Diabetes Blood Sugar Management 5 — Questions and Answers
Question 1: A person with type 1 diabetes plans to run a half-marathon. What proactive blood sugar strategy is most recommended?
- Skip all insulin doses on race day to prevent hypoglycemia
- Reduce basal/bolus insulin and increase carbohydrate intake around the event (Correct answer)
- Increase insulin doses to handle the carb-loading before the race
- Avoid all carbohydrates to keep glucose stable
Correct answer: Reduce basal/bolus insulin and increase carbohydrate intake around the event
Reducing insulin and increasing carbohydrate intake around prolonged exercise helps prevent exercise-induced hypoglycemia.
Question 2: What is the primary reason blood glucose should be checked before driving for a person with insulin-treated diabetes?
- High glucose impairs night vision specifically
- Hypoglycemia impairs cognitive function and reaction time, creating accident risk (Correct answer)
- Glucose meters are only accurate in a stationary environment
- Driving raises glucose and requires dose adjustment
Correct answer: Hypoglycemia impairs cognitive function and reaction time, creating accident risk
Hypoglycemia reduces alertness and reaction time, making driving dangerous; a pre-drive check ensures glucose is in a safe range.
Question 3: Which insulin storage rule is critical to maintain potency?
- All insulin should be frozen until the day of use
- Open insulin vials in use can be kept at room temperature for up to 28–30 days (Correct answer)
- Insulin should be shaken vigorously before each injection
- Insulin exposed to sunlight for under an hour is still fully effective
Correct answer: Open insulin vials in use can be kept at room temperature for up to 28–30 days
Most insulin formulations can be kept at room temperature for 28–30 days after opening without significant loss of potency.
Question 4: What is 'glycemic variability' and why does it matter beyond A1C?
- The difference between morning and evening A1C readings
- Fluctuations in blood glucose levels throughout the day, which increase oxidative stress and complication risk (Correct answer)
- The amount of insulin needed to lower glucose by one point
- Weekly variation in fasting glucose numbers
Correct answer: Fluctuations in blood glucose levels throughout the day, which increase oxidative stress and complication risk
High glycemic variability, even with an acceptable A1C, increases oxidative stress and is associated with greater diabetes complication risk.
Question 5: In a patient with hypoglycemia unawareness, what is the recommended treatment approach?
- Increase insulin doses to prevent any high glucose episodes
- Raise the blood glucose targets temporarily to restore hypoglycemia awareness (Correct answer)
- Avoid all exercise permanently
- Switch from insulin to oral medications only
Correct answer: Raise the blood glucose targets temporarily to restore hypoglycemia awareness
Deliberately relaxing glucose targets to prevent hypoglycemia allows counter-regulatory hormone responses to recover, restoring awareness.
Question 6: Which carbohydrate counting approach is used in intensive insulin therapy to match bolus insulin precisely to meal intake?
- Plate method
- Insulin-to-carb ratio (ICR) (Correct answer)
- Glycemic index scoring
- Carb elimination diet
Correct answer: Insulin-to-carb ratio (ICR)
The insulin-to-carb ratio defines how many grams of carbohydrate one unit of rapid-acting insulin will cover.
Question 7: Which of the following best describes 'reactive hypoglycemia'?
- Low blood sugar occurring during fasting or overnight
- Blood sugar drop 1–3 hours after a high-carbohydrate meal due to excessive insulin response (Correct answer)
- Hypoglycemia triggered by physical activity
- Low glucose caused by intentionally skipping meals
Correct answer: Blood sugar drop 1–3 hours after a high-carbohydrate meal due to excessive insulin response
Reactive hypoglycemia is a postprandial drop in blood glucose caused by an exaggerated insulin response to carbohydrate intake.
Diabetes Blood Sugar Management 5
A person with type 1 diabetes plans to run a half-marathon.
What proactive blood sugar strategy is most recommended?