BC ADM Psychosocial Support & Care Coordination 3 — Questions and Answers
Question 1: A patient expresses fear of hypoglycemia that leads them to run consistently high blood glucose levels. This behavior is best described as:
- Diabetes denial
- Fear of hypoglycemia (FoH) (Correct answer)
- Intentional hyperglycemia disorder
- Glycemic avoidance syndrome
Correct answer: Fear of hypoglycemia (FoH)
Fear of hypoglycemia (FoH) is a recognized psychosocial barrier that causes patients to deliberately maintain elevated glucose levels to avoid lows.
Question 2: Which approach best reflects the chronic care model's emphasis in diabetes psychosocial support?
- Provider-driven treatment with minimal patient input
- Productive interactions between informed patients and prepared care teams (Correct answer)
- Annual comprehensive diabetes reviews only
- Referral to specialists for all psychosocial concerns
Correct answer: Productive interactions between informed patients and prepared care teams
The Chronic Care Model emphasizes productive, collaborative interactions between proactive care teams and activated, informed patients.
Question 3: A 35-year-old woman with type 1 diabetes is newly pregnant and expresses significant anxiety about managing glucose during pregnancy. The BEST initial response is to:
- Reassure her that technology will manage everything automatically
- Validate her concerns and connect her to a multidisciplinary perinatal diabetes team (Correct answer)
- Advise her to wait until the second trimester to address concerns
- Focus solely on adjusting insulin doses without addressing emotional concerns
Correct answer: Validate her concerns and connect her to a multidisciplinary perinatal diabetes team
Perinatal diabetes management requires coordinated multidisciplinary care and emotional support beginning early in pregnancy.
Question 4: Which of the following is a key component of motivational interviewing (MI) used in diabetes care?
- Confronting patients directly about poor adherence
- Expressing empathy and rolling with resistance (Correct answer)
- Providing detailed lists of diabetes complications to motivate change
- Setting strict behavioral contracts with consequences
Correct answer: Expressing empathy and rolling with resistance
Motivational interviewing uses empathy, reflective listening, and rolling with resistance rather than confrontation to elicit intrinsic motivation.
Question 5: A patient with diabetes reports they cannot afford their insulin. As the diabetes care specialist, your FIRST action should be:
- Suggest the patient ration their current supply
- Explore manufacturer patient assistance programs and lower-cost insulin options (Correct answer)
- Switch to an older oral agent without consulting the provider
- Document the issue and wait for the next scheduled visit
Correct answer: Explore manufacturer patient assistance programs and lower-cost insulin options
Connecting patients to manufacturer assistance programs and lower-cost alternatives is a critical care coordination response to insulin affordability barriers.
Question 6: Disordered eating behaviors in people with type 1 diabetes sometimes include intentional insulin omission for weight control. This behavior is known as:
- Hypoglycemia unawareness
- Diabulimia (Correct answer)
- Insulin resistance syndrome
- Reactive hyperphagia
Correct answer: Diabulimia
Diabulimia refers to the deliberate restriction of insulin to cause glycosuria and weight loss, a dangerous eating disorder specific to type 1 diabetes.
Question 7: Which of the following best supports cultural humility in diabetes care?
- Assuming all patients from a given culture share identical beliefs about diabetes
- Asking open-ended questions to understand each patient's unique cultural context (Correct answer)
- Using culturally specific diabetes education materials without individualization
- Avoiding discussion of cultural practices to prevent offending patients
Correct answer: Asking open-ended questions to understand each patient's unique cultural context
Cultural humility requires asking open-ended questions and remaining curious about individual patients' beliefs rather than applying group stereotypes.
BC ADM Psychosocial Support & Care Coordination 3
A patient expresses fear of hypoglycemia that leads them to run consistently high blood glucose levels.
This behavior is best described as: