Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

In a case of a type 1 diabetic experiencing nausea, vomiting, and mild fever with elevated glucose and trace ketones, what is the recommended advice?

1. Limit carbohydrate intake

2. Stop and/or hold basal insulin until symptoms subside

3. Limit fluid intake to 2 oz per hour

4. Continue to test blood glucoses 4 times a day

The correct answer is: Continue to test blood glucoses 4 times a day

In this scenario, the key factor is to monitor blood glucose levels closely due to the presence of nausea, vomiting, and mild fever in a person with type 1 diabetes. The combination of these symptoms along with elevated glucose levels and trace ketones can be indicative of a potential illness or stress response, which can impact insulin needs and blood sugar levels. Continuing to test blood glucose four times a day allows for timely adjustments to the diabetes management plan based on fluctuations in glucose levels. Frequent monitoring is crucial in detecting any significant changes or trends that require intervention, especially since illness can lead to unpredictable glucose spikes. Regular monitoring also provides vital information to guide decisions about insulin management and other treatments that may be necessary in case of worsening symptoms or increased ketone production. It is essential to ensure that the patient remains in good health and to avoid complications such as diabetic ketoacidosis, which can occur with poor glucose control during illness. The other options present various management strategies related to dietary intake and insulin usage, but they do not emphasize the immediate and critical need to monitor blood glucose levels, which is foundational in managing potential complications in this situation.