CDE Patient Education 5 — Questions and Answers
Question 1: A patient reports they sometimes skip insulin doses because injections hurt. The educator should FIRST:
- Document non-compliance and notify the physician
- Explore injection technique, site rotation, and needle length to identify and address the source of pain (Correct answer)
- Switch the patient to oral medications
- Reassure the patient that pain is normal and expected
Correct answer: Explore injection technique, site rotation, and needle length to identify and address the source of pain
Injection discomfort is often caused by improper technique, dull needles, or poor site selection — identifying the cause allows targeted correction.
Question 2: When educating a patient about the glycemic index (GI), the educator should explain that:
- All high-GI foods must be permanently eliminated from the diet
- GI reflects how quickly a food raises blood glucose, and food combinations can modify the effect (Correct answer)
- GI is the most important factor in diabetes meal planning
- Low-GI foods have no effect on blood glucose
Correct answer: GI reflects how quickly a food raises blood glucose, and food combinations can modify the effect
GI indicates the relative speed of glucose absorption, but real-world impact is modified by portion size, cooking method, and food combinations.
Question 3: A culturally diverse patient with diabetes eats traditional foods not found in standard exchange lists. The best educator action is to:
- Ask the patient to switch to a standard American diet for better glucose control
- Research the carbohydrate content of traditional foods and incorporate them into the meal plan (Correct answer)
- Tell the patient the traditional diet is incompatible with diabetes management
- Estimate carbohydrate content based on similar Western foods only
Correct answer: Research the carbohydrate content of traditional foods and incorporate them into the meal plan
Culturally responsive education incorporates the patient's actual foods into the meal plan, improving adherence and respecting cultural identity.
Question 4: A patient with type 2 diabetes asks whether they will need insulin eventually. The best educator response is:
- 'Insulin is only for people who fail to manage their diabetes properly'
- 'Insulin may become necessary as diabetes progresses because the pancreas produces less insulin over time — it's not a failure' (Correct answer)
- 'You will definitely need insulin within 5 years'
- 'If you exercise and diet correctly, you will never need insulin'
Correct answer: 'Insulin may become necessary as diabetes progresses because the pancreas produces less insulin over time — it's not a failure'
Reframing insulin as a natural disease progression response rather than personal failure reduces stigma and improves openness to future treatment changes.
Question 5: Which factor MOST affects a patient's ability to perform successful self-management of diabetes?
- The complexity of their prescribed medication regimen
- The patient's self-efficacy and belief in their ability to manage the disease (Correct answer)
- The frequency of their medical appointments
- Access to the latest diabetes technology
Correct answer: The patient's self-efficacy and belief in their ability to manage the disease
Self-efficacy — the patient's confidence in their ability to perform self-management behaviors — is one of the strongest predictors of successful diabetes self-management.
Question 6: A patient with diabetes who is planning surgery asks about managing their glucose during the perioperative period. The educator should advise them to:
- Stop all diabetes medications the week before surgery independently
- Consult their surgical team and diabetes provider for specific perioperative medication and monitoring instructions (Correct answer)
- Continue all medications unchanged regardless of fasting requirements
- Rely on the hospital staff to manage glucose without prior preparation
Correct answer: Consult their surgical team and diabetes provider for specific perioperative medication and monitoring instructions
Perioperative diabetes management requires individualized guidance from the surgical and diabetes care team due to fasting, anesthesia, and physiological stress effects.
Question 7: A patient with type 1 diabetes asks about driving safety. The educator should teach that:
- Driving is safe as long as the patient feels fine
- Blood glucose should be checked before driving, and driving should be avoided if glucose is below 70 mg/dL (Correct answer)
- Hypoglycemia only affects driving ability if the patient loses consciousness
- Only patients with frequent severe hypoglycemia need to restrict driving
Correct answer: Blood glucose should be checked before driving, and driving should be avoided if glucose is below 70 mg/dL
Hypoglycemia impairs cognition and reaction time before symptomatic awareness; checking glucose before driving and treating levels below 70 mg/dL prevents accidents.
CDE Patient Education 5
A patient reports they sometimes skip insulin doses because injections hurt.
The educator should FIRST: