CSOWM EXAM PREP QUESTIONS AND
ANSWERS 2026 VERIFIED.
Physical Activity for Children/Adolescents with DM (1 & 2) & Pre-DM - ANS 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 - ANS 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 - ANS Retinopathy (risk of vitreous
hemorrhage or retinal detachment)
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 52
,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 - ANS 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
Critical times to evaluate DSMES - ANS 1. At diagnosis
2. Annually
3. When complications arise
4. When transitions in care occur
Behavior Management for Diabetics - ANS DSMES
MNT
Physical Activity
Smoking cessation
Psychosocial care
Pharmacotherapy for type 2 DM - ANS 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
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 52
,DPP-4 inhibitors - ANS weight neutral type II DM medication
ends in -gliptin
(Januvia)
Better GI tolerability over Metformin
Type II DM Meds that cause weight gain - ANS Thiazolidinediones (low cost)
Sulfonylureas (Glyburide, Glipizide, Glimepiride) (low cost)
Insulin
GLP-1 Agonists - ANS Liraglutide (Victoza, Saxenda)
Semaglutide (Ozempic, Wegovy)
Exenatide
Dulaglutide (Trulicity)
Injections that affect POMC neurons and cause satiety
SGLT2 inhibitors - ANS 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 - ANS 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)
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 52
, For pt's with high weight-related stress, special accommodations should be made to ensure
privacy
Obesity Management in Type II DM (short-term) - ANS 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
Obesity Management in Type II DM (long-term) - ANS For >/= 1 year weight maintenance:
- minimum monthly contact
- 200-300 min/wk of physical activity
-self-monitoring
Look AHEAD Trial - ANS 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)
DM meds that can promote weight loss - ANS Metformin
Alpha-glucosidase inhibitors
SGLT-2 inhibitors
@COPYRIGHT ALL RIGHTS RESERVED PAGE 4 OF 52
ANSWERS 2026 VERIFIED.
Physical Activity for Children/Adolescents with DM (1 & 2) & Pre-DM - ANS 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 - ANS 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 - ANS Retinopathy (risk of vitreous
hemorrhage or retinal detachment)
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 52
,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 - ANS 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
Critical times to evaluate DSMES - ANS 1. At diagnosis
2. Annually
3. When complications arise
4. When transitions in care occur
Behavior Management for Diabetics - ANS DSMES
MNT
Physical Activity
Smoking cessation
Psychosocial care
Pharmacotherapy for type 2 DM - ANS 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
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 52
,DPP-4 inhibitors - ANS weight neutral type II DM medication
ends in -gliptin
(Januvia)
Better GI tolerability over Metformin
Type II DM Meds that cause weight gain - ANS Thiazolidinediones (low cost)
Sulfonylureas (Glyburide, Glipizide, Glimepiride) (low cost)
Insulin
GLP-1 Agonists - ANS Liraglutide (Victoza, Saxenda)
Semaglutide (Ozempic, Wegovy)
Exenatide
Dulaglutide (Trulicity)
Injections that affect POMC neurons and cause satiety
SGLT2 inhibitors - ANS 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 - ANS 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)
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 52
, For pt's with high weight-related stress, special accommodations should be made to ensure
privacy
Obesity Management in Type II DM (short-term) - ANS 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
Obesity Management in Type II DM (long-term) - ANS For >/= 1 year weight maintenance:
- minimum monthly contact
- 200-300 min/wk of physical activity
-self-monitoring
Look AHEAD Trial - ANS 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)
DM meds that can promote weight loss - ANS Metformin
Alpha-glucosidase inhibitors
SGLT-2 inhibitors
@COPYRIGHT ALL RIGHTS RESERVED PAGE 4 OF 52
