For last week’s practice question, we quizzed participants on in-patient diabetes care. 42% 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 below: Answer Question

Question: JR was admitted to the hospital with an infection and newly discovered diabetes. To get glucose to ADA target range for hospitalized individuals, JR was started on 12 units of basal insulin plus bolus insulin with meals. JR experienced a morning BG of 87 mg/dL, so the provider decreased the basal insulin to 9 units. JR’s morning blood sugar the next day was 157 mg/dL. 

What is the best action?

Answer Choices:

1. Increase basal insulin by 10- 20%.
2. Intensify correction scale.
3. Continue with same basal dose.
4. Ask MS if they are snacking during the night before making adjustments.

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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 1 is incorrect. 23.23% chose this answer. “Increase basal insulin by 10- 20%.” This is a juicy answer because we typically consider the target glucose range 80-130 fasting and before meals. However, according to ADA Standards, the target glucose range during hospitalization is 140-180 mg/dL in general, and 100-180mg/dL in the non-critical care setting. Based on these inpatient goals, we wouldn’t need to increase basal insulin since JR’s morning glucose of 157 is right on target.

Answer 2 is incorrect. 10.17% of you chose this answer. “Intensify correction scale.” Another juicy answer because we typically consider the target glucose range 80-130 fasting and before meals. However, according to ADA Standards, the target glucose range during hospitalization is 140-180 mg/dL in general, and 100-180mg/dL in the non-critical care setting. Based on these inpatient goals, we wouldn’t need to intensify the correction scale since JR’s morning glucose of 157 is right on target. In addition, correction insulin doesn’t have much impact on fasting glucose. That’s the job of basal insulin.

Answer 3 is correct. About 41.52% of respondents chose this. “Continue with same basal dose.” YES, this is the BEST answer. According to ADA Standards, the target glucose range during hospitalization is 140-180 mg/dL in general, and 100-180mg/dL in the non-critical care setting. Based on these inpatient goals, we wouldn’t need to intensify the basal insulin since JR’s morning glucose of 157 is right on target.

Finally, Answer 4 is incorrect. 25.08% chose this answer. “Ask MS if they are snacking during the night before making adjustments.” Another juicy answer. It doesn’t really matter if MS was snacking, since according to ADA Standards, the target glucose range during hospitalization is 140-180 mg/dL in general, and 100-180mg/dL in the non-critical care setting. Based on these inpatient goals, regardless of whether or not they were snacking, JR’s morning glucose of 157 is right on target.

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!

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Want to learn more about this question? Enroll in our

Level 2 | Hospitals & Hyperglycemia | 1.5 CEs

 

Research clearly demonstrates the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge. This course reviews the evidence that supports inpatient glucose control & outlines practical strategies to achieve targets in the inpatient setting. We incorporate the latest American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes & provide links to resources & inpatient management templates.

Objectives:

1. Describe the impact of hyperglycemia in the hospital setting.
2. Discuss the importance of inpatient glucose control.
3. List three strategies to get glucose to goal in the hospital setting.

Intended Audience: A great course for healthcare professionals seeking strategies to manage and improve inpatient diabetes care.

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

All hours earned count toward your CDCES Accreditation Information

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The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.