For last week’s practice question, we quizzed participants on what defines overbasalization according to 2025 ADA Standards?. 52% 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:
What defines overbasalization according to 2025 ADA Standards?
According to the new 2025 ADA Standards of Care, which of the following most accurately reflects overbasalization?
Answer Choices:
- basal insulin doses exceeding 0.5 units/kg/day
- significant bedtime-to-morning or postprandial-to-preprandial glucose differential
- low glycemic variability
- basal insulin dose exceeding 50 units twice per day
Getting to the Best Answer
Answer 1 is incorrect. 25% chose this answer: basal insulin doses exceeding 0.5 units/kg/day. This year, the ADA Recommendation was revised to remove consideration of basal insulin doses exceeding 0.5 units/kg/day as evidence of overbasalization. Instead, signs of overbasalization including significant bedtime-to-morning or postprandial-to-preprandial glucose differential, occurrences of hypoglycemia (aware or unaware), and high glycemic variability should be used.
Answer 2 is correct. 52% of you chose this answer: significant bedtime-to-morning or postprandial-to-preprandial glucose differential. GREAT JOB! In the 2025 ADA Standards (9), they define overbasalization as significant bedtime-to-morning or postprandial-to-preprandial glucose differential, occurrences of hypoglycemia (aware or unaware), and high glycemic variability.
Answer 3 is incorrect. About 18% of respondents chose this: low glycemic variability, This is a juicy and tempting answer. However, high glycemic variability (lots of ups and downs) is more closely associated with hypoglycemia.
Finally, Answer 4 is incorrect 3% chose this answer: basal insulin dose exceeding 50 units twice per day. Overbasalization is not defined by the amount of insulin used, but by the glucose response including significant bedtime-to-morning or postprandial-to-preprandial glucose differential, occurrences of hypoglycemia (aware or unaware), and high glycemic variability
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!
Want to learn more about this question?
Enroll in our Level 3
Diabetes Mastery & Cert Readiness
Ready for your certification exams? Our Level 3 course series is the final step in your exam prep, complementing our Level 1, 2, or 4 bundles. Designed for healthcare professionals preparing for diabetes certification exams in 3-6 months, this master-level series covers key topics like pharmacology, technology, MNT, and person-centered care, all based on the latest ADA Standards of Care.
Each course includes a video, podcast, practice test, and additional resources—available immediately for one full year. Boost your knowledge and confidence to succeed in your certification!
![](/wp-content/uploads/2023/01/insta-png-v5.png")
