For last week’s practice question, we quizzed participants on actions for managing stage 2, type 1 diabetes. 63% 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: LT has just been diagnosed with stage 2, type 1 diabetes.  They have 2 positive antibodies and their blood sugars are slightly elevated.  They ask you if they are a candidate for “that therapy” that can protect their beta cells and slow progression of type 1 diabetes. 

What is the most accurate response?

Answer Choices:

1. Unfortunately, you are not a candidate, since you already have 2 positive antibodies.
2. Let’s talk to your provider about the possibility of starting Teplizumab therapy.
3. With your blood sugar elevation, the best early intervention is insulin therapy.
4. Since you are already in stage 2, the monoclonal antibody therapy won’t be effective.

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. 9.23% chose this answer. “Unfortunately, you are not a candidate, since you already have 2 positive antibodies.” Teplizumab IS indicated for the individual in stage 2 type 1 diabetes, or for those with two or more islet autoantibodies and abnormal glycemia but still asymptomatic. People with stage 2 type 1 diabetes, have a nearly 100% lifetime risk of progression to clinical (stage 3) type 1 diabetes and a 75% risk of developing the condition within 5 years.

Answer 2 is correct. 62.93% of you chose this answer. “Let’s talk to your provider about the possibility of starting Teplizumab therapy.” YES, this is the BEST ANSWER, According to ADA Standards, Teplizumab is the first disease-modifying therapy that impedes the progression of type 1 diabetes by binding to the surface of T cells to dampen the unwanted immune system response. It can delay the onset of symptomatic stage 3 type 1 diabetes in adults and children 8 years and older with stage 2 type 1 diabetes (see staging chart).  It is administered by intravenous infusion once daily for 14 consecutive days and is expected to cost in the region of $200,000 for the course of treatment. Based on current data, it can delay the expression of stage 3 diabetes by 2 years or longer.

Answer 3 is incorrect. About 13.64% of respondents chose this. “With your blood sugar elevation, the best early intervention is insulin therapy.” Actually, according to ADA Guidelines, LT is a perfect candidate, since Teplizumab IS indicated for the individual in stage 2 type 1 diabetes, or for those with two or more islet autoantibodies and abnormal glycemia but still asymptomatic.

Finally, Answer 4 is incorrect. 14.20% chose this answer. “Since you are already in stage 2, the monoclonal antibody therapy won’t be effective.” Actually, according to ADA Guidelines, LT is a perfect candidate, since Teplizumab IS indicated for the individual in stage 2 type 1 diabetes, or for those with two or more islet autoantibodies and abnormal glycemia but still asymptomatic.

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!

For more information, see our blog on Teplizumab Therapy to Delay Type 1 Diabetes.

Want to learn more about this practice question?
Join us LIVE in San Diego for our DiabetesEd Training Conference
October 11-13th, 2023

Two Registration Options

Join Coach Beverly and Team for two and a half days of knowledge-sharing, fun, networking, games with prizes, and “aha” moments in beautiful San Diego. 

You don’t want to miss this one-of-a-kind learning opportunity. Get away from all those daily responsibilities and immerse yourself in a fun and intensive conference with plenty of networking opportunities.    

Attendees will leave this conference with new tools and a more complete understanding of the latest advances in diabetes care, from medications to technology to Medical Nutrition Therapy! 

Bring your colleagues and enjoy our friend discount.

Our team expertly translates the complex science of diabetes into understandable terms while keeping it real, practical, and fun. 

Team of expert faculty includes:

• Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES – Educator of the Year, 2020
• Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM
• Ashley LaBrier, MS, RD, CDCES, Diabetes Program Coordinator 

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 diabetes certification exams. CBDCE & ADCES does not endorse any preparatory or review materials for the certification exams, except for those published by CBDCE & ADCES.