Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What is the most likely cause of elevated blood glucose in a homeless man who only eats one meal a day?

1. Lack of transportation to the pharmacy

2. Inability to pay for insulin

3. Irregular meal schedule

4. Multiple use of the same syringe

The correct answer is: Inability to pay for insulin

The most likely cause of elevated blood glucose in this situation is the inability to pay for insulin. When individuals cannot afford their insulin, it can lead to inadequately managed diabetes, causing blood glucose levels to rise significantly. Insulin is critical for those with type 1 diabetes and for many with type 2 diabetes who require it to maintain glycemic control. Without access to insulin, the body cannot effectively lower blood glucose levels, resulting in hyperglycemia. The other options, while they may contribute to various challenges in diabetes management, do not directly explain the immediate elevation in blood glucose levels as convincingly as the financial barrier to accessing insulin. Lack of transportation to the pharmacy is more about accessibility, and irregular meal schedules can affect blood sugar levels, but primarily in the context of an existing insulin regimen. Multiple use of the same syringe would pose a risk for infections or injection site issues but wouldn’t directly cause elevated blood glucose unless linked to an improper administration of insulin, which again ties back to the inability to afford it.