in 3 months.
- Simplify regimen to support current state of diabetes distress.
- Refer to a qualified behavioral health professional for evaluation and treatment.
- Recommend referral to MNT for a structured weight-loss program.
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