CSOWM EXAM FINAL PAPER VERIFIED QUESTIONS ACCURATE SOLUTIONS
Question:
Physical Activity for Adults with DM
Answer:
150 min of moderate to vigorous aerobic activity weekly (over at least 3 days) no more than 2
consecutive days w/o activity 75 min of vigorous aerobic activity weekly (if appropriate) 2-3 weekly
sessions of resistance exercise on non consecutive days all adults should decrease sedentary time
(interrupt every 30 min for BG benefit) flexibility & balance training recommended 2-3 times
weekly for older adults with DM
Question:
Potential contraindications for diabetes and exercise
Answer:
Retinopathy (risk of vitreous hemorrhage or retinal detachment) Peripheral neuropathy (exam feet,
wear protection) Autonomic neuropathy (thorough cardiac eval) Diabetic kidney disease (acutely
increase urinate albumin excretion), however no specific exercise restrictions needed.
Question:
DM and Psychosocial Care
Answer:
Should be integrated with a pt- centered approach & provided to all people diagnosed may include
attitudes: expectations with meds and outcomes, affect or mood, QOL, resources like financial,
social, emotional, and psychiatric history
Question:
,Critical times to evaluate DSMES
Answer:
1. At diagnosis 2. Annually 3. When complications arise 4. When transitions in care occur
Question:
Behavior Management for Diabetics
Answer:
DSMES MNT Physical Activity Smoking cessation Psychosocial care
Question:
Pharmacotherapy for type 2 DM
Answer:
Metformin initially (low cost) Early insulin if evidence of catabolism, hyperglycemia, & A1c > 10%
SGLT-2 inhibitors or GLP-1 agonist in patients with CVD, kidney dx, or heart failure
Question:
DPP-4 inhibitors
Answer:
weight neutral type II DM medication ends in -gliptin (Januvia) Better GI tolerability over
Metformin
Question:
Type II DM Meds that cause weight gain
Answer:
Thiazolidinediones (low cost) Sulfonylureas (Glyburide, Glipizide, Glimepiride) (low cost) Insulin
Question:
,GLP-1 Agonists
Answer:
Liraglutide (Victoza, Saxenda) Semaglutide (Ozempic, Wegovy) Exenatide Dulaglutide (Trulicity)
Injections that affect POMC neurons and cause satiety
Question:
SGLT2 inhibitors
Answer:
Canagliflozin (Invokana) Dapagliflozin (Farxiga) Empagliflozin (Jardiance) prevents reabsorptions
of glucose as well as water in the renal tubules
Question:
Assessment of Obesity Management in Type II DM
Answer:
Annual BMI calculations (more frequently if necessary) Inpatient eval may be necessary if
deterioration of medical status is associated with significant weight gain or loss (medication use,
food intake, glycemic status) For pt's with high weight-related stress, special accommodations
should be made to ensure privacy
Question:
Obesity Management in Type II DM (short-term)
Answer:
Diet, PA, and BT designed to achieve and maintain >/= 5% weight loss (3-5% is minimum for any
benefit) >/= 16 sessions in 6 months Achieve a 500-750 kcal deficit (individualized meal planning)
Individual or group settings Very low-calorie diets (</= 800 kcal) prescribed only to carefully
selected patients
Question:
Obesity Management in Type II DM (long-term)
, Answer:
For >/= 1 year weight maintenance: minimum monthly contact 200-300 min/wk of physical activity
self-monitoring
Question:
Look AHEAD Trial
Answer:
Assessed long-term health consequences of intentional wt loss. Showed feasibility of achieving and
maintaining long-term (13.5 years) weight loss in patients with type II DM. Participants randomly
assigned to the intensive lifestyle group achieved equivalent risk factor control but required fewer
glucose-, blood pressure-, and lipid-lowering meds than those randomly assigned to standard care.
Other improvements included increased mobility, physical and sexual functioning, and
health-related QoL (did NOT show reduced CVD events in diabetics & overweight/obesity)
Question:
DM meds that can promote weight loss
Answer:
Metformin Alpha-glucosidase inhibitors SGLT-2 inhibitors GLP-1 agonsits Amylin mimetics
(Pramlintide)
Question:
Metabolic Surgery for Type II DM
Answer:
BMI >/= 35 (Asian Americans >/= 32.5) Pts who do not achieve durable weight loss and
improvement in comorbidities with nonsurgical methods Can be considered with BMI of >/= 30
(Asians of >/= 27.5) who do not achieve durable weight loss & improvement in comorbidities with
tested efficacious nonsurgical methods
Question:
Adverse Effects of Metabolic Surgery
Question:
Physical Activity for Adults with DM
Answer:
150 min of moderate to vigorous aerobic activity weekly (over at least 3 days) no more than 2
consecutive days w/o activity 75 min of vigorous aerobic activity weekly (if appropriate) 2-3 weekly
sessions of resistance exercise on non consecutive days all adults should decrease sedentary time
(interrupt every 30 min for BG benefit) flexibility & balance training recommended 2-3 times
weekly for older adults with DM
Question:
Potential contraindications for diabetes and exercise
Answer:
Retinopathy (risk of vitreous hemorrhage or retinal detachment) Peripheral neuropathy (exam feet,
wear protection) Autonomic neuropathy (thorough cardiac eval) Diabetic kidney disease (acutely
increase urinate albumin excretion), however no specific exercise restrictions needed.
Question:
DM and Psychosocial Care
Answer:
Should be integrated with a pt- centered approach & provided to all people diagnosed may include
attitudes: expectations with meds and outcomes, affect or mood, QOL, resources like financial,
social, emotional, and psychiatric history
Question:
,Critical times to evaluate DSMES
Answer:
1. At diagnosis 2. Annually 3. When complications arise 4. When transitions in care occur
Question:
Behavior Management for Diabetics
Answer:
DSMES MNT Physical Activity Smoking cessation Psychosocial care
Question:
Pharmacotherapy for type 2 DM
Answer:
Metformin initially (low cost) Early insulin if evidence of catabolism, hyperglycemia, & A1c > 10%
SGLT-2 inhibitors or GLP-1 agonist in patients with CVD, kidney dx, or heart failure
Question:
DPP-4 inhibitors
Answer:
weight neutral type II DM medication ends in -gliptin (Januvia) Better GI tolerability over
Metformin
Question:
Type II DM Meds that cause weight gain
Answer:
Thiazolidinediones (low cost) Sulfonylureas (Glyburide, Glipizide, Glimepiride) (low cost) Insulin
Question:
,GLP-1 Agonists
Answer:
Liraglutide (Victoza, Saxenda) Semaglutide (Ozempic, Wegovy) Exenatide Dulaglutide (Trulicity)
Injections that affect POMC neurons and cause satiety
Question:
SGLT2 inhibitors
Answer:
Canagliflozin (Invokana) Dapagliflozin (Farxiga) Empagliflozin (Jardiance) prevents reabsorptions
of glucose as well as water in the renal tubules
Question:
Assessment of Obesity Management in Type II DM
Answer:
Annual BMI calculations (more frequently if necessary) Inpatient eval may be necessary if
deterioration of medical status is associated with significant weight gain or loss (medication use,
food intake, glycemic status) For pt's with high weight-related stress, special accommodations
should be made to ensure privacy
Question:
Obesity Management in Type II DM (short-term)
Answer:
Diet, PA, and BT designed to achieve and maintain >/= 5% weight loss (3-5% is minimum for any
benefit) >/= 16 sessions in 6 months Achieve a 500-750 kcal deficit (individualized meal planning)
Individual or group settings Very low-calorie diets (</= 800 kcal) prescribed only to carefully
selected patients
Question:
Obesity Management in Type II DM (long-term)
, Answer:
For >/= 1 year weight maintenance: minimum monthly contact 200-300 min/wk of physical activity
self-monitoring
Question:
Look AHEAD Trial
Answer:
Assessed long-term health consequences of intentional wt loss. Showed feasibility of achieving and
maintaining long-term (13.5 years) weight loss in patients with type II DM. Participants randomly
assigned to the intensive lifestyle group achieved equivalent risk factor control but required fewer
glucose-, blood pressure-, and lipid-lowering meds than those randomly assigned to standard care.
Other improvements included increased mobility, physical and sexual functioning, and
health-related QoL (did NOT show reduced CVD events in diabetics & overweight/obesity)
Question:
DM meds that can promote weight loss
Answer:
Metformin Alpha-glucosidase inhibitors SGLT-2 inhibitors GLP-1 agonsits Amylin mimetics
(Pramlintide)
Question:
Metabolic Surgery for Type II DM
Answer:
BMI >/= 35 (Asian Americans >/= 32.5) Pts who do not achieve durable weight loss and
improvement in comorbidities with nonsurgical methods Can be considered with BMI of >/= 30
(Asians of >/= 27.5) who do not achieve durable weight loss & improvement in comorbidities with
tested efficacious nonsurgical methods
Question:
Adverse Effects of Metabolic Surgery
