CDCES Psychosocial Care and Social Determinants of Health

Question 1

A patient says they feel overwhelmed and burned out by the daily demands of diabetes self-management but do not meet criteria for major depression. This is best described as what?

Accepted Answer

Diabetes distress

Answer

Diabetes distress is the emotional burden of living with and managing diabetes. It is distinct from clinical depression and is assessed with tools such as the PAID scale or the Diabetes Distress Scale. Management includes support and DSMES.

Question 2

Which tool is commonly used to screen people with diabetes for depression?

Accepted Answer

PHQ-9

Answer

The Patient Health Questionnaire (PHQ-2, followed by the PHQ-9 if positive) is widely used to screen for depression. The CAGE screens for alcohol use and the MoCA screens for cognition.

Question 3

A teenager with type 1 diabetes admits to skipping insulin doses in order to lose weight. What is the most appropriate response?

Accepted Answer

Recognize it as disordered eating and coordinate referral to mental health and eating-disorder specialists

Answer

Deliberate insulin omission for weight control is a form of disordered eating that raises the risk of DKA and complications. Screening, a nonjudgmental approach and an interdisciplinary referral are the standard of care.

Question 4

A patient is rationing insulin because of cost. What is the best first step?

Accepted Answer

Assess cost barriers and connect them to assistance programs, lower-cost insulin options and community resources

Answer

Cost-related nonadherence is a social determinant of health issue. Clinicians should explore the barrier nonjudgmentally and use manufacturer programs, lower-cost formulations and social work or community resources.

Question 5

Which approach is recommended for screening for food insecurity in people with diabetes?

Accepted Answer

Use a validated brief screener, such as the two-item Hunger Vital Sign

Answer

ADA recommends screening for food insecurity and other social determinants of health. The two-item Hunger Vital Sign is a brief validated tool, and results should guide the meal plan, medication choices and referrals.

(CDCES) Certified Diabetes Care and Education Specialist Practice Test

(CDCES) Certified Diabetes Care and Education Specialist Practice Test

CDCES Psychosocial Care and Social Determinants of Health