CP/PE/RF/Patho/Sequelae
List at least 4 risk factors of T2DM. (400pts)
Family History and Genetics
Weight/Obesity
Lifestyle and Environmental Factors
Physical Inactivity
Diet
Stress and Sleep
Demographic Factors
Age
Race and Ethnicity.
Pre-existing Medical Conditions
Prediabetes.
Pregnancy-Related Risks
Metabolic Syndrome Components
Other Conditions
What is the difference between HbA1c and plasma glucose? (300pts)
HbA1c measures average blood glucose over two to three months
Plasma glucose measures the immediate level of sugar in the blood at the moment of testing.
List the 3 reasons why sitagliptin was added to Ms. Breaux’s medication regimen. (500pts)
Favorable benefit to risk ratio
availability as a combination tablet with metformin
coverage on her insurance provider’s formulary of sitagliptin
How can lifestyle changes affect adipose tissue metabolism? (400pts)
Abdominal fat promotes insulin resistance by releasing free fatty acids and triggering inflammation. A plant-based diet and reduced simple carbohydrates promote weight loss, shrinking adipose tissue to decrease these inflammatory factors and improve insulin response.
List at least 3 long-term complications that can occur if T2DM is not managed. (300pts)
Diabetic Retinopathy
Diabetic Nephropathy
Diabetic Neuropathy
Cardiovascular Disease
Foot Ulcers and Amputations
Systemic Conditions
What level of HbA1c indicates diabetes? (500pts)
≥6.5% diagnoses diabetes
What is the MOA of metformin? (300pts)
A biguanide that inhibits mitochondrial complex I in the liver, which decreases glucose production, decreasing intestinal absorption, and increasing insulin sensitivity.
What is the utility of a point-of-care fingerstick glucose test? (300pts)
Quick Screening/Diagnosis
Patients can track daily blood sugar at home, measuring the impact of lifestyle changes and identifying hyper- or hypoglycemia trends.
List at least 4 symptoms of T2DM. (400pts)
What are the ideal values for glycemic control? (500pts)
Daily Blood Glucose Levels should ideally be maintained between 90 to 130 mg/dL.
Hemoglobin A1c (HbA1c) should be less than 7%.
What is the MOA of sitagliptin? (300pts)
DPP-4 inhibitor, prevents degradation of GLP-1 and GIP. This boosts insulin secretion and reduces glucagon to lower blood glucose.
When can bariatric surgery be used as a treatment for T2DM? (400pts)
It is typically reserved for those with major comorbidities whose condition remains uncontrolled despite medical treatment.
indicated for BMI greater than 35 regardless of co-morbidities, or a BMI greater than 30 with metabolic diseases like Type 2 diabetes.
Which pancreatic cell is involved in T2DM? (300pts)
Beta-cells that secrete insulin
What level of fasting plasma glucose indicates diabetes? (500pts)
Pre-diabetes is 100–125 mg/dL; ≥126 mg/dL diagnoses diabetes.
What is the boxed warning complication that occurs with metformin? (400pts)
Metformin inhibits mitochondrial complex I, reducing liver gluconeogenesis and increasing lactate production.
How can lifestyle changes affect skeletal muscle metabolism? (400pts)
Muscles are primary sites for glucose uptake. Activity directly consumes blood glucose, while regular exercise improves insulin sensitivity for more efficient absorption.
What is the proper term that describes “Velvety, hyper-pigmented patches?” (300pts)
Acanthosis nigricans
What does the finding of elevated C-peptide indicate? (300pts)
Released with insulin; high levels indicate hyperinsulinemia.
This shows the pancreas is overproducing insulin to compensate for peripheral resistance, typical of early to mid-stage T2DM.
What is the purpose of using B12 supplementations for this patient? (300pts)
For type 2 diabetes patients on metformin due to the risk of deficiency. This can cause anemia, leading to a falsely elevated HbA1c, which compromises the accuracy of glycemic monitoring.
List at least 4 lifestyle modifications that can be done to manage T2DM. (400pts)
Dietary Adjustments: Prioritize a plant-based diet high in fiber, whole grains, and healthy fats while avoiding saturated fats and refined carbs.
Physical Activity: Perform 150+ minutes of aerobic exercise weekly across five days. Avoid prolonged sitting by moving every 30 minutes.
Weight Management: Losing 5% to 10% of body weight improves insulin sensitivity.
Quit Smoking & Alcohol: reduce cardiovascular risks and improve management.
Stress & Sleep: chronic stress and poor sleep negatively impact blood sugar.
Monitoring & Daily Care: Perform daily blood glucose checks and foot inspections
Mental Health: Diabetes significantly increases risks for depression and anxiety