CDE Technology in Diabetes 5 — Questions and Answers
Question 1: A patient reports their CGM consistently reads high during exercise compared to fingerstick results. What is the most likely physiological explanation?
- Increased blood flow to the skin speeds up interstitial glucose equilibration
- Sweat dilutes the sensor enzyme and raises apparent glucose
- Blood glucose rises faster than interstitial glucose during exercise-induced glucose spikes (Correct answer)
- The sensor shifts position during physical activity
Correct answer: Blood glucose rises faster than interstitial glucose during exercise-induced glucose spikes
During rapid glucose rises from exercise-induced hepatic glucose output, blood glucose can increase faster than interstitial fluid glucose, causing CGM to lag behind.
Question 2: Which technology is used in the Omnipod 5 hybrid closed-loop system to wirelessly communicate between the CGM and the pod?
- Wi-Fi
- NFC
- Bluetooth (Correct answer)
- Infrared
Correct answer: Bluetooth
The Omnipod 5 uses Bluetooth to communicate between the compatible CGM (Dexcom G6) and the pod controller for automated insulin adjustments.
Question 3: According to ADA standards of care, what Time in Range (TIR) target is recommended for most adults with type 1 or type 2 diabetes?
- >50%
- >60%
- >70% (Correct answer)
- >90%
Correct answer: >70%
The ADA recommends a TIR target of greater than 70% (glucose 70–180 mg/dL) for most non-pregnant adults with diabetes.
Question 4: A patient calls stating their pump has an 'E1' or 'motor error' alarm. What is the appropriate educator response?
- Instruct the patient to restart the pump and resume use
- Tell the patient to increase basal rates to compensate
- Advise the patient to contact the pump manufacturer and use injection therapy in the interim (Correct answer)
- Recommend manually priming the pump tubing three times
Correct answer: Advise the patient to contact the pump manufacturer and use injection therapy in the interim
A motor error indicates a mechanical pump failure; the patient should switch to injection therapy and contact the manufacturer for device replacement.
Question 5: When using telemedicine visits for diabetes technology management, which CGM data-sharing method is most commonly used to review patient glucose trends before or during a visit?
- Patient reads glucose values aloud over the phone
- Provider remotely accesses the patient's CGM app via cloud-based clinic software (e.g., Dexcom Clarity, LibreView) (Correct answer)
- Patient screenshots and emails individual glucose readings
- Provider uses a Bluetooth receiver at the office during the call
Correct answer: Provider remotely accesses the patient's CGM app via cloud-based clinic software (e.g., Dexcom Clarity, LibreView)
Cloud-based clinic platforms like Dexcom Clarity and Abbott LibreView allow providers to view comprehensive CGM reports before or during telehealth appointments.
Question 6: A patient on a sensor-augmented pump (SAP) needs MRI imaging. What is the standard recommendation regarding their devices?
- Both pump and CGM can remain in place if the MRI is below 1.5 Tesla
- The CGM sensor may stay on but the pump must be removed
- Both the pump and CGM must be removed before entering the MRI suite (Correct answer)
- Only the transmitter must be removed; the sensor pod can remain
Correct answer: Both the pump and CGM must be removed before entering the MRI suite
Both insulin pumps and CGM transmitters/sensors must be removed before MRI imaging because the magnetic field can damage devices and the metal components pose safety risks.
Question 7: A CDE is educating a patient about interpreting the GMI (Glucose Management Indicator) from their CGM report. What does GMI represent?
- The exact A1C value confirmed by a lab test
- An estimated A1C calculated from average CGM glucose over the reporting period (Correct answer)
- The percentage of time glucose is above 250 mg/dL
- A score from 1–10 reflecting overall diabetes management quality
Correct answer: An estimated A1C calculated from average CGM glucose over the reporting period
GMI is a formula-derived estimate of A1C based on average glucose from CGM data and provides a timely approximation without a laboratory blood draw.
CDE Technology in Diabetes 5
A patient reports their CGM consistently reads high during exercise compared to fingerstick results.
What is the most likely physiological explanation?