Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What is the greatest priority intervention for a 22-year-old female with type 1 diabetes who has not been responsible with her self-care?

1. Referral to a nephrologist to check for CKD

2. Referral to an ophthalmologist for an annual dilated eye exam

3. Referral for medical nutrition therapy for a review of good eating practices

4. Pre-conception counseling to prevent unplanned pregnancy

The correct answer is: Pre-conception counseling to prevent unplanned pregnancy

The priority intervention for a 22-year-old female with type 1 diabetes who has struggled with self-care is pre-conception counseling to prevent unplanned pregnancy. This is crucial for women of childbearing age with diabetes, as uncontrolled blood glucose levels before and during pregnancy can significantly increase the risk of serious complications for both the mother and the baby, including congenital malformations, macrosomia, and pregnancy loss. Pre-conception counseling emphasizes the importance of achieving good glycemic control prior to conception, as well as educating the patient about the risks of unplanned pregnancy for someone with diabetes. This intervention not only addresses immediate health needs but also promotes long-term health outcomes for both the mother and future children. Other interventions, while important, do not address the immediate risks associated with the potential for pregnancy. Referrals for kidney checks, eye exams, and nutritional therapy are important for overall diabetes management but are not as urgent in the context of preventing the specific risks associated with pregnancy in young women with type 1 diabetes. This makes pre-conception counseling the most critical priority in this scenario.