ABFM DIABETES EXAM QUESTIONS AND
ANSWERS LATEST DOWNLOAD 2024/2025 A
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Which of the following lipid-lowering agents can worsen glycemic control? (Mark all that are
true.)
Colestipol (Colestid)
Ezetimibe (Zetia)
Gemfibrozil (Lopid)
Niacin
Atorvastatin (Lipitor) - CORRECT ANSWERS D AND E
Niacin is not only the most effective agent for raising HDL-cholesterol, producing an increase
of 15%-35%, it also reduces triglycerides by 20%-50% and LDL-cholesterol by 5%-25%.
Hyperglycemia is a side effect of niacin therapy, particularly at high doses. A dosage of 750-
2000 mg/day is associated with only moderate rises in blood glucose, and at one time was
considered a treatment option in patients with diabetes, particularly those with low HDL-
cholesterol levels. However, the recommendations for niacin use were changed as a result of
the AIM-HIGH trial (Atherothrombosis Intervention in Metabolic Syndrome with Low
HDL/High Triglycerides: Impact on Global Health Outcomes), which found no incremental
clinical benefit from the addition of niacin to statin therapy in patients with coronary heart
disease and LDL-cholesterol levels >70 mg/dL.Recent studies support a link between statin
use and the development of diabetes mellitus. In a meta-analysis of 13 studies, statin
therapy was associated with a 9% increased risk for incident diabetes. Another meta-analysis
corroborated this result and found that intensive-dose statin therapy was associated with a
higher risk of new-onset diabetes compared with moderate-dose statin therapy. In 2012, the
FDA modified the package labeling of statins to include the risk of increased blood glucose
levels and the development of type 2 diabetes. The benefit of statin therapy, however,
outweighs the risk; it was estimated there would be 1 additional case of diabetes for every
498 patients treated for 1 year, compared with 1 less patient experiencing a cardiovascular
event for every 155 patients treated for 1 year.
A 58-year-old male with type 2 diabetes mellitus comes in during the early afternoon for his
annual physical examination. His current medication regimen consists of insulin glargine
(Lantus), 18 units in the evening; glipizide (Glucotrol), 20 mg/day; metformin (Glucophage),
1000 mg twice a day; and acarbose (Precose), 100 mg three times a day. He suddenly
,ABFM DIABETES EXAM QUESTIONS AND
ANSWERS LATEST DOWNLOAD 2024/2025 A
COMPLETE SOLUTION ALL ANSWERS 100%
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becomes shaky, diaphoretic, and pale, and tells you he thinks it is because he skipped lunch
before his appointment.Which of the following would be effective for managing this
episode? (Mark all that are true.)
Glucose tablets
A sugar cube
A banana
A soft drink containing sugar
Raisins
Glucagon - CORRECT ANSWERS A AND F
Acarbose, an α-glucosidase inhibitor, inhibits an enzyme present in the brush border of the
proximal intestinal epithelium that breaks down disaccharides and more complex
carbohydrates. As a result, if hypoglycemia were to occur in a patient on an α-glucosidase
inhibitor, reversal requires either the consumption of glucose itself (as opposed to complex
carbohydrates) or the injection of glucagon.
Which of the following medications can cause hyperglycemia? (Mark all that are true.)
Niacin
Clozapine (Clozaril)
Prednisone
Spironolactone
Ramipril (Altace) - CORRECT ANSWERS A, B, C
Several medications have been shown to affect glucose homeostasis, resulting in impaired
glucose tolerance and hyperglycemia. Agents associated with the development of
hyperglycemia include pentamidine, niacin, glucocorticoids, thyroid hormone, diazoxide, β-
,ABFM DIABETES EXAM QUESTIONS AND
ANSWERS LATEST DOWNLOAD 2024/2025 A
COMPLETE SOLUTION ALL ANSWERS 100%
CORRECT VERIFIED BEST RATED TO SCORE A+
FOR SUCCESS
adrenergic agonists, thiazide diuretics, phenytoin, and α-interferon. In addition, second-
generation antipsychotic agents, particularly clozapine and olanzapine, have also been linked
to the development of hyperglycemia and diabetes mellitus. Spironolactone and ramipril
have not been linked to the development of diabetes. In fact, in the HOPE (Heart Outcomes
Prevention Evaluation) study, the use of ramipril, an ACE inhibitor, appeared to reduce the
risk for developing type 2 diabetes mellitus by 20%-35%.
A 55-year-old African-American male sees you for a routine visit. His past medical history is
notable for an 8-year history of diabetes mellitus and a past history of hypercholesterolemia.
His current medications are atorvastatin (Lipitor), 20 mg/day, and extended-release
metformin (Glucophage XR), 1000 mg/day. He also reports a history of peanut allergy
manifested by lip angioedema, and carries an epinephrine auto-injector (EpiPen).On
examination he has a blood pressure of 124/80 mm Hg. His hemoglobin A1c is 6.7%. A spot
urine sample contains 40 µg albumin/mg creatinine.You see the patient 6 months later for a
follow-up visit, and a spot urine sample has an albumin/creatinine ratio of 45 µg/mg.Which
one of the following would be most appropriate initially?
Have the patient return in 6 months for a repeat urine test for albumin and creatinine
Order a 24-hour urine collection for creatinine
Recommend that the patient - CORRECT ANSWERS E
Diabetic nephropathy develops in 20%-40% of patients with diabetes, and is the leading
cause of end-stage renal disease. Persistent albuminuria in the range of 30-200 mg/24 hr
(microalbuminuria) is the earliest sign of nephropathy in patients with type 1 diabetes, and
is a marker for nephropathy in type 2 diabetes. Patients with microalbuminuria who
progress to macroalbuminuria (>300 mg/24 hr) are likely to progress to end-stage renal
disease over a period of years.Although timed 4- and 24-hour urine collections for creatinine
can be used to screen for microalbuminuria, a random spot urine specimen for
measurement of the albumin-to-creatinine ratio is the preferred method. A minimum of two
of three tests showing a urine albumin level >30 µg/mg creatinine or more over a 6-month
period confirms the diagnosis of microalbuminuria.Intensive diabetic management and the
use of ACE inhibitors and angiotensin receptor blockers (ARBs) have been shown to delay
the progression from microalbuminuria to macroalbuminuria in patients with type 1 or type
2 diabetes. Since the antiproteinuric effect is believed to be independent of blood pressure,
current ADA guidelines recommend the use of ACE inhibitors or ARBs as first-line therapy for
, ABFM DIABETES EXAM QUESTIONS AND
ANSWERS LATEST DOWNLOAD 2024/2025 A
COMPLETE SOLUTION ALL ANSWERS 100%
CORRECT VERIFIED BEST RATED TO SCORE A+
FOR SUCCESS
both type 1 and type 2 diabetic patients with microalbuminuria, even if their blood pressure
is normal. Some studies, however, have raised questions about the value of early renin-
angiotensin blockade for preventing microalbuminuria in normotensive patients with type 1
or type 2 diabetes, and ADA guidelines recommend against the use of these drugs for
patients with normal blood pressure and no albuminuria.Compared to whites, African-
Americans and Asians have a three- to fourfold higher risk of angioedema associated with
the use of ACE inhibitors. The American Heart Association recommends that ACE in
True statements regarding carbohydrate intake and diabetes mellitus include which of the
following? (Mark all that are true.)
The glycemic index is not useful in the management of diabetes mellitus
Carbohydrate sources high in protein are effective for treating hypoglycemia
Low-fat diets are more effective for achieving weight loss than low-carbohydrate diets (<130
g/day)
Excessive intake of sugar-sweetened beverages has been shown to increase the risk for
diabetes mellitus
Carbohydrates have fewer calories per gram than alcohol - CORRECT ANSWERS D AND E
Weight loss is an important therapeutic objective in overweight or obese individuals with
prediabetes or diabetes mellitus. Although low-fat diets have traditionally been promoted
for weight loss, studies indicate that diets that provide the same caloric restriction but differ
in protein, carbohydrate, or fat content are equally effective (SOR A). Both the amount and
type of carbohydrates in food influence blood glucose levels. Monitoring the total grams of
carbohydrates and using the glycemic index are both regarded as helpful strategies for
achieving glycemic control. Dietary sucrose does not increase glycemia more than isocaloric
amounts of starch, and intake of sucrose and sucrose-containing foods does not need to be
restricted because of concerns about aggravating hyperglycemia in patients with diabetes
mellitus. The use of nonnutritive sweeteners in place of caloric sweeteners has the potential
to reduce carbohydrate intake. However, it has been shown that consumption of excessive
amounts of sugar-sweetened beverages by nondiabetic persons is associated with a greater
risk of developing type 2 diabetes. Although the energy content of alcohol is approximately 7
kcal/g, compared to 4 kcal/g for carbohydrates, alcohol consumption may place patients
ANSWERS LATEST DOWNLOAD 2024/2025 A
COMPLETE SOLUTION ALL ANSWERS 100%
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FOR SUCCESS
Which of the following lipid-lowering agents can worsen glycemic control? (Mark all that are
true.)
Colestipol (Colestid)
Ezetimibe (Zetia)
Gemfibrozil (Lopid)
Niacin
Atorvastatin (Lipitor) - CORRECT ANSWERS D AND E
Niacin is not only the most effective agent for raising HDL-cholesterol, producing an increase
of 15%-35%, it also reduces triglycerides by 20%-50% and LDL-cholesterol by 5%-25%.
Hyperglycemia is a side effect of niacin therapy, particularly at high doses. A dosage of 750-
2000 mg/day is associated with only moderate rises in blood glucose, and at one time was
considered a treatment option in patients with diabetes, particularly those with low HDL-
cholesterol levels. However, the recommendations for niacin use were changed as a result of
the AIM-HIGH trial (Atherothrombosis Intervention in Metabolic Syndrome with Low
HDL/High Triglycerides: Impact on Global Health Outcomes), which found no incremental
clinical benefit from the addition of niacin to statin therapy in patients with coronary heart
disease and LDL-cholesterol levels >70 mg/dL.Recent studies support a link between statin
use and the development of diabetes mellitus. In a meta-analysis of 13 studies, statin
therapy was associated with a 9% increased risk for incident diabetes. Another meta-analysis
corroborated this result and found that intensive-dose statin therapy was associated with a
higher risk of new-onset diabetes compared with moderate-dose statin therapy. In 2012, the
FDA modified the package labeling of statins to include the risk of increased blood glucose
levels and the development of type 2 diabetes. The benefit of statin therapy, however,
outweighs the risk; it was estimated there would be 1 additional case of diabetes for every
498 patients treated for 1 year, compared with 1 less patient experiencing a cardiovascular
event for every 155 patients treated for 1 year.
A 58-year-old male with type 2 diabetes mellitus comes in during the early afternoon for his
annual physical examination. His current medication regimen consists of insulin glargine
(Lantus), 18 units in the evening; glipizide (Glucotrol), 20 mg/day; metformin (Glucophage),
1000 mg twice a day; and acarbose (Precose), 100 mg three times a day. He suddenly
,ABFM DIABETES EXAM QUESTIONS AND
ANSWERS LATEST DOWNLOAD 2024/2025 A
COMPLETE SOLUTION ALL ANSWERS 100%
CORRECT VERIFIED BEST RATED TO SCORE A+
FOR SUCCESS
becomes shaky, diaphoretic, and pale, and tells you he thinks it is because he skipped lunch
before his appointment.Which of the following would be effective for managing this
episode? (Mark all that are true.)
Glucose tablets
A sugar cube
A banana
A soft drink containing sugar
Raisins
Glucagon - CORRECT ANSWERS A AND F
Acarbose, an α-glucosidase inhibitor, inhibits an enzyme present in the brush border of the
proximal intestinal epithelium that breaks down disaccharides and more complex
carbohydrates. As a result, if hypoglycemia were to occur in a patient on an α-glucosidase
inhibitor, reversal requires either the consumption of glucose itself (as opposed to complex
carbohydrates) or the injection of glucagon.
Which of the following medications can cause hyperglycemia? (Mark all that are true.)
Niacin
Clozapine (Clozaril)
Prednisone
Spironolactone
Ramipril (Altace) - CORRECT ANSWERS A, B, C
Several medications have been shown to affect glucose homeostasis, resulting in impaired
glucose tolerance and hyperglycemia. Agents associated with the development of
hyperglycemia include pentamidine, niacin, glucocorticoids, thyroid hormone, diazoxide, β-
,ABFM DIABETES EXAM QUESTIONS AND
ANSWERS LATEST DOWNLOAD 2024/2025 A
COMPLETE SOLUTION ALL ANSWERS 100%
CORRECT VERIFIED BEST RATED TO SCORE A+
FOR SUCCESS
adrenergic agonists, thiazide diuretics, phenytoin, and α-interferon. In addition, second-
generation antipsychotic agents, particularly clozapine and olanzapine, have also been linked
to the development of hyperglycemia and diabetes mellitus. Spironolactone and ramipril
have not been linked to the development of diabetes. In fact, in the HOPE (Heart Outcomes
Prevention Evaluation) study, the use of ramipril, an ACE inhibitor, appeared to reduce the
risk for developing type 2 diabetes mellitus by 20%-35%.
A 55-year-old African-American male sees you for a routine visit. His past medical history is
notable for an 8-year history of diabetes mellitus and a past history of hypercholesterolemia.
His current medications are atorvastatin (Lipitor), 20 mg/day, and extended-release
metformin (Glucophage XR), 1000 mg/day. He also reports a history of peanut allergy
manifested by lip angioedema, and carries an epinephrine auto-injector (EpiPen).On
examination he has a blood pressure of 124/80 mm Hg. His hemoglobin A1c is 6.7%. A spot
urine sample contains 40 µg albumin/mg creatinine.You see the patient 6 months later for a
follow-up visit, and a spot urine sample has an albumin/creatinine ratio of 45 µg/mg.Which
one of the following would be most appropriate initially?
Have the patient return in 6 months for a repeat urine test for albumin and creatinine
Order a 24-hour urine collection for creatinine
Recommend that the patient - CORRECT ANSWERS E
Diabetic nephropathy develops in 20%-40% of patients with diabetes, and is the leading
cause of end-stage renal disease. Persistent albuminuria in the range of 30-200 mg/24 hr
(microalbuminuria) is the earliest sign of nephropathy in patients with type 1 diabetes, and
is a marker for nephropathy in type 2 diabetes. Patients with microalbuminuria who
progress to macroalbuminuria (>300 mg/24 hr) are likely to progress to end-stage renal
disease over a period of years.Although timed 4- and 24-hour urine collections for creatinine
can be used to screen for microalbuminuria, a random spot urine specimen for
measurement of the albumin-to-creatinine ratio is the preferred method. A minimum of two
of three tests showing a urine albumin level >30 µg/mg creatinine or more over a 6-month
period confirms the diagnosis of microalbuminuria.Intensive diabetic management and the
use of ACE inhibitors and angiotensin receptor blockers (ARBs) have been shown to delay
the progression from microalbuminuria to macroalbuminuria in patients with type 1 or type
2 diabetes. Since the antiproteinuric effect is believed to be independent of blood pressure,
current ADA guidelines recommend the use of ACE inhibitors or ARBs as first-line therapy for
, ABFM DIABETES EXAM QUESTIONS AND
ANSWERS LATEST DOWNLOAD 2024/2025 A
COMPLETE SOLUTION ALL ANSWERS 100%
CORRECT VERIFIED BEST RATED TO SCORE A+
FOR SUCCESS
both type 1 and type 2 diabetic patients with microalbuminuria, even if their blood pressure
is normal. Some studies, however, have raised questions about the value of early renin-
angiotensin blockade for preventing microalbuminuria in normotensive patients with type 1
or type 2 diabetes, and ADA guidelines recommend against the use of these drugs for
patients with normal blood pressure and no albuminuria.Compared to whites, African-
Americans and Asians have a three- to fourfold higher risk of angioedema associated with
the use of ACE inhibitors. The American Heart Association recommends that ACE in
True statements regarding carbohydrate intake and diabetes mellitus include which of the
following? (Mark all that are true.)
The glycemic index is not useful in the management of diabetes mellitus
Carbohydrate sources high in protein are effective for treating hypoglycemia
Low-fat diets are more effective for achieving weight loss than low-carbohydrate diets (<130
g/day)
Excessive intake of sugar-sweetened beverages has been shown to increase the risk for
diabetes mellitus
Carbohydrates have fewer calories per gram than alcohol - CORRECT ANSWERS D AND E
Weight loss is an important therapeutic objective in overweight or obese individuals with
prediabetes or diabetes mellitus. Although low-fat diets have traditionally been promoted
for weight loss, studies indicate that diets that provide the same caloric restriction but differ
in protein, carbohydrate, or fat content are equally effective (SOR A). Both the amount and
type of carbohydrates in food influence blood glucose levels. Monitoring the total grams of
carbohydrates and using the glycemic index are both regarded as helpful strategies for
achieving glycemic control. Dietary sucrose does not increase glycemia more than isocaloric
amounts of starch, and intake of sucrose and sucrose-containing foods does not need to be
restricted because of concerns about aggravating hyperglycemia in patients with diabetes
mellitus. The use of nonnutritive sweeteners in place of caloric sweeteners has the potential
to reduce carbohydrate intake. However, it has been shown that consumption of excessive
amounts of sugar-sweetened beverages by nondiabetic persons is associated with a greater
risk of developing type 2 diabetes. Although the energy content of alcohol is approximately 7
kcal/g, compared to 4 kcal/g for carbohydrates, alcohol consumption may place patients
