For last week’s practice question, we quizzed participants on TIR (Time of Range) of 89% , and what is your concern. % 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
JZ is proud of their Time of Range of 89%. You notice their time below range is 7%. JZ uses a rapid-acting insulin pen 4–6 times daily to keep glucose in target range and occasionally increases the glargine dose when evening glucose is elevated.
What is your primary concern?
- Is JZ consistently rotating injection sites to prevent lipohypertrophy?
- What is JZ’s rationale for adjusting the glargine dose?
- How is JZ feeling about their frequency of hypoglycemia?
- Does JZ adjust insulin for physical activity?
Getting to the Best Answer
Answer A is incorrect: % chose this answer, “Is JZ consistently rotating injection sites to prevent lipohypertrophy?” Injection site rotation is important for preventing lipohypertrophy and absorption variability, but not the most immediate safety risk.
Answer B is incorrect: % chose this answer, “What is JZ’s rationale for adjusting the glargine dose?” Basal insulin is generally titrated based on overnight and fasting blood glucose levels, not reactively based on the evening glucose. This is clinically relevant, but still secondary to hypoglycemia risk.
Answer C is correct: % chose this answer, “How is JZ feeling about their frequency of hypoglycemia?” Since JZ is experiencing hypoglycemia more than the target below target range of 5%, we want to explore their feelings around their diabetes and diabetes distress.
Answer D is incorrect: % chose this answer, “Does JZ adjust insulin for physical activity?” Adjusting insulin for exercise is essential for self-management, yet the first priority is identifying whether dangerous lows are occurring.
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!
Learn More From the Experts:
Coach Beverly Thomassian, Dr. Diana Isaacs, & Christine Craig
Virtual DiabetesEd Training Conference
April 15th-17th, 2026
Gain fresh insights, practical tools, and a deeper understanding of the latest in person-centered diabetes care. Our expert team brings the ADA Standards of Care to life—covering medications, behavior change, technology, and more!
If you’re preparing for the CDCES or BC-ADM exam, this conference, paired with a handful of free bonus courses, serves as the ideal study companion! Plus, this content counts toward the ADA Standards requirements for CDCES Renewal.
With interactive co-teaching, we keep sessions engaging, relevant, and fun.
Let’s learn and grow together!
Course credits through AMA PRA Category 1 Credits™, ACPE, ANCC, and CDR!
Program Objectives:
Upon completion of this activity, participants should be able to:
- Describe the current ADA Standards for diagnosis, goals, and person-centered diabetes management across the lifespan.
- Demonstrate insulin pattern management and dosing strategies in clinical scenarios.
- Implement timely screening and risk reduction strategies for microvascular and cardiovascular complications.
- Incorporate behavior change techniques and medical nutrition therapy to support people with diabetes self-management and lifestyle adjustment.
