Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What statement about medication administration indicates further education is needed for the patient?

1. "When I had to skip breakfast and lunch the day of a procedure, I took my glyburide but skipped my levemir"

2. "I leave my Lantus pen on my nightstand all the time to remember it at bedtime"

3. "I take my metformin every morning even if I will be skipping breakfast"

4. "I throw away the NL vial I am using after 4 weeks even if it's still half full"

The correct answer is: "When I had to skip breakfast and lunch the day of a procedure, I took my glyburide but skipped my levemir"

The statement indicating that further education is needed is related to the patient's management of insulin and oral hypoglycemic agents during periods of fasting. Specifically, taking glyburide, an oral medication that promotes insulin release from the pancreas, without consuming any food can lead to hypoglycemia. This means that on days when the patient is skipping meals, it’s crucial to adjust the medication regimen accordingly to prevent potential dangerously low blood sugar levels. In contrast, Levemir, a long-acting insulin, could typically be administered regardless of meal time, but individualized recommendations should be based on blood glucose levels and specific medical advice from a healthcare provider. In this scenario, it’s essential for patients to fully understand how to adjust their medication based on dietary intake and the timing of their insulin or oral diabetes medications. The other statements reflect more appropriate practices regarding medication adherence, storage, and management. For example, storing Lantus at room temperature on a nightstand is a recognized method for keeping it accessible, and taking metformin consistently aligns with its prescribed usage. Lastly, disposing of an unopened vial of insulin after four weeks, regardless of its fullness, follows the manufacturer's guidelines for insulin expiration, showcasing an understanding of proper handling and safety.