Diabetes Education Certification Insulin Therapy & Administration 3

Question 1

A patient using an insulin pump reports unexplained hyperglycemia for 3 consecutive hours. After ruling out illness, what should be checked first?

Accepted Answer

The infusion site and catheter for kinking or occlusion

Answer

Infusion site problems such as kinking, occlusion, or lipohypertrophy are the most common causes of unexplained pump hyperglycemia.

Question 2

What is the recommended maximum volume for a single subcutaneous insulin injection to ensure proper absorption?

Accepted Answer

1 mL

Answer

Subcutaneous injections should not exceed 1 mL to avoid pooling, discomfort, and unpredictable absorption.

Question 3

A patient with type 2 diabetes on metformin requires the addition of insulin. Which starting regimen is most consistent with current guidelines?

Accepted Answer

Basal insulin at bedtime with continuation of oral agents

Answer

Current ADA guidelines recommend starting with basal insulin added to existing oral agents as the simplest and most effective first insulin strategy.

Question 4

Which patient behavior is most likely to cause lipohypertrophy at injection sites?

Accepted Answer

Reusing the same injection site repeatedly without rotation

Answer

Lipohypertrophy results from repeated trauma and insulin exposure to the same fatty tissue, causing abnormal growth that impairs absorption.

Question 5

When converting a patient from twice-daily NPH to once-daily insulin glargine, what is the typical starting dose conversion ratio?

Accepted Answer

Use 80% of the total daily NPH dose as glargine

Answer

Converting from NPH to glargine typically involves starting at 80% of the total daily NPH dose to reduce hypoglycemia risk, then titrating to target.

Diabetes Practice Test