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?
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.
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