Blood Glucose Monitoring & Targets Flashcards

A patient with type 1 diabetes wants to use CGM during exercise. Which glucose-related concern is most important to address before starting vigorous aerobic exercise?

Answer: Glucose may fall rapidly; starting exercise above 90 mg/dL with carbohydrates available is recommended

Aerobic exercise increases insulin sensitivity and glucose uptake, risking hypoglycemia; ADA recommends starting exercise with glucose ≥90 mg/dL and having fast-acting carbs available.

Which of the following correctly describes the relationship between eAG (estimated average glucose) and A1C?

Answer: eAG = (A1C × 28.7) − 46.7

The ADA formula for eAG is: eAG (mg/dL) = (28.7 × A1C) − 46.7, allowing clinicians to report average glucose in familiar mg/dL units.

A diabetes educator notices a patient consistently reports blood glucose values ending in '0' or '5' (e.g., 120, 135, 150). This pattern suggests which issue?

Answer: The patient may be fabricating or estimating glucose readings

Glucose logbook entries consistently ending in 0 or 5 suggest rounding or fabrication; true glucose values are distributed randomly and rarely cluster at round numbers.

For patients with type 2 diabetes not on insulin, the ADA states that the value of routine SMBG is limited. In which scenario is SMBG MOST clinically useful for a non-insulin-treated type 2 patient?

Answer: When used as structured testing to assess impact of medication changes, meal choices, or activity

Structured SMBG—paired pre/post testing around specific events—provides actionable data for non-insulin-treated patients evaluating the effect of lifestyle or medication adjustments.

Which CGM metric best reflects the risk of hypoglycemia and is recommended as a primary endpoint in clinical CGM reporting?

Answer: Time Below Range (<70 mg/dL)

Time Below Range (<70 mg/dL) directly quantifies hypoglycemia exposure and is a primary CGM endpoint in international consensus recommendations.

A patient asks why her A1C improved from 8.5% to 7.2% but her glucometer log shows no significant change in her average daily glucose. What is the most likely explanation?

Answer: She reduced postprandial spikes that her usual fasting-focused SMBG schedule did not capture

SMBG focused on fasting values misses postprandial spikes; if the patient addressed diet-related excursions not previously measured, A1C would improve without an apparent change in her logged values.

What is the recommended bedtime blood glucose target range to minimize overnight hypoglycemia risk for adults with type 1 diabetes on basal-bolus insulin therapy?

Answer: 100–140 mg/dL

A bedtime glucose of 100–140 mg/dL provides a buffer above the hypoglycemia threshold while the patient sleeps and basal insulin acts overnight.