CSOWM exam UPDATED Exam
Questions and CORRECT Answers
Physical Activity for Children/Adolescents with DM (1 & 2) & Pre-DM - CORRECT
ANSWER - At least 60 min/day of moderate to vigorous aerobic activity
vigorous muscle strengthening and bone strengthening activity at least 3 days per week
Physical Activity for Adults with DM - CORRECT 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
Potential contraindications for diabetes and exercise - CORRECT 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.
DM and Psychosocial Care - CORRECT ANSWER - Should be integrated with a pt-
centered approach and provided to all people diagnosed
may include attitudes, expectations with meds and outcomes, affect or mood, QOL, resources
like financial, social, and emotional, and psychiatric history
Critical times to evaluate DSMES - CORRECT ANSWER - 1. At diagnosis
2. Annually
3. When complications arise
4. When transitions in care occur
Behavior Management for Diabetics - CORRECT ANSWER - DSMES
MNT
Physical Activity
Smoking cessation
Psychosocial care
Pharmacotherapy for type 2 DM - CORRECT ANSWER - Metformin initially (low cost)
Early insulin if evidence of catabolism, hyperglycemia, and A1c > 10%
SGLT-2 inhibitors or GLP-1 agonist in patients with CVD, kidney dx, or heart failure
DPP-4 inhibitors - CORRECT ANSWER - weight neutral type II DM medication
ends in -gliptin
(Januvia)
, Better GI tolerability over Metformin
Type II DM Meds that cause weight gain - CORRECT ANSWER - Thiazolidinediones
(low cost)
Sulfonylureas (Glyburide, Glipizide, Glimepiride) (low cost)
Insulin
GLP-1 Agonists - CORRECT ANSWER - Liraglutide (Victoza, Saxenda)
Semaglutide (Ozempic, Wegovy)
Exenatide
Dulaglutide (Trulicity)
Injections that affect POMC neurons and cause satiety
SGLT2 inhibitors - CORRECT ANSWER - Canagliflozin (Invokana)
Dapagliflozin (Farxiga)
Empagliflozin (Jardiance)
prevents reabsorptions of glucose as well as water in the renal tubules
Assessment of Obesity Management in Type II DM - CORRECT 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
Questions and CORRECT Answers
Physical Activity for Children/Adolescents with DM (1 & 2) & Pre-DM - CORRECT
ANSWER - At least 60 min/day of moderate to vigorous aerobic activity
vigorous muscle strengthening and bone strengthening activity at least 3 days per week
Physical Activity for Adults with DM - CORRECT 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
Potential contraindications for diabetes and exercise - CORRECT 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.
DM and Psychosocial Care - CORRECT ANSWER - Should be integrated with a pt-
centered approach and provided to all people diagnosed
may include attitudes, expectations with meds and outcomes, affect or mood, QOL, resources
like financial, social, and emotional, and psychiatric history
Critical times to evaluate DSMES - CORRECT ANSWER - 1. At diagnosis
2. Annually
3. When complications arise
4. When transitions in care occur
Behavior Management for Diabetics - CORRECT ANSWER - DSMES
MNT
Physical Activity
Smoking cessation
Psychosocial care
Pharmacotherapy for type 2 DM - CORRECT ANSWER - Metformin initially (low cost)
Early insulin if evidence of catabolism, hyperglycemia, and A1c > 10%
SGLT-2 inhibitors or GLP-1 agonist in patients with CVD, kidney dx, or heart failure
DPP-4 inhibitors - CORRECT ANSWER - weight neutral type II DM medication
ends in -gliptin
(Januvia)
, Better GI tolerability over Metformin
Type II DM Meds that cause weight gain - CORRECT ANSWER - Thiazolidinediones
(low cost)
Sulfonylureas (Glyburide, Glipizide, Glimepiride) (low cost)
Insulin
GLP-1 Agonists - CORRECT ANSWER - Liraglutide (Victoza, Saxenda)
Semaglutide (Ozempic, Wegovy)
Exenatide
Dulaglutide (Trulicity)
Injections that affect POMC neurons and cause satiety
SGLT2 inhibitors - CORRECT ANSWER - Canagliflozin (Invokana)
Dapagliflozin (Farxiga)
Empagliflozin (Jardiance)
prevents reabsorptions of glucose as well as water in the renal tubules
Assessment of Obesity Management in Type II DM - CORRECT 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
