Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What might be a consequence of not properly coordinating the transition from IV to subcutaneous insulin?

1. Improved diabetes education

2. Risk of blood glucose fluctuations

3. Less frequent monitoring

4. Enhanced patient satisfaction

The correct answer is: Risk of blood glucose fluctuations

Not properly coordinating the transition from IV to subcutaneous insulin can lead to blood glucose fluctuations, which is a significant concern in diabetes management. When patients are switched from intravenous insulin, which provides tight and immediate control over blood glucose levels, to subcutaneous insulin, which has a slower onset and duration, there can be a gap in effective insulin delivery that may result in hyperglycemia or hypoglycemia. This risk is compounded if the timing, dosage, or pharmacokinetics of the subcutaneous insulin are not appropriately managed during the transition. Proper coordination is crucial to ensure that the subcutaneous insulin adequately replaces the IV insulin. Failure to do so can result in periods where blood glucose levels are not adequately controlled, leading to potential complications, including long-term damage to various organs and systems. In this context, blood glucose fluctuations can have serious implications on overall diabetes management, such as increasing the risk of acute complications like diabetic ketoacidosis or hyperglycemic hyperosmolar state. Therefore, ensuring a well-coordinated transition is vital for maintaining stable blood glucose levels and avoiding these risks.