For last week’s practice question, we quizzed participants on getting A1C to goal. 65% 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: AR’s has an A1C of 7.5% and is taking empagliflozin (Jardiance) 10mg daily, plus trying to eat healthy and ride their bike 4-5 days a week for 30 minutes.  The provider suggests increasing the empagliflozin dose to 25mg to get the A1C below 7%.  AR says that they don’t want to increase their medication dose and says they are dedicated to lowering their A1C through more activity. 

Based on this scenario, what ADA recommended activity addition or change would help AR reach their A1C target?

Answer Choices:

1. Consistently decrease portion size and increase vegetable intake.
2. Ask AR if they can increase bike riding to daily.
3. Explore addition of twice weekly strength training.
4. Encourage AR to reconsider increasing empagliflozin dose.

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. 13.09% chose this answer. “Consistently decrease portion size and increase vegetable intake.” This juicy answer is tempting, since it addresses portion size and includes more vegetable intake. However, it is not the best answer since it doesn’t match AR’s stated goal that “they are dedicated to lowering their A1C through more activity.”

Answer 2 is incorrect. 14.42% of you chose this answer. “Ask AR if they can increase bike riding to daily.” Based on the ADA Standards, individuals are encouraged to maintain 150 minutes of activity a week, plus strengthening activities twice weekly. Asking AR to increase bike to riding to daily, is not the best approach in this scenario to achieve A1C targets.

Answer 3 is correct. About 64.52% of respondents chose this. “Explore addition of twice weekly strength training.” YES, this is the best answer. Based on the ADA Standards, individuals are encouraged to maintain 150 minutes of activity a week, plus strengthening activities twice weekly. Studies show that increasing muscle mass significantly lowers glucose and A1C.

Finally, Answer 4 is incorrect. 7.97% chose this answer. “Encourage AR to reconsider increasing empagliflozin dose.” This juicy answer is tempting, since increasing the empagliflozin dose would most likely decrease AR’s blood sugar. However, it is not the best answer since it doesn’t match AR’s stated goal that “they are dedicated to lowering their A1C through more activity.”

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!.