Finally, Answer D is correct. 65.11% chose this answer, “Explore how JR thinks this management strategy is working.” Great job, you chose the correct answer! This best answer because it reflects person-centered care, shared decision-making, and assessment before making recommendations.

The scenario provides several clues that the healthcare professional should first understand why JR is using this strategy before suggesting changes.

The first step is to understand JR’s perspective and goals. Although taking rapid-acting insulin after meals is generally less effective than premeal dosing, JR has maintained an A1C of 6.7% and expresses pride in their management. At age 78 with a 20-year history of type 2 diabetes, an A1C below 7% may be tighter than necessary depending on comorbidities, functional status, and hypoglycemia risk.

Before recommending changes, the diabetes care professional needs to explore JR’s reasoning, assess for hypoglycemia, review CGM metrics (particularly time in range and time below range), and determine whether postmeal dosing is intentional (e.g., due to unpredictable intake or fear of hypoglycemia). This approach aligns with person-centered care and avoids making assumptions.