Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What is the primary recommendation for addressing hypo unawareness?

1. Increase blood glucose monitoring and CGM use

2. Set less stringent glucose targets for several weeks

3. Focus on more stringent blood glucose control

4. Increase precautions like ceasing driving

The correct answer is: Set less stringent glucose targets for several weeks

The primary recommendation for addressing hypoglycemia unawareness is to set less stringent glucose targets for several weeks. This approach is beneficial because individuals with hypoglycemia unawareness often have a diminished ability to recognize the warning signs of low blood sugar, which may lead to severe hypoglycemic episodes without realizing it. By temporarily relaxing glucose targets, the individual can help prevent low blood sugar levels and allow their body to regain the ability to recognize hypoglycemia when it does occur. This period of less stringent control helps to minimize the risk of hypoglycemia and supports more stable glucose levels. In contrast, increasing blood glucose monitoring and using continuous glucose monitoring (CGM) are helpful practices for overall diabetes management and may assist in awareness, but they do not directly address the underlying issue of hypoglycemia unawareness. Focusing on more stringent blood glucose control can increase the risk of hypoglycemia in individuals already experiencing unawareness, and increasing precautions, such as ceasing driving, may be necessary as a safety measure but doesn't directly resolve the issue of unawareness. Therefore, setting less stringent glycemic targets is the most effective initial recommendation to support those experiencing hypo unawareness.