Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

For insulin-requiring patients experiencing a hypoglycemic event right before a meal, what is the best course of action?

1. Skip insulin if blood glucose is low and take insulin later

2. Eat the meal but delay insulin until an hour later

3. Treat as normal, then take the recommended insulin dose

4. Administer insulin immediately, then eat as usual

The correct answer is: Treat as normal, then take the recommended insulin dose

The best course of action for insulin-requiring patients experiencing a hypoglycemic event right before a meal is to treat as normal and then take the recommended insulin dose. This approach ensures that the immediate concern of hypoglycemia is addressed first. If a patient is currently experiencing low blood glucose levels, it is important to first raise the blood sugar to a safe level before proceeding with their usual insulin regimen. By treating the hypoglycemic event, typically through the consumption of fast-acting carbohydrates, the patient can stabilize their blood glucose levels. Once blood sugars have returned to a safer range, taking the recommended insulin dose helps maintain proper glucose management while accounting for the anticipated carbohydrate intake from the meal. This strategy aligns with best practices in diabetes management, promoting both safety and effective control of blood glucose levels. In contrast, skipping insulin could lead to excessive blood sugar spikes after the meal since the necessary insulin to manage the carbohydrate intake wouldn't be administered. Delaying insulin could complicate blood sugar management as the timing of insulin action is important relative to meal intake. Administering insulin immediately during a hypoglycemic state without first addressing the low blood sugar could risk further lowering blood glucose levels, potentially leading to severe hypoglycemia. Thus, treating the hypoglycemic