Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What is the appropriate action for a patient with T2DM who has an increasing A1c after multiple months of self-care?

1. Reassure the patient that this is common and normal

2. Encourage the patient to be more diligent with self-care

3. Discuss potential anxiety related to diabetes management

4. Suggest the patient consult with a mental health professional

The correct answer is: Suggest the patient consult with a mental health professional

For a patient with Type 2 Diabetes Mellitus (T2DM) who is experiencing an increasing A1c level after several months of self-care, suggesting that the patient consult with a mental health professional is a crucial step. This approach acknowledges that diabetes management is multifaceted and can significantly be impacted by psychological factors, including anxiety and depression. Mental health issues can create barriers to effective self-care, making it difficult for the patient to adhere to treatment plans or maintain healthy lifestyle changes. Addressing mental health is essential because it can lead to improved self-management and, subsequently, better glycemic control. When a patient struggles with anxiety or other psychological challenges, it can affect their motivation and ability to engage in necessary self-care behaviors such as monitoring blood glucose, adhering to dietary recommendations, or exercising regularly. Consulting with a mental health professional provides the opportunity for the patient to receive support and strategies to manage these challenges, thereby potentially improving their overall diabetes management and A1c levels. While encouraging the patient to be more diligent with self-care is important, this alone may not address underlying issues that contribute to their rising A1c. Similarly, reassuring the patient that fluctuations in A1c are common may overlook the need for further evaluation and intervention. Discussing