Chronic Pediatric Conditions Practice Test

A 12-year-old girl with type 1 diabetes has 2 months of wide glucose swings (50–350 mg/dL) and fatigue; HbA1c 9.4%. She often skips breakfast, counts carbs inconsistently, and avoids bolusing at school due to embarrassment. She uses basal glargine nightly and rapid-acting insulin with meals but misses lunchtime doses 3–4 days/week. What is the next best step in management?

A 12-year-old girl with type 1 diabetes reports frequent hypoglycemia during afternoon soccer practices for 1 month. Glucose logs show lows (50–70 mg/dL) after practice; HbA1c 7.9%. She takes rapid-acting insulin with lunch at school and often cannot finish her meal due to short lunch period. What is the most appropriate adjustment to the current treatment plan?