BC ADM Blood Glucose Monitoring 3 — Questions and Answers
Question 1: Which postprandial blood glucose target is recommended by the American Diabetes Association for most non-pregnant adults with diabetes when measured 1–2 hours after meal start?
- <140 mg/dL
- <180 mg/dL (Correct answer)
- <200 mg/dL
- <160 mg/dL
Correct answer: <180 mg/dL
ADA guidelines recommend a postprandial glucose target of <180 mg/dL (1–2 hours after meal start) for most non-pregnant adults with diabetes.
Question 2: What is the primary reason CGM is preferred over SMBG for detecting nocturnal hypoglycemia?
- CGM is more accurate at low glucose levels
- CGM provides continuous data and alarms without requiring the patient to wake and test (Correct answer)
- CGM does not require calibration overnight
- CGM strips are less expensive than SMBG strips
Correct answer: CGM provides continuous data and alarms without requiring the patient to wake and test
CGM continuously monitors glucose and triggers low glucose alarms during sleep, detecting nocturnal hypoglycemia that patients would otherwise be unaware of.
Question 3: A T2D patient on basal insulin alone has fasting glucose averaging 195 mg/dL but A1C of 8.9%. Which structured SMBG pattern would best inform the next treatment decision?
- Postprandial-only testing for 2 weeks
- 7-point glucose profiles (pre/post meals and bedtime) for 3 days (Correct answer)
- Random glucose checks throughout the day
- Fasting-only testing for 30 days
Correct answer: 7-point glucose profiles (pre/post meals and bedtime) for 3 days
7-point structured glucose profiles capture the full daily glucose pattern, revealing whether fasting, postprandial, or both contribute to elevated A1C to guide medication adjustments.
Question 4: Which of the following correctly describes the relationship between A1C and estimated average glucose (eAG)?
- eAG (mg/dL) = 28.7 × A1C − 46.7 (Correct answer)
- eAG (mg/dL) = A1C × 18
- eAG (mg/dL) = 35.6 × A1C − 77.3
- eAG (mg/dL) = A1C × 28
Correct answer: eAG (mg/dL) = 28.7 × A1C − 46.7
The ADA-endorsed formula is eAG (mg/dL) = 28.7 × A1C − 46.7, derived from the ADAG study correlating A1C to average glucose over 3 months.
Question 5: When interpreting ambulatory glucose profile (AGP) reports, a CV ≥36% indicates:
- Excellent glycemic control
- High glycemic variability requiring therapeutic attention (Correct answer)
- Normal variability for T1D
- Sensor malfunction
Correct answer: High glycemic variability requiring therapeutic attention
A CV ≥36% indicates high glycemic variability, associated with increased hypoglycemia risk and poor glycemic control, and warrants therapeutic review.
Question 6: A patient using a Flash glucose monitoring (FGM) system reports they scan their sensor 2–3 times per day. What is the clinical concern with this frequency?
- Scanning too frequently drains the sensor battery
- Infrequent scanning misses hypoglycemic and hyperglycemic episodes between scans (Correct answer)
- Scanning activates a bolus calculator unnecessarily
- FGM sensors are less accurate with more scans
Correct answer: Infrequent scanning misses hypoglycemic and hyperglycemic episodes between scans
FGM sensors store data in rolling 8-hour windows; scanning fewer than every 8 hours risks losing glucose data and missing undetected glycemic excursions.
Question 7: Which patient population has the strongest evidence-based recommendation for real-time CGM use to improve clinical outcomes?
- T2D managed with lifestyle modification alone
- T1D on intensive insulin therapy (MDI or pump) (Correct answer)
- T2D on once-daily basal insulin only
- Gestational diabetes managed with diet
Correct answer: T1D on intensive insulin therapy (MDI or pump)
Multiple RCTs (DIAMOND, GOLD, CONCEPTT) demonstrate CGM significantly improves A1C and reduces hypoglycemia in T1D patients on intensive insulin therapy.
BC ADM Blood Glucose Monitoring 3
Which postprandial blood glucose target is recommended by the American Diabetes Association for most non-pregnant adults with diabetes when measured 1–2 hours after meal start?