CDCES CDCES Diabetes Technology and Devices 2 — Questions and Answers
Question 1: What is an insulin pump (CSII) used for in diabetes management?
- Measuring blood glucose automatically every hour
- Delivering continuous subcutaneous insulin infusion to replace multiple daily injections (Correct answer)
- Implanting an artificial pancreas permanently under the skin
- Providing oral insulin via a programmable device
Correct answer: Delivering continuous subcutaneous insulin infusion to replace multiple daily injections
CSII (Continuous Subcutaneous Insulin Infusion) delivers a programmed basal rate of insulin plus patient-activated bolus doses via a small catheter inserted under the skin.
Question 2: What is a closed-loop automated insulin delivery (AID) system?
- A CGM that automatically administers oral medications based on glucose
- A system where CGM data automatically adjusts insulin pump delivery without user input (Correct answer)
- A glucometer connected wirelessly to a hospital monitor
- An insulin pen with a built-in glucose sensor
Correct answer: A system where CGM data automatically adjusts insulin pump delivery without user input
Automated Insulin Delivery (AID) systems use CGM data and an algorithm to automatically adjust insulin pump delivery in real time, sometimes called an 'artificial pancreas.'
Question 3: A patient using an insulin pump reports unexplained hyperglycemia. What is the first troubleshooting step a CDCES should recommend?
- Immediately switch to multiple daily injections
- Check the infusion site and tubing for occlusion, air bubbles, or dislodgement (Correct answer)
- Increase the basal rate by 50%
- Stop the pump and take a correction dose via insulin pen
Correct answer: Check the infusion site and tubing for occlusion, air bubbles, or dislodgement
Unexplained hyperglycemia in pump users most commonly results from infusion site problems such as occlusion, kinking, air in tubing, or site dislodgement.
Question 4: What is the recommended infusion site rotation interval for insulin pump users to prevent lipohypertrophy?
- Change every 12 hours
- Change every 2–3 days (Correct answer)
- Change every 7 days
- Change only when site becomes painful
Correct answer: Change every 2–3 days
Insulin pump infusion sets should be changed every 2–3 days and sites should be rotated systematically to prevent lipohypertrophy and maintain insulin absorption.
Question 5: Which insulin is used in most insulin pumps?
- NPH insulin
- Regular insulin only
- Rapid-acting insulin analogs (e.g., lispro, aspart, glulisine) (Correct answer)
- Long-acting basal insulin analogs (e.g., glargine, detemir)
Correct answer: Rapid-acting insulin analogs (e.g., lispro, aspart, glulisine)
Insulin pumps use only rapid-acting insulin analogs to provide both basal rates (tiny continuous doses) and mealtime boluses.
Question 6: What does 'time below range' (TBR) refer to in CGM ambulatory glucose profile reporting?
- Percentage of time glucose is above 180 mg/dL
- Percentage of time glucose is below 70 mg/dL (Correct answer)
- The duration of a single hypoglycemic episode
- The lowest glucose value recorded over 24 hours
Correct answer: Percentage of time glucose is below 70 mg/dL
Time Below Range (TBR) is the percentage of CGM readings below 70 mg/dL and is a key safety metric for assessing hypoglycemia burden.
CDCES CDCES Diabetes Technology and Devices 2
What is an insulin pump (CSII) used for in diabetes management?