For last week’s practice question, we quizzed participants on prediabetes after GDM. It was a challenging question and 60% 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:

LR experienced gestational diabetes with their third pregnancy and now, at age 41, was just diagnosed with prediabetes. LR’s BMI is 29.3 and she is trying to lose weight.

Based on the 2023 ADA Standards of Care, in addition to providing LR with lifestyle coaching, what other intervention is recommended?

Answer Choices:

1. Start a GLP-1 RA Inhibitor to support weight loss.
2. Initiate metformin therapy.
3. Start pioglitazone (Actos) at a low dose
4. Suggest adding a SGLT-2i to lower glucose and protect renal function.

---

Getting to the Best Answer

Answer 1 is incorrect. 29.67% chose this answer, “Start a GLP-1 RA Inhibitor to support weight loss.” Since LR has prediabetes, not diabetes, and her BMI is less than 30, GLP-1 RA therapy isn’t indicated. Plus, this recommendation isn’t included in the ADA standards (see below).

Answer 2 is correct. 60.63% of you chose this answer, “Initiate metformin therapy.” YES, this is the BEST answer. GREAT JOB! For people with a history of GDM who now express prediabetes, they have a very high risk of getting diabetes in the near future. In addition to referring to a Diabetes Prevention Program, the Standards recommend initiation of metformin therapy to delay the onset of diabetes.

Answer 3 is incorrect. 2.27% of respondents chose this answer, “Start pioglitazone (Actos) at a low dose” Although low dose pioglitazone is recommended for those with prediabetes or diabetes and a history of stroke, LR has no history of stroke. In addition, pioglitazone is associated with weight gain and is not recommended in the ADA Standards to treat prediabetes.

Finally, Answer 4 is incorrect. 7.44% chose this answer, “Suggest adding a SGLT-2i to lower glucose and protect renal function.” Since LR has prediabetes, not diabetes and no signs of kidney problems, SGLT-2i therapy isn’t indicated. Plus, this recommendation isn’t included in the ADA standards (see below).

Thank you so much for reading this “Rationale of the Week”. For more information on this topic, we also invite you to join our Online Courses and Virtual DiabetesEd Training Program.

---

2 Scholarships for

Virtual DiabetesEd Training Conference

Deadline Today, Thursday, March 2nd – Apply Today!

We are offering 2 Scholarship Options for our DiabetesEd Specialist Virtual Conference, April 26-28th, 2023.

1. Making a Difference Exemplar – valued at $499 for a diabetes specialist who exemplifies advocacy and compassionate care in their community and is pursuing their CDCES. This top-tier scholarship provides funds to cover course registration for our Deluxe Virtual Conference, April 26-28, 2023.
2. Making a Difference Scholar – valued at $399 for a diabetes specialist who exemplifies advocacy and compassionate care in their community and is pursuing their CDCES. This scholarship provides funds to cover course registration for our Basic Virtual Conference, April 26-28 2023

If you are passionate about diabetes education, actively involved in providing the best diabetes care, preparing for certification, and seeking financial assistance to attend our DiabetesEd Specialist Course, you are invited to apply for one of these scholarships.

We don’t want financial barriers to stop anyone from attending this conference. In appreciation of those who are role models and advocates for practicing the best diabetes care in their communities, we are offering one $499 Scholarship and one $399 dollar scholarship.

Scholarship Applications
Due, Today, March 2, 2023

---

Virtual DiabetesEd Training Conference

Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice.

If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan.

Group discounts are available!*

Download Course Flyer | Download Schedule

All hours earned count toward your CDCES Accreditation Information

---

Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

---

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.