Diabetes Blood Sugar Management 4 — Questions and Answers
Question 1: An A1C of 7.5% corresponds to an estimated average glucose (eAG) of approximately:
- 154 mg/dL
- 169 mg/dL (Correct answer)
- 183 mg/dL
- 197 mg/dL
Correct answer: 169 mg/dL
An A1C of 7.5% corresponds to an eAG of approximately 169 mg/dL using the standard conversion formula.
Question 2: What is 'insulin stacking' and why is it dangerous?
- Taking two different insulin brands simultaneously, causing allergic reactions
- Giving correction doses before the previous dose has fully acted, risking severe hypoglycemia (Correct answer)
- Mixing long-acting and short-acting insulin in the same syringe incorrectly
- Using an insulin pump with more than one basal rate programmed
Correct answer: Giving correction doses before the previous dose has fully acted, risking severe hypoglycemia
Insulin stacking occurs when repeated correction doses overlap, leading to accumulative effect and severe hypoglycemia.
Question 3: Which of the following is NOT a symptom of hyperglycemia?
- Polyuria (frequent urination)
- Polydipsia (excessive thirst)
- Trembling and diaphoresis (Correct answer)
- Blurred vision
Correct answer: Trembling and diaphoresis
Trembling and diaphoresis (sweating) are classic symptoms of hypoglycemia, not hyperglycemia.
Question 4: How does stress affect blood glucose levels in people with diabetes?
- Stress always lowers glucose by suppressing appetite
- Stress has no reliable effect on glucose
- Stress hormones like cortisol and adrenaline raise blood glucose (Correct answer)
- Stress lowers glucose only in type 1 diabetes
Correct answer: Stress hormones like cortisol and adrenaline raise blood glucose
Stress triggers the release of cortisol and adrenaline, which stimulate glucose production by the liver.
Question 5: A patient on a basal-bolus insulin regimen forgets their lunchtime bolus dose. What is the MOST appropriate action?
- Take the full missed dose immediately regardless of timing
- Skip the dose entirely and take the next scheduled dose normally
- Take a reduced bolus if still within the mealtime window and glucose is elevated (Correct answer)
- Double the evening dose to compensate
Correct answer: Take a reduced bolus if still within the mealtime window and glucose is elevated
A partial correction bolus during the mealtime window is safer than skipping or doubling, minimizing hypo- and hyperglycemia risk.
Question 6: Which laboratory value best reflects average blood glucose control over the past 2–3 months?
- Fasting plasma glucose
- Postprandial glucose at 2 hours
- Glycated hemoglobin (A1C) (Correct answer)
- C-peptide level
Correct answer: Glycated hemoglobin (A1C)
A1C reflects glycation of hemoglobin over the lifespan of red blood cells (~2–3 months) and serves as a long-term glucose marker.
Question 7: Which of the following conditions can cause a falsely elevated A1C result?
- Iron-deficiency anemia
- Hemolytic anemia
- Chronic kidney disease (uremia) (Correct answer)
- Pregnancy
Correct answer: Chronic kidney disease (uremia)
Uremia from chronic kidney disease can cause carbamylation of hemoglobin, which some assays read as glycated hemoglobin, falsely raising A1C.
Diabetes Blood Sugar Management 4
An A1C of 7.5% corresponds to an estimated average glucose (eAG) of approximately: