Practice Test Geeks(BC ADM) Advanced Diabetes Management Certification Practice Test
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Insulin Therapy Flashcards

7 cards from real BC ADM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Insulin Therapy flashcards as text

  1. A patient on basal-bolus insulin therapy has consistently elevated 2-hour postprandial glucose after dinner but acceptable fasting and pre-meal values. The most appropriate adjustment is:

    Answer: Increase the pre-dinner rapid-acting insulin dose

    Isolated postprandial hyperglycemia after a specific meal indicates insufficient mealtime (prandial) insulin coverage for that meal.

  2. Which factor most significantly reduces insulin absorption rate from a subcutaneous injection?

    Answer: Injection into a lipohypertrophic site

    Lipohypertrophic tissue is fibrotic and poorly vascularized, substantially slowing and unpredictably altering insulin absorption.

  3. The 'dawn phenomenon' in diabetes refers to:

    Answer: Early morning hyperglycemia due to physiologic rise in counter-regulatory hormones

    The dawn phenomenon is caused by early-morning surges in growth hormone and cortisol that increase hepatic glucose production, raising fasting blood glucose.

  4. A patient using CSII (insulin pump) therapy develops diabetic ketoacidosis. The most likely pump-related cause is:

    Answer: Catheter occlusion or site failure interrupting insulin delivery

    Catheter kinking, dislodgment, or site occlusion can completely interrupt subcutaneous insulin delivery, rapidly leading to DKA since pumps use only rapid-acting insulin.

  5. When calculating an insulin-to-carbohydrate ratio (ICR), the '450 rule' is used instead of the '500 rule' in which scenario?

    Answer: When the patient uses regular (short-acting) insulin for meals

    The 450 rule is applied when regular (human) insulin is used for meal coverage because its slower onset requires a slightly different ratio than rapid-acting analogs.

  6. Pramlintide (Symlin) is used as an adjunct to mealtime insulin primarily because it:

    Answer: Suppresses glucagon, delays gastric emptying, and reduces appetite

    Pramlintide is an amylin analog that suppresses postprandial glucagon secretion, slows gastric emptying, and promotes satiety, reducing postprandial glucose excursions.

  7. A type 1 diabetes patient on MDI reports consistent hypoglycemia between 2–4 AM with rebound hyperglycemia by 7 AM. The most appropriate initial intervention is:

    Answer: Reduce the evening basal insulin dose and verify with nighttime CGM

    Nocturnal hypoglycemia followed by rebound suggests excess evening basal; reducing it and monitoring with CGM confirms the pattern before further adjustments.