Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What would be the best choice to resolve hyperglycemia after breakfast for a teenager with type 1 diabetes?

1. Suggest taking pre-breakfast lispro earlier.

2. Suggest adding a midmorning snack.

3. Suggest increasing his basal insulin.

4. Suggest exercising daily either before or after breakfast.

The correct answer is: Suggest taking pre-breakfast lispro earlier.

Taking pre-breakfast lispro earlier is an effective strategy to address post-breakfast hyperglycemia in a teenager with type 1 diabetes. Insulin therapy in type 1 diabetes typically relies on the timing and amount of insulin administered relative to carbohydrate intake. By administering lispro, a rapid-acting insulin, earlier, it allows the insulin to start working before the glucose from the breakfast begins to enter the bloodstream. This can effectively manage the blood sugar spikes that often occur after meals. Timing is critical in managing blood glucose levels, especially in children and adolescents who may have varying absorption rates and different activity levels. Early administration can align better with the glucose rise from their meal, therefore aiding in keeping blood sugar levels within a target range post-meal. This option is preferable for someone already on a set insulin regimen. Adjustments to medication schedules, such as moving lispro to be administered sooner, provide a direct action aligned with meals, which is essential in managing the condition effectively. The other options, while they may have their benefits, do not directly counteract the immediate impact of a hyperglycemic response to a meal. For instance, adding a midmorning snack could help in maintaining overall blood glucose levels but does not specifically address the issue