Diabetes

Diagnosis/monitoring parameters

100

Signs of Hypoglycemia

Tachycardia

Shakiness

Hypertension

Diaphoresis

Decreased plasma glucose

200

What is the A1C goal for most diabetic patients? 

< 7%

300

Glycemic goal for patients with diabetes

Preprandial 80-130 mg/dL

Postprandial <180 mg/dL

400

What is recommended for patients who are at risk of level 2 or 3 hypoglycemia?

Glucagon

500

How is Hypoglycemia classified?

Level 1: glucose < 70 mg/dL, but > 54 mg/dL

Level 2: glucose < 54 mg/dL

Level 3: "severe event characterized by altered mental and/or physical status requiring assistance for treatment of hypoglycemia"

Pharmacology

100

What glucose-lowering medication class has ASCVD and Heart Failure benefits?

Sodium-Glucose Cotransporter 2 (SGLT-2) Inhibitors

200

Hypoglycemia is an adverse effect of which of the following?

a. metformin

b. glyburide

c. semaglutide

b. glyburide

300

Mrs. Picazo is a 45-year-old patient who is newly diagnosed with type 2 diabetes. The doctor initiated 4 different diabetic medications. She comes to the clinic and reports difficulty urinating and a burning sensation upon urinating. She wants to know if any of the medications she is taking caused this. Which medication is most likely the culprit?

a. metformin

b. pioglitazone

c. semaglutide

d. empagliflozin

c. glipizide

d. empagliflozin

400

Onglyza is recommended for patients at risk of heart failure

a. true

b. false

b. false

Saxagliptin (dipeptidyl peptidase-4 inhibitors) may increase the risk of heart failure

500

Mrs. Smith has a past medical history of Type 2 Diabetes and CHF. She is on Metformin 1000 mg twice a day. Vitals are as follows: BP 90/58, HR 65, BMI 28. Which of the following would be the most appropriate treatment to add to metformin? 

a. Onglyza

b. Farxiga 

c. Ozempic

d. Actos

c. Ozempic

Insulins

100

How is insulin given?

Subcutaneously (under the skin)

200

Insulin is the preferred therapy for what type of diabetes?

type 1 diabetes

300

Mrs. Finlay visited the clinic today and her glucometer records show that her morning fasting blood glucose is elevated, which insulin dose would you adjust?

a. Bolus insulin before breakfast

b. evening basal insulin

c. Bolus insulin before dinner

d. Bolus insulin before lunch

b. evening basal insulin

400

How is basal insulin dose initiated in Type 2 diabetes? 

Fixed dose: start 10 units once a day 

Weight-based: 0.1 to 0.2 units/kg/day

500

When do we consider insulin over GLP-1 receptor agonist or initiation of insulin?

unusual weight loss

symptoms of hyperglycemia (polyuria, polydipsia, polyphagia)

HbA1c >10%

Blood glucose levels 300 mg/dL or more

Prevention

100

How are lipids being managed in patients with diabetes?

All patients age 40-75 years with diabetes

HMG-CoA reductase inhibitors (statin)

200

What vaccines are recommended for patients who have a history or have diabetes?

Hepatitis B vaccine

Pneumococcal vaccine

Influenza vaccine

COVID-19 vaccine

300

Do any of the glucose-lowering agents improve cardiovascular risk? Give examples of those medications, if any. 

Yes

SGLT-2 inhibitors

GLP-1 Receptor Agonists

400

What agent was approved by the U.S. Food and Drug Administration (FDA) for diabetes prevention?

none

500

Microvascular complications of diabetes

Neuropathy

Nephropathy

Retinopathy