Page 1 of 79
DIABETES PRACTICE QUESTIONS EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
DIABETES PRACTICE QUESTIONS – 250 QUESTIONS WITH RATIONALES
SECTION 1: PATHOPHYSIOLOGY & CLASSIFICATION (Questions 1-50)
1. What best describes diabetes mellitus?
A) An acute infectious disease caused by bacteria
B) A disorder defined by low blood glucose
C) A chronic metabolic disorder characterized by hyperglycemia
D) A condition limited to the pancreas only
Correct Answer: C
Rationale: Diabetes mellitus is a chronic metabolic disorder characterized by
hyperglycemia resulting from defects in insulin secretion, insulin action, or both . The
other options are incorrect descriptions of the condition.
2. Type 1 diabetes results from:
A) Insulin resistance and impaired beta cell function
B) Autoimmune destruction of the islet beta cells in the pancreas
C) Excessive glucagon production
D) Obesity and sedentary lifestyle
Correct Answer: B
Rationale: Type 1 diabetes results from autoimmune destruction of the islet beta cells
in the pancreas . This leads to absolute insulin deficiency. Infiltrating immune cells
produce inflammatory agents that destroy beta cells, and environmental factors such
as viral infections may trigger this process.
3. Which of the following best explains the pathophysiology of type 2 diabetes?
, Page 2 of 79
A) Autoimmune destruction of beta cells only
B) Impaired beta cell function, impaired insulin responsiveness, and excessive glucagon
production
C) Low glucagon production with normal insulin action
D) Increased insulin responsiveness in all tissues
Correct Answer: B
Rationale: Type 2 diabetes is characterized by a combination of impaired beta cell
function, impaired insulin responsiveness in target tissues (insulin resistance), and
excessive glucagon production . Patients with insulin resistance initially have high
circulating insulin levels, but beta cells eventually fail, leading to diabetes .
4. What percentage of beta cell destruction typically leads to hyperglycemia and
clinical diagnosis of type 1 diabetes?
A) 10-20%
B) 30-40%
C) 50-60%
D) 80-90%
Correct Answer: D
Rationale: Destruction of approximately 80-90% of beta cells leads to hyperglycemia
and clinical diagnosis . This explains why type 1 diabetes often presents acutely.
5. In type 2 diabetes, resistance to insulin occurs in which tissues? (Select all that
apply.)
A) Skeletal muscle
B) Adipose tissue
C) Liver
D) All of the above
Correct Answer: D
Rationale: Insulin resistance in type 2 diabetes affects skeletal muscle, adipose tissue,
and the liver . Impaired insulin responsiveness in these tissues impedes glucose
transport from circulation.
6. Which HLA haplotypes present a high risk for developing type 1 diabetes?
, Page 3 of 79
A) DR1 and DR2
B) DR3 and DR4
C) DR5 and DR6
D) DR7 and DR8
Correct Answer: B
Rationale: HLA haplotypes DR3 and DR4 present a high risk for developing type 1
diabetes . These genetic markers are associated with autoimmune susceptibility.
7. In type 2 diabetes, what is the role of glucagon?
A) Glucagon secretion is decreased in most patients
B) Glucagon secretion is inappropriately elevated in many patients
C) Glucagon has no role in diabetes
D) Glucagon secretion is normal
Correct Answer: B
Rationale: In many patients with type 2 diabetes, glucagon secretion by pancreatic
alpha cells appears to be inappropriately elevated, contributing to hyperglycemia . A
decreased insulin:glucagon ratio contributes to elevated blood glucose.
8. What is the primary mechanism by which insulin resistance develops?
A) Increased glucose uptake in tissues
B) Abnormal insulin receptors and post-receptor suppression of insulin signals
C) Increased insulin secretion
D) Autoimmune destruction of beta cells
Correct Answer: B
Rationale: Insulin resistance can develop from abnormal insulin receptors (structure or
count) and post-receptor suppression of the insulin signal . This prevents tissues from
responding appropriately to insulin.
9. Which chromosome abnormalities are associated with type 1 diabetes?
A) Chromosomes 9 and 22
B) Chromosomes 6 and 11
C) Chromosomes 7 and 12
D) Chromosomes 2 and 8
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Correct Answer: B
Rationale: Type 1 diabetes is associated with genetic abnormalities on chromosomes 6
and 11 . These regions contain genes related to immune function and beta cell
susceptibility.
10. What is the most important risk factor for developing type 2 diabetes?
A) Autoimmune predisposition
B) Obesity and family history of diabetes
C) Viral infection
D) Hyperkinetic lifestyle
Correct Answer: B
Rationale: Important risk factors for type 2 diabetes include obesity and family
predisposition . Lifestyle factors such as sedentary behavior and poor diet also
contribute significantly to risk.
11. A 21-year-old patient with BMI of 41 kg/m² and HbA1c of 9.2% is diagnosed with
type 2 diabetes at age 14. The pathophysiology of his condition is best
characterized by:
A) Autoimmune destruction of beta cells only
B) Insulin resistance and beta cell dysfunction
C) Decreased peripheral glucose uptake
D) Decreased hepatic gluconeogenesis
Correct Answer: B
Rationale: Type 2 diabetes is characterized by resistance to insulin actions in target
tissues. Pancreatic beta cells initially compensate by increasing insulin secretion, but
eventually they fail. Thus, both insulin resistance and insufficiency of beta cell function
are important features in type 2 diabetes pathogenesis .
12. In type 1 diabetes, the "vulnerability" of beta cells in genetic predisposition is
presented as:
A) Unmotivated beta cell apoptosis
B) Increased sensitivity to external provocators (viruses, toxins)
C) Autochthonic autoimmune beta-cellular rejection
D) Normoglycemic beta-cellular vulnerability
DIABETES PRACTICE QUESTIONS EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
DIABETES PRACTICE QUESTIONS – 250 QUESTIONS WITH RATIONALES
SECTION 1: PATHOPHYSIOLOGY & CLASSIFICATION (Questions 1-50)
1. What best describes diabetes mellitus?
A) An acute infectious disease caused by bacteria
B) A disorder defined by low blood glucose
C) A chronic metabolic disorder characterized by hyperglycemia
D) A condition limited to the pancreas only
Correct Answer: C
Rationale: Diabetes mellitus is a chronic metabolic disorder characterized by
hyperglycemia resulting from defects in insulin secretion, insulin action, or both . The
other options are incorrect descriptions of the condition.
2. Type 1 diabetes results from:
A) Insulin resistance and impaired beta cell function
B) Autoimmune destruction of the islet beta cells in the pancreas
C) Excessive glucagon production
D) Obesity and sedentary lifestyle
Correct Answer: B
Rationale: Type 1 diabetes results from autoimmune destruction of the islet beta cells
in the pancreas . This leads to absolute insulin deficiency. Infiltrating immune cells
produce inflammatory agents that destroy beta cells, and environmental factors such
as viral infections may trigger this process.
3. Which of the following best explains the pathophysiology of type 2 diabetes?
, Page 2 of 79
A) Autoimmune destruction of beta cells only
B) Impaired beta cell function, impaired insulin responsiveness, and excessive glucagon
production
C) Low glucagon production with normal insulin action
D) Increased insulin responsiveness in all tissues
Correct Answer: B
Rationale: Type 2 diabetes is characterized by a combination of impaired beta cell
function, impaired insulin responsiveness in target tissues (insulin resistance), and
excessive glucagon production . Patients with insulin resistance initially have high
circulating insulin levels, but beta cells eventually fail, leading to diabetes .
4. What percentage of beta cell destruction typically leads to hyperglycemia and
clinical diagnosis of type 1 diabetes?
A) 10-20%
B) 30-40%
C) 50-60%
D) 80-90%
Correct Answer: D
Rationale: Destruction of approximately 80-90% of beta cells leads to hyperglycemia
and clinical diagnosis . This explains why type 1 diabetes often presents acutely.
5. In type 2 diabetes, resistance to insulin occurs in which tissues? (Select all that
apply.)
A) Skeletal muscle
B) Adipose tissue
C) Liver
D) All of the above
Correct Answer: D
Rationale: Insulin resistance in type 2 diabetes affects skeletal muscle, adipose tissue,
and the liver . Impaired insulin responsiveness in these tissues impedes glucose
transport from circulation.
6. Which HLA haplotypes present a high risk for developing type 1 diabetes?
, Page 3 of 79
A) DR1 and DR2
B) DR3 and DR4
C) DR5 and DR6
D) DR7 and DR8
Correct Answer: B
Rationale: HLA haplotypes DR3 and DR4 present a high risk for developing type 1
diabetes . These genetic markers are associated with autoimmune susceptibility.
7. In type 2 diabetes, what is the role of glucagon?
A) Glucagon secretion is decreased in most patients
B) Glucagon secretion is inappropriately elevated in many patients
C) Glucagon has no role in diabetes
D) Glucagon secretion is normal
Correct Answer: B
Rationale: In many patients with type 2 diabetes, glucagon secretion by pancreatic
alpha cells appears to be inappropriately elevated, contributing to hyperglycemia . A
decreased insulin:glucagon ratio contributes to elevated blood glucose.
8. What is the primary mechanism by which insulin resistance develops?
A) Increased glucose uptake in tissues
B) Abnormal insulin receptors and post-receptor suppression of insulin signals
C) Increased insulin secretion
D) Autoimmune destruction of beta cells
Correct Answer: B
Rationale: Insulin resistance can develop from abnormal insulin receptors (structure or
count) and post-receptor suppression of the insulin signal . This prevents tissues from
responding appropriately to insulin.
9. Which chromosome abnormalities are associated with type 1 diabetes?
A) Chromosomes 9 and 22
B) Chromosomes 6 and 11
C) Chromosomes 7 and 12
D) Chromosomes 2 and 8
, Page 4 of 79
Correct Answer: B
Rationale: Type 1 diabetes is associated with genetic abnormalities on chromosomes 6
and 11 . These regions contain genes related to immune function and beta cell
susceptibility.
10. What is the most important risk factor for developing type 2 diabetes?
A) Autoimmune predisposition
B) Obesity and family history of diabetes
C) Viral infection
D) Hyperkinetic lifestyle
Correct Answer: B
Rationale: Important risk factors for type 2 diabetes include obesity and family
predisposition . Lifestyle factors such as sedentary behavior and poor diet also
contribute significantly to risk.
11. A 21-year-old patient with BMI of 41 kg/m² and HbA1c of 9.2% is diagnosed with
type 2 diabetes at age 14. The pathophysiology of his condition is best
characterized by:
A) Autoimmune destruction of beta cells only
B) Insulin resistance and beta cell dysfunction
C) Decreased peripheral glucose uptake
D) Decreased hepatic gluconeogenesis
Correct Answer: B
Rationale: Type 2 diabetes is characterized by resistance to insulin actions in target
tissues. Pancreatic beta cells initially compensate by increasing insulin secretion, but
eventually they fail. Thus, both insulin resistance and insufficiency of beta cell function
are important features in type 2 diabetes pathogenesis .
12. In type 1 diabetes, the "vulnerability" of beta cells in genetic predisposition is
presented as:
A) Unmotivated beta cell apoptosis
B) Increased sensitivity to external provocators (viruses, toxins)
C) Autochthonic autoimmune beta-cellular rejection
D) Normoglycemic beta-cellular vulnerability
