NAPLEX Diabetes Questions with 100% Correct Answers

NAPLEX Diabetes Questions with 100% Correct Answers C-peptide What test is done to determine if a patient is still producing insulin? Very low or absent (undetectable) How do you diagnose T1DM with C-peptide test? insulin (preferred; metformin and glyburide are sometimes used) What medications are preferred in diabetes in pregnancy? 35 years old When should patients be screened for diabetes? Diabetes: 6.5% or higher Prediabetes: 5.7-6.4% Diagnostic criteria for diabetes and prediabetes (A1c)? Diabetes: 126 or higher Prediabetes: 100-125 Diagnostic criteria for diabetes and prediabetes (FPG)? Diabetes: 200 or higher Prediabetes: 140-199 Diagnostic criteria for diabetes and prediabetes (OGTT)? A1c: <7% Pre-prandial: 80-130 2-hr PPG: <180 Glycemic targets in diabetes (not pregnant)? Pre-prandial: 95 or lower 1-hr PPG: 140 or lower 2-hr PPG: 120 or lower Glycemic targets in diabetes (pregnant)? 6% = 126mg/dL Each additional 1% = 28mg/dL A1c and eAG (estimated average glucose) <35 inches (females) <40 inches (males) What is the goal waist circumference? - retinopathy - diabetic kidney disease (nephropathy) - peripheral neuropathy - autonomic neuropathy (gastroparesis, loss of bladder control, erectile dysfunction) What are examples of microvascular complications with diabetes? - CAD (including MI) - Cerebrovascular disease (including stroke, CVA) - PAD What are examples of macrovascular complications with diabetes? pregabalin, duloxetine, gabapentin What are some treatment options to treat peripheral neuropathy? Diabetes + ASCVD Age 50-75 years + multiple ASCVD risk factors When is a high-intensity statin indicated in patients with diabetes? Diabetes + age 40-75 years (no ASCVD) Diabetes + age <40 years + ASCVD risk factors When is a moderate-intensity statin indicated in patients with diabetes? Ezetimibe What add on therapy can be considered for cholesterol control in diabetic patients when the patients ASCVD 10-yr risk >20% Icosapent ethyl What add on therapy can be considered for cholesterol control in diabetic patients when the patients LDL is controlled but TGs are 135-499mg/dL ACE-I or ARB What medication is recommended in diabetic patients with albuminuria? SGLT2 inhibitor (or Finerenone in patients unable to take SGLT2i) What medication is recommended in diabetic patients with eGFR 25 or more and urine albumin 300 or more? GLP-1a or SGLT2i Which medications have been proven benefit at baseline regardless of A1C in patients who have ASCVD, HF, or CKD? metformin + non-insulin drug What should be done at baseline of A1C 8.5-10% Insulin What can be started initially if hyperglycemia is severe (A1c >10% or BG 300 or more)? DPP-4i, GLP-1a, SGLT2i, TZD Which antidiabetics are best for hypoglycemic risk? GLP-1a and SGLT2i Which antidiabetics are best for weight loss? SU or TZD Which antidiabetics are best for cost? DPP4i + GLP-1a SU + insulin Which antidiabetics should not be combined? Metformin works by decreasing hepatic glucose production, increasing insulin sensitivity, and decreasing intestinal absorption of glucose mg/day What is the max dose of Metformin? 1000mg BID What is the usual maintenance dose of Metformin? eGFR <30, acute or chronic metabolic acidosis (includes DKA) What are contraindications for Metformin? Lactic acidosis (increased with renal impairment, contrast, excessive alcohol, certain drugs) Not recommended in eGFR 30-45 Vitamin B12 deficiency What are some warnings for Metformin? decrease 1-2% What effect does metformin have on A1c? 48 hours When should metformin be restarted after using contrast media? iodinated contrast media, excessive alcohol