CDE Monitoring Techniques 3

Question 1

A patient's HbA1c is 6.8% but her CGM data shows frequent hypoglycemic episodes. What phenomenon explains this discordance?

Accepted Answer

Glucose variability with high/low averaging

Answer

Alternating hyperglycemic and hypoglycemic episodes can average to a deceptively 'normal' HbA1c while masking dangerous glycemic variability.

Question 2

Which CGM metric best quantifies the degree of glucose fluctuation beyond the average level?

Accepted Answer

Coefficient of variation (CV)

Answer

Coefficient of variation (CV) measures glucose variability as a percentage of the mean; a CV ≤36% is generally considered stable.

Question 3

A continuous glucose monitor sensor placed on the abdomen shows a consistent 20–30 minute lag behind fingerstick values during rapid glucose changes. This is because:

Accepted Answer

CGM measures interstitial fluid glucose, which lags behind blood glucose

Answer

CGM sensors measure glucose in interstitial fluid, which equilibrates with blood glucose with a physiological lag of approximately 5–15 minutes that is amplified during rapid changes.

Question 4

What is the recommended blood ketone (beta-hydroxybutyrate) threshold that should prompt a patient to seek emergency care?

Accepted Answer

≥3.0 mmol/L

Answer

Blood ketone levels ≥3.0 mmol/L indicate high DKA risk and warrant immediate emergency evaluation.

Question 5

A structured SMBG pattern shows consistently elevated glucose readings 2 hours after dinner but not after breakfast or lunch. What is the most appropriate clinical response?

Accepted Answer

Evaluate and modify the evening meal composition and/or pre-dinner medication

Answer

Pattern management directs intervention to the specific meal and corresponding medication or dietary factors causing the postprandial spike.

Certified Diabetes Educator Test Practice Test

Certified Diabetes Educator Test Practice Test

CDE Monitoring Techniques 3