Why asking for details about diabetes management matters when interviewing a client with type 1 diabetes

Interviewing a client with type 1 diabetes: start with what they manage, not just what’s wrong

In nursing, the first moments with a patient set the tone for the whole encounter. When a client with type 1 diabetes comes in, the natural impulse might be to look for immediate signs—blood glucose levels, symptoms of hypo- or hyperglycemia, or risk flags. But here’s the thing: the most important first move during the interview is to ask for details about how they manage their diabetes. That question—open-ended and patient-centered—unlocks the story behind the numbers.

Let me explain why this matters. Type 1 diabetes isn’t just a diagnosis; it’s a daily routine. Insulin timing, the foods eaten, activity levels, how blood glucose is checked, and even how a person copes on stressful days—these pieces all shape a client’s current health status. If you skip asking about management, you risk missing gaps in knowledge, misinterpreting symptoms, or proposing education that doesn’t fit their reality. By inviting the client to describe their management, you build trust, encourage active participation, and lay the groundwork for tailored, effective care.

What details truly matter when you’re gathering the story

During the interview, you want a clear map of the client’s diabetes management. Here are the key areas to explore, in conversational chunks that feel natural rather than checklist-like:

• Insulin regimen

• What types of insulin are they using (rapid-acting, long-acting, or premixed)?

• How is the dosing scheduled (before meals, at bedtime, or a combination)?

• How do they adjust doses for meals, exercise, or illness?

• Do they ever miss doses or have trouble obtaining insulin?

• Blood glucose monitoring

• How often do they check their blood glucose?

• Do they use a continuous glucose monitor (CGM) or finger-stick checks?

• What are their usual target ranges, and have those targets changed recently?

• Have they noticed patterns around certain times of day, foods, or activities?

• Diet and carbohydrate management

• Do they carb-count or follow a fixed meal plan?

• How do they estimate insulin doses based on carbs?

• Are there foods that consistently cause unexpected highs or lows?

• Physical activity and exercise

• What kinds of activity do they engage in, and how often?

• How does exercise affect their glucose readings, and how do they respond?

• Sick day management

• What do they do when they’re sick—any changes in insulin, fluids, or meals?

• Do they monitor ketones or seek medical help during illness?

• Complications and risks

• Have they experienced severe hypoglycemia or diabetic ketoacidosis in the past?

• Are there frequent emergency visits or hospitalizations?

• Access, adherence, and psychosocial factors

• Are there barriers to getting insulin, supplies, or a healthy diet?

• How is their mental health—do stress or burnout affect their management?

• Do they have family support or a caregiver who helps with care?

• Knowledge gaps and education needs

• Which areas of diabetes management feel confusing or overwhelming?

• Are they comfortable recognizing hypo- and hyperglycemia, and do they know what actions to take?

A gentle script you can adapt in the moment

You don’t need a script, but having a flexible framework helps. Here are open-ended prompts you can weave into the conversation:

• “Tell me about a typical day in managing your diabetes.”

• “What part of your regimen feels straightforward, and what feels tricky right now?”

• “What does your insulin schedule look like around meals or workouts?”

• “How do you handle high or low readings when you’re at work or school?”

• “Are there any supplies or costs that have made management harder recently?”

• “What would you like education or support with most at the moment?”

If the client lichens with you long enough, you’ll hear the rhythm of their life and how diabetes fits into it. That rhythm tells you where to focus next—whether it’s refining insulin timing, planning meals around activity, or addressing a recurring barrier.

Why this is the best first move, not the other options

You might wonder about the other possible actions in the moment: checking a blood glucose level, encouraging a support group, or providing education right away. Here’s why starting with detailed management questions is the smarter opening:

• Assess before you intervene: Asking about management gives you a real-time snapshot of how the client actually lives with diabetes. It frames what you observe in the moment (glucose readings, symptoms, or test results) within the context of daily routines.

• Tailor the next steps: If the client can describe their regimen clearly, you can pinpoint exactly where education, adjustment, or support is needed. A generic admonition to “learn more about diabetes” might feel distant or irrelevant if you haven’t heard their lived experience.

• Build rapport and empower the patient: People tend to engage more when they’re invited to share their story. This isn’t just soft talk—engagement correlates with adherence and better outcomes. When clients feel heard, they’re more likely to participate in crafting a plan that fits their life.

From details to care: how the interview informs the care plan

Once you’ve gathered the management details, you transform information into action. Here’s how the thread weaves together:

• Identify gaps and priorities: Are there misunderstandings about insulin dosing? Is there inconsistent monitoring? Are sick-day rules unclear? Prioritize the issues that pose immediate risks or are most likely to improve daily life.

• Personalize education: Education isn’t one-size-fits-all. If a client struggles with carb counting, you tailor nutrition-focused coaching. If they’re new to CGM data, you guide how to interpret trends and respond to alarms.

• Align with the client’s routine: You’ll suggest strategies that fit their day-to-day—work schedules, school routines, family responsibilities. The more their plan mirrors real life, the more sustainable it becomes.

• Plan follow-up and monitoring: Schedule check-ins on insulin adjustments, monitor for patterns in glucose data, and adjust targets as needed. This isn’t a one-off; diabetes care thrives on ongoing collaboration.

Common sense tips to sharpen the interviewing craft

These small moves make a big difference in the interview’s quality and usefulness:

• Use active listening: nod, summarize, and reflect back what you hear. “So your morning readings are higher after breakfast, and you adjust with a small basal insulin dose, correct?”

• Ask neutral, nonjudgmental questions: avoid implying fault or blame for lapses in management. The goal is understanding, not fault-finding.

• Paraphrase what you hear: repeating a key point confirms accuracy and invites correction if you misunderstood.

• Document clearly and promptly: jot down the specifics—insulin types, doses, monitoring frequency, and any patient-reported barriers. Good notes reduce miscommunication later.

• Balance breadth and depth: cover the essentials, but allow space for topics that matter to the client. You’ll often learn more by following the client’s lead.

A quick tour of tools that enrich the assessment

In today’s care environment, technology can be a gentle ally during the interview:

• Glucose meters and CGMs offer data-rich conversation fodder. You can ask, “Tell me what the CGM trends show over the past 24 hours.”

• Logbooks and apps (for example, popular platforms like Dexcom or Libre-compatible apps) help you translate numbers into real-life behavior.

• Telehealth and digital education resources make follow-up feasible when in-person visits aren’t possible.

How this aligns with ATI content and everyday clinical reasoning

Within ATI’s assessment-related materials, nurses are encouraged to approach each client as a person with a life outside the clinic walls. The interview isn’t just about collecting data; it’s about building a partnership. By starting with what the client currently does to manage diabetes, you gather context that sharpens your clinical judgment, guides safe care, and supports better health outcomes. The ability to translate a patient’s routine into tailored interventions is a core skill you’ll rely on far beyond exams and into a real-world practice.

Three takeaways you can carry forward

• Begin with the management story: asking for details about how the client lives with diabetes is the best first step in any interview.

• Use open-ended questions to uncover patterns: insulin timing, monitoring habits, diet, exercise, sick-day plans, and psychosocial factors all matter.

• Move smoothly from story to plan: once you understand their routine, craft education and support that fit their life, then revisit and adapt as needed.

A few practical questions to tuck into your next client interview

• “Walk me through a typical day of managing your diabetes.”

• “How do you adjust your insulin around meals and workouts?”

• “What happens if you notice a high or a low reading—what steps do you take?”

• “Are there any barriers to getting needles, test strips, or other supplies right now?”

• “What would help you feel more confident about your diabetes management?”

The bottom line

When the client with type 1 diabetes sits in front of you, the best first action is to ask for details about how they manage their condition. This approach builds rapport, reveals practical needs, and sets the stage for a personalized care plan that respects their life as it is lived. It’s a small step with big implications—and it’s exactly the kind of thoughtful assessment that anchors successful nursing care.

If you’re exploring ATI content and want to strengthen your assessment skills, keep practicing this patient-centered interviewing approach. The better you get at inviting stories, the more you’ll understand the numbers behind them—and the better outcomes you’ll help your clients achieve.