CBDCE CBDCE Diabetes Technology and Monitoring 2 — Questions and Answers
Question 1: What is the primary advantage of an insulin pump (CSII) over multiple daily injections (MDI) for intensive diabetes management?
- It eliminates the need for blood glucose monitoring
- It delivers precise basal and bolus insulin doses mimicking normal pancreatic secretion (Correct answer)
- It works without any user input
- It does not require carbohydrate counting
Correct answer: It delivers precise basal and bolus insulin doses mimicking normal pancreatic secretion
Continuous Subcutaneous Insulin Infusion (CSII) delivers programmable basal rates and user-activated bolus doses, closely mimicking physiological insulin secretion.
Question 2: A patient on an insulin pump is experiencing unexplained hyperglycemia. What is the first troubleshooting step a CDCES should recommend?
- Immediately inject a correction dose via syringe and check the infusion site (Correct answer)
- Increase the basal rate by 20%
- Disconnect the pump and restart
- Take an oral medication instead
Correct answer: Immediately inject a correction dose via syringe and check the infusion site
Unexplained pump hyperglycemia may indicate an infusion site failure, so the first step is to give a correction dose by injection and inspect/replace the infusion site.
Question 3: Which insulin pump feature automatically suspends insulin delivery when the CGM predicts the glucose will drop below a set threshold?
- Extended bolus
- Predictive low glucose suspend (PLGS) (Correct answer)
- Dual-wave bolus
- Manual suspend
Correct answer: Predictive low glucose suspend (PLGS)
Predictive Low Glucose Suspend (PLGS) uses CGM trend data to stop insulin delivery before a projected hypoglycemic event, reducing hypoglycemia frequency.
Question 4: When a patient uses a closed-loop 'artificial pancreas' system, what three components must work together?
- CGM, insulin pump, and control algorithm (Correct answer)
- Glucometer, syringe, and basal insulin
- CGM, oral medications, and exercise tracker
- Pump, glucagon kit, and nutrition app
Correct answer: CGM, insulin pump, and control algorithm
A closed-loop system integrates a CGM for glucose sensing, an insulin pump for delivery, and a control algorithm that automatically adjusts insulin based on CGM data.
Question 5: A CDCES is helping a patient calculate an insulin-to-carbohydrate ratio (ICR). If the patient requires 1 unit of insulin for every 15 grams of carbohydrate, how much insulin is needed for a meal with 60 grams of carbohydrate?
- 2 units
- 4 units (Correct answer)
- 6 units
- 8 units
Correct answer: 4 units
60g ÷ 15g per unit = 4 units of insulin required to cover this meal using the patient's established insulin-to-carbohydrate ratio.
Question 6: What is a correction factor (sensitivity factor) used for in insulin pump therapy?
- To determine the carbohydrate content of a meal
- To calculate how much one unit of insulin is expected to lower blood glucose (Correct answer)
- To set the basal rate overnight
- To adjust the sensor glucose threshold
Correct answer: To calculate how much one unit of insulin is expected to lower blood glucose
The correction factor (or insulin sensitivity factor) defines the expected drop in blood glucose per unit of rapid-acting insulin, used to calculate correction bolus doses.
CBDCE CBDCE Diabetes Technology and Monitoring 2
What is the primary advantage of an insulin pump (CSII) over multiple daily injections (MDI) for intensive diabetes management?