Answer A is incorrect: % chose this answer, “Partner with CS to reduce missed boluses and reassess in 3 months.” Answer A is incorrect as it is not the best answer. 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: % chose this answer, “Simplify regimen to support current state of diabetes distress.” Answer B is incorrect; it is not the best answer. 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: % chose this answer, “Refer to a qualified behavioral health professional for evaluation and treatment.” Answer C is correct. 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: % chose this answer, “Recommend referral to MNT for a structured weight-loss program.” Answer D is incorrect. 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!