Test Your Knowledge Answers

A: A QI process is a systematic review of process and outcome data to measure the effectiveness of the education and support and looks for ways to improve any identified gaps in service or service quality. The process includes staff from a variety of levels and departments that are relevant to the specific QI project (B). A QI project can select a number of groups as the customer, including people with diabetes, thirdparty payers, regulatory agencies, and so on. (C) Implementing a QI process in a DSMES program is recommended in the National Standards (D).

B: People with diabetes are more likely than others to suffer from dental problems and periodontal diseases. Prolonged hyperglycemia and the accumulation of advanced glycation end products in gingival tissue are thought to be primarily responsible for oral complications of diabetes. Periodontal disease is thought to the be most prevalent oral complication of diabetes.

Although these symptoms (A, C, and D) certainly occur in people with diabetes, none of these is the most prevalent oral complication.

B: Thyroid disorders are the most common autoimmune disorder associated with type 1 diabetes, with an incidence of about 17%. People with thyroid autoimmunity may be euthyroid, hypothyroid, or hyperthyroid. Adults with type 1 diabetes are also prone to many other autoimmune disorders (A, C, D).

D: Osmotic changes in the lens is correct. Blurred vision that improves and worsens with changes in glucose is likely related to osmotic changes. Detached retina (C), macular degeneration (B), and nonproliferative diabetic retinopathy (A) all represent changes that are constant once they occur.