Blood Glucose Monitoring & Targets Flashcards

A patient's CGM ambulatory glucose profile (AGP) shows a coefficient of variation (CV) of 42%. What does this indicate?

Answer: High glucose variability requiring evaluation

A CV above 36% indicates high glucose variability, which is associated with increased hypoglycemia risk and cardiovascular risk, regardless of average glucose.

Which of the following best explains why A1C may be falsely LOW in a patient with sickle cell trait?

Answer: Reduced red blood cell lifespan decreases glucose exposure time to hemoglobin

Conditions that shorten RBC lifespan (including hemolytic anemias and sickle cell trait) reduce the time hemoglobin is exposed to glucose, causing falsely low A1C values.

A diabetes educator is teaching a patient the '15-15 rule.' What does this rule describe?

Answer: Consume 15 g of carbs, wait 15 minutes, then recheck glucose for hypoglycemia

The 15-15 rule for treating mild hypoglycemia: take 15 g of fast-acting carbohydrate, wait 15 minutes, and recheck blood glucose.

In which patient population does the ADA recommend the most stringent A1C goal of less than 6.5%, if achievable without hypoglycemia?

Answer: Newly diagnosed patients with long life expectancy and no hypoglycemia risk

A stringent A1C goal of <6.5% is appropriate for newly diagnosed, younger, or otherwise healthy patients with long life expectancy where it can be achieved safely without significant hypoglycemia.

A patient's fasting glucose is consistently 145–160 mg/dL despite good postprandial control. Which physiological mechanism most likely explains this pattern?

Answer: Excessive hepatic glucose production overnight (Dawn phenomenon or Somogyi effect)

Elevated fasting glucose with normal postprandial values typically reflects excessive overnight hepatic glucose output, characteristic of the dawn phenomenon.

When performing SMBG, which site is considered the reference standard for accuracy and is recommended for detecting hypoglycemia?

Answer: Fingertip (fingerstick)

Fingertip capillary blood glucose is the reference standard for SMBG accuracy; alternate sites like the forearm lag behind during rapid glucose changes, making fingersticks essential for hypoglycemia detection.

A type 1 diabetes patient's CGM shows 'Time in Range' of 68%, 'Time Above Range' of 25%, and 'Time Below Range' of 7%. Which metric most urgently needs intervention?

Answer: Time Below Range, which far exceeds the <1% target

Time Below Range of 7% far exceeds the consensus target of <1%, making hypoglycemia reduction the highest priority intervention.