For last week’s practice question, we quizzed test takers on the best blood sugar fix. 64% of respondents chose the best answer. We want to 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 below: Answer Question

Question: LS wears an insulin pump and uses lispro insulin. LS has an average basal rate of 0.6 units and hour, a 1:15 carb ratio and a 1:50 correction ratio.  Based on the ambulatory glucose profile, LS is experiencing elevated glucose levels from 4am to 7am. To get glucose to target, what is the best next step?

Answer Choices:

1. Add basal insulin glargine to prevent Somogyi effect
2. Make sure LS isn’t consuming carbohydrates after 10pm
3. Ask LS to double check their CGM insertion site
4. Increase the basal rate to prevent glucose elevations  

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As shown above, the most common choice was option 4, the second most common answer was option 1, then option 2, and finally 3.

Getting to the Best Answer

Answer 1 is incorrect. 16.26% chose this answer, “Add basal insulin glargine to prevent Somogyi effect.” Since LS uses an insulin pump, they don’t need to inject additional basal insulin (glargine) to get overnight blood sugars to target. With an insulin pump, the bolus insulin (lispro) acts as the basal insulin, delivering background insulin at 0.6 units an hour. In addition, Simogyi is defined as rebound hyperglycemia, or the sudden increase in blood sugars, due to stress hormones, after a significant hypoglycemic event. There is no symptoms in the question that indicate that LS is experiencing a Somogyi event. This is a juicy answer, but on closer inspection, not the best one.

Answer 2 is incorrect. 14.63% of you chose this answer, “Make sure LS isn’t consuming carbohydrates after 10pm.” Based on the glucose profile, LS blood sugars are increasing around 4am, which is most likely due to the Dawn Phenomena, not late night snacking. In the middle of the night, the body starts releasing growth hormone cortisol, and catecholamines, which causes an increase in blood sugars around 4am for many people with type 1 diabetes. This is referred to as the Dawn Phenomena. The best way to manage this is to slightly increase basal rate during the period when blood sugar is on the rise.

Answer 3 is incorrect. 4.88% of respondents chose this answer, “Ask LS to double check their CGM insertion site.” While it’s always good to check to make sure devices are working properly, this isn’t the case for this question. LS is having consistent glucose elevations from 4am to 7am, which is commonly referred to as the Dawn Phenomena. In the middle of the night, the body starts releasing growth hormone cortisol, and catecholamines, which causes an increase in blood sugars around 4am for many people with type 1 diabetes. The best way to manage this is to slightly increase basal rate during the period when blood sugar is on the rise.

Finally, Answer 4 is correct. 64.23% chose this answer, “Increase the basal rate to prevent glucose elevations.” YES, GREAT JOB. LS is having consistent glucose elevations from 4am to 7am, which is commonly referred to as the Dawn Phenomena. In the middle of the night, the body starts releasing growth hormone cortisol, and catecholamines, which causes an increase in blood sugars around 4am for many people with type 1 diabetes. The best way to manage this is to slightly increase basal rate during the period when blood sugar is on the rise.

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Want to learn more about this question? Join us for our upcoming webinar

Test Taking Practice Exam Toolkit | FREE Webinar 

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Learn Test-Taking Secrets with Coach Bev – Option to add on 200+ Computerized Practice Test Questions for $49

During this webinar, Coach Beverly will help you transform your nervousness into focused energy that will help you succeed. She will provide test-taking tips based on her experience taking the certification exam six times.  

To provide plenty of practice, Coach Beverly will sample 20 test questions that have been plucked from our Test Taking Toolkit during this live webinar.

She will explain how to dissect the question, eliminate wrong answers and avoid getting lured in by juicy answers.

Two Ways to Join

Includes a review of 20 sample test questions with test taking strategies.

This includes access to the recorded version of this webinar on your Online University Student Portal.

Plus, the Test Taking Toolkit provides you with over 200+ sample online practice questions, simulating the exam experience.

A perfect way to assess your knowledge and create a focused study plan, while increasing your test-taking confidence.

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• Q & A Session with the instructor after each webinar.
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• Resources for each session.
• Access to free podcasts and video recordings within a week of each live session for one year.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

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