For last week’s practice question, we quizzed participants on which of the following responses is the least appropriate (i.e., the WRONG thing to say) to Maria. % 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
Maria, a 52‑year‑old woman with type 2 diabetes for 8 years, attends a follow‑up visit. Her A1C has risen from 7.8% to 9.2% over the past year. She reports feeling “overwhelmed” and says she didn’t want to start the medication her clinician recommended at the last visit. She explains, “I’m scared of side effects, and I feel like needing medication means I failed.”
Which of the following responses is the least appropriate (i.e., the WRONG thing to say) to Maria?
- “It sounds like you’re feeling overwhelmed. Can you tell me more about what worries you most about starting this medication?”
- “Many people feel this way. Let’s look at your options together so you can make a choice that works for you.”
- “I understand that this is challenging and overwhelming. However, if you don’t start this medication, you are choosing to risk complications like kidney disease or blindness.”
- “It’s completely understandable to have concerns. Would it help if we reviewed what the medication does, talk about the pro’s and the con’s, and about what alternatives exist?”
Getting to the Best Answer
Answer A is incorrect: % chose this answer,“ It sounds like you’re feeling overwhelmed. Can you tell me more about what worries you most about starting this medication?” Appropriate — Person centered, exploratory. This response uses reflective listening and invites the patient to share her concerns. It aligns with ADA Standards of Care recommendations for collaborative communication and supports assessment of diabetes distress.
Answer B is incorrect: % chose this answer, “Many people feel this way. Let’s look at your options together so you can make a choice that works for you.” Appropriate — Normalizes feelings and supports shared decision making. This option reduces stigma by acknowledging that many people experience similar emotions. It reinforces autonomy and partnership, which are core components of effective diabetes self management support.
Answer C is correct: % chose this answer, “I understand that this is challenging and overwhelming. However, if you don’t start this medication, you are choosing to risk complications like kidney disease or blindness.” Incorrect — Stigmatizing, blaming, and fear based. This statement uses threat based language (“you are choosing to risk complications…”) and implies personal failure. It increases shame, undermines trust, and can worsen diabetes distress. It does not incorporate person first language or collaborative care or help identify barriers and personalized solutions. Oh, and it probably won’t be very successful!
Answer D is incorrect: % chose this answer, “It’s completely understandable to have concerns. Would it help if we reviewed what the medication does, talk about the pro’s and the con’s, and about what alternatives exist?” Appropriate — Validates concerns and offers. Information without pressure. This response acknowledges the patient’s emotions and provides an opening for education and shared exploration of options. It supports autonomy and reduces the sense of failure associated with medication use.
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:
William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD
ENGAGING THE DISENGAGED | Live in San Diego at Marina Village
April 18th, 2026 from 9 AM to 4 PM PST!
In this course, William H. Polonsky, PhD, CDCES, and Susan Guzman, PhD, examine the powerful role of psychosocial factors in diabetes self-management. Through innovative strategies, participants will learn how to recognize and address common barriers to effective self-care and cardiometabolic medication initiation and maintenance, while fostering respectful, stigma-free clinical encounters.
Through a collaborative and person-centered approach, the course emphasizes communication strategies that enhance motivation, build confidence, and reinforce the value of self-management. Participants will develop skills in diabetes-focused action planning, addressing medication hesitancy, and providing ongoing support and resources to sustain behavior change over time. The goal is to help clinicians make diabetes care more doable, meaningful, and effective for people living with diabetes.
