Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which patient statement suggests that specialty care provider resources are not utilized according to ADA recommendations?

1. "I see a dentist twice a year even though I do not have and have never had gum disease."

2. "I see my ophthalmologist every 1-2 years even though he says I have no signs of retinopathy."

3. "I had my cholesterol checked when I was diagnosed with diabetes, and because I did not require meds, I will have a lipid profile taken every 5 years."

4. "I see a nephrologist annually even though my blood pressure is within normal limits and I have no diagnosed kidney problems."

The correct answer is: "I see a nephrologist annually even though my blood pressure is within normal limits and I have no diagnosed kidney problems."

The statement indicating the utilization of specialty care provider resources not aligned with ADA recommendations is the one about seeing a nephrologist annually despite having normal blood pressure and no diagnosed kidney issues. According to the American Diabetes Association (ADA), it is important for patients with diabetes to receive regular assessments for the early detection of complications related to diabetes, especially concerning kidney health. However, the organization also recommends that such specialized consultations should be proportionate to the patient's health status and risk factors. Seeing a nephrologist annually may be considered excessive in this context if there are no indicators or risk factors present that necessitate such frequent monitoring. The recommendation for nephrology referrals hinges on the presence of diabetes-related kidney issues, abnormal blood pressure, or other risk factors that could lead to kidney complications. In this case, stating that the patient sees a nephrologist annually suggests a misalignment with the ADA's approach of targeting healthcare resources based on the patient's specific health needs and the presence of complications rather than a routine, blanket approach. This demonstrates an understanding of the need to appropriately utilize specialty care based on clinical necessity rather than on a set schedule that lacks justification by the patient's current health status.