Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What recommendation is typically given to diabetic patients regarding the management of high blood sugar during illness?

1. Maintain normal basal insulin levels regardless of food intake

2. Increase basal insulin to help manage elevated glucose levels

3. Only take bolus insulin when eating

4. Avoid checking blood glucose when feeling unwell

The correct answer is: Increase basal insulin to help manage elevated glucose levels

The recommendation to increase basal insulin during illness for diabetic patients is grounded in the physiological changes that occur when the body is under stress. Illness can trigger the release of stress hormones such as cortisol and epinephrine, which can lead to increased insulin resistance and elevated blood glucose levels. To counteract these effects, it is often advised that patients adjust their insulin dosage, particularly their basal insulin, to maintain better control over their blood sugar levels. Patients may experience reduced oral intake due to illness, which can complicate blood sugar management. Maintaining normal hormone levels through basal insulin can prevent excessive glucose accumulation in the bloodstream. This proactive approach is vital for avoiding complications, such as diabetic ketoacidosis or hyperglycemic emergencies, particularly when food intake is not as regular due to illness. It's also important to note that maintaining normal basal insulin levels regardless of food intake, only taking bolus insulin when eating, or avoiding blood glucose checks altogether could increase the risk of uncontrolled hyperglycemia during such times. Thus, the recommendation to increase basal insulin is crucial for managing blood sugar levels effectively during illness.