CDE Technology in Diabetes 2 — Questions and Answers
Question 1: A patient using a CGM notices persistent signal loss alerts. Which troubleshooting step should the educator recommend first?
- Replace the transmitter immediately
- Check that the receiver or smartphone is within 20 feet of the sensor (Correct answer)
- Recalibrate with a fingerstick glucose
- Remove and reinsert the sensor
Correct answer: Check that the receiver or smartphone is within 20 feet of the sensor
CGM signal loss is most commonly caused by the receiver or paired device being out of Bluetooth range, typically beyond 20 feet.
Question 2: Which feature of a hybrid closed-loop insulin delivery system distinguishes it from a standard insulin pump?
- It delivers only basal insulin automatically
- It automatically adjusts basal rates based on CGM data (Correct answer)
- It eliminates the need for mealtime boluses entirely
- It uses a dual-hormone approach with glucagon
Correct answer: It automatically adjusts basal rates based on CGM data
Hybrid closed-loop systems automatically adjust basal insulin delivery in response to real-time CGM glucose values, though users still manually bolus for meals.
Question 3: A patient reports that their CGM readings are consistently 20–30 mg/dL lower than fingerstick values. What is the most likely explanation?
- The sensor is measuring interstitial fluid, not blood glucose (Correct answer)
- The meter is poorly calibrated
- The patient is dehydrated, raising blood glucose artificially
- The sensor has expired
Correct answer: The sensor is measuring interstitial fluid, not blood glucose
CGMs measure glucose in interstitial fluid, which lags behind blood glucose and can read lower especially during rapid glucose changes.
Question 4: When educating a patient on insulin pump infusion set changes, how often should sets typically be changed to prevent site infections and lipohypertrophy?
- Every 24 hours
- Every 2–3 days (Correct answer)
- Once a week
- Only when the reservoir is empty
Correct answer: Every 2–3 days
Infusion sets should be changed every 2–3 days to reduce infection risk and prevent insulin absorption problems from lipohypertrophy.
Question 5: Which CGM system uses a factory-calibrated sensor that does NOT require routine fingerstick calibrations in most users?
- Medtronic Guardian 3
- Dexcom G4
- Abbott FreeStyle Libre 3 (Correct answer)
- Senseonics Eversense
Correct answer: Abbott FreeStyle Libre 3
The Abbott FreeStyle Libre systems are factory-calibrated and do not require routine fingerstick calibrations for standard use.
Question 6: A diabetes educator is reviewing AGP (Ambulatory Glucose Profile) data with a patient. What does a narrow interquartile range on the AGP indicate?
- High average glucose levels
- Consistent and predictable glucose patterns (Correct answer)
- Frequent hypoglycemia events
- Poor sensor accuracy
Correct answer: Consistent and predictable glucose patterns
A narrow interquartile range on the AGP indicates that glucose values are clustered closely together, reflecting consistent and predictable glycemic patterns.
Question 7: A patient with an insulin pump calls reporting that their blood glucose has been rising for 3 hours despite corrections. What should the educator assess first?
- Increase the correction factor in pump settings
- Check the infusion site for occlusion or dislodgement (Correct answer)
- Switch to a longer-acting insulin in the pump
- Advise the patient to eat a low-carb meal
Correct answer: Check the infusion site for occlusion or dislodgement
Persistent unexplained hyperglycemia in pump users most often results from an occluded or dislodged infusion set preventing insulin delivery.
CDE Technology in Diabetes 2
A patient using a CGM notices persistent signal loss alerts.
Which troubleshooting step should the educator recommend first?