CSOWM STUDY GUIDE QUESTIONS
WITH COMPLETE SOLUTIONS
A1C value diagnostic for diabetes - Correct Answers -A1C ≥ 6.5% (48 mmol/mol),
confirmed by NGSP-certified method standardized to the DCCT assay.
Fasting plasma glucose (FPG) level indicating diabetes - Correct Answers -FPG ≥ 126
mg/dL (7.0 mmol/L) after no caloric intake for at least 8 hours.
2-hour plasma glucose (2-h PG) level during a 75-g OGTT indicating diabetes - Correct
Answers -2-h PG ≥ 200 mg/dL (11.1 mmol/L).
Criteria for diagnosing prediabetes - Correct Answers -A1C: 5.7-6.4% (39-47
mmol/mol), FPG: 100-125 mg/dL (5.6-6.9 mmol/L), 2-h PG: 140-199 mg/dL (7.8-11.0
mmol/L).
Age to begin diabetes screening for asymptomatic individuals without risk factors -
Correct Answers -Age 35 years.
Screening frequency for individuals with normal glucose levels but high risk - Correct
Answers -At least every 3 years, or sooner if risk factors change.
Components of a comprehensive lifestyle intervention - Correct Answers -Reduced-
calorie diet, increased physical activity, and behavioral strategies.
Recommended equation to estimate RMR - Correct Answers -Mifflin-St. Jeor equation
using actual weight.
Physical activity factor for sedentary adults - Correct Answers -1.0 to <1.4.
Medications that increase diabetes risk - Correct Answers -Glucocorticoids, second-
generation antipsychotics, and some HIV medications.
Test that identifies more individuals with prediabetes and diabetes - Correct Answers -2-
h PG during OGTT.
Most effective lifestyle interventions in preventing type 2 diabetes - Correct Answers -
Dietary changes, increased physical activity, and weight loss.
, Two main strategies for diagnosing gestational diabetes mellitus (GDM) - Correct
Answers -One-step: 75-g OGTT with fasting, 1-h, and 2-h measurements; Two-step: 50-
g glucose load test followed by 100-g OGTT if positive.
Postpartum follow-up for individuals diagnosed with GDM - Correct Answers -75-g
OGTT at 4-12 weeks postpartum and lifelong screening every 1-3 years.
Advantages of A1C testing over glucose testing - Correct Answers -No fasting required,
greater preanalytical stability, and reflects chronic glycemia.
Conditions that may interfere with A1C accuracy - Correct Answers -Hemoglobin
variants, anemia, pregnancy, HIV, dialysis, and recent blood loss.
Pathophysiology of type 2 diabetes - Correct Answers -Progressive insulin resistance
combined with a relative insulin secretory defect.
Primary cause of type 1 diabetes - Correct Answers -Autoimmune destruction of
pancreatic β-cells, leading to absolute insulin deficiency.
Risk factors for type 2 diabetes - Correct Answers -Overweight/obesity, physical
inactivity, family history, race/ethnicity, hypertension, dyslipidemia, history of GDM or
PCOS.
Significance of early detection of prediabetes - Correct Answers -Enables timely lifestyle
interventions to prevent or delay progression to type 2 diabetes.
Recommended test for postpartum screening in women with GDM - Correct Answers -
75-g OGTT at 4-12 weeks postpartum.
Role of weight management in diabetes prevention - Correct Answers -Weight loss
improves insulin sensitivity and reduces risk of progression from prediabetes to type 2
diabetes.
Limitations of the OGTT - Correct Answers -Requires fasting, is time-consuming, and
results can be affected by recent diet or activity.
Reliability of A1C in certain populations - Correct Answers -Conditions affecting red
blood cell turnover (e.g., anemia, hemoglobinopathies) can distort A1C results.
Monogenic diabetes - Correct Answers -A rare form of diabetes caused by single gene
mutations, often misdiagnosed as type 1 or type 2 diabetes.
ADA's stance on using A1C for screening in children - Correct Answers -A1C is less
sensitive in children; FPG or OGTT may be preferred for accurate diagnosis.
WITH COMPLETE SOLUTIONS
A1C value diagnostic for diabetes - Correct Answers -A1C ≥ 6.5% (48 mmol/mol),
confirmed by NGSP-certified method standardized to the DCCT assay.
Fasting plasma glucose (FPG) level indicating diabetes - Correct Answers -FPG ≥ 126
mg/dL (7.0 mmol/L) after no caloric intake for at least 8 hours.
2-hour plasma glucose (2-h PG) level during a 75-g OGTT indicating diabetes - Correct
Answers -2-h PG ≥ 200 mg/dL (11.1 mmol/L).
Criteria for diagnosing prediabetes - Correct Answers -A1C: 5.7-6.4% (39-47
mmol/mol), FPG: 100-125 mg/dL (5.6-6.9 mmol/L), 2-h PG: 140-199 mg/dL (7.8-11.0
mmol/L).
Age to begin diabetes screening for asymptomatic individuals without risk factors -
Correct Answers -Age 35 years.
Screening frequency for individuals with normal glucose levels but high risk - Correct
Answers -At least every 3 years, or sooner if risk factors change.
Components of a comprehensive lifestyle intervention - Correct Answers -Reduced-
calorie diet, increased physical activity, and behavioral strategies.
Recommended equation to estimate RMR - Correct Answers -Mifflin-St. Jeor equation
using actual weight.
Physical activity factor for sedentary adults - Correct Answers -1.0 to <1.4.
Medications that increase diabetes risk - Correct Answers -Glucocorticoids, second-
generation antipsychotics, and some HIV medications.
Test that identifies more individuals with prediabetes and diabetes - Correct Answers -2-
h PG during OGTT.
Most effective lifestyle interventions in preventing type 2 diabetes - Correct Answers -
Dietary changes, increased physical activity, and weight loss.
, Two main strategies for diagnosing gestational diabetes mellitus (GDM) - Correct
Answers -One-step: 75-g OGTT with fasting, 1-h, and 2-h measurements; Two-step: 50-
g glucose load test followed by 100-g OGTT if positive.
Postpartum follow-up for individuals diagnosed with GDM - Correct Answers -75-g
OGTT at 4-12 weeks postpartum and lifelong screening every 1-3 years.
Advantages of A1C testing over glucose testing - Correct Answers -No fasting required,
greater preanalytical stability, and reflects chronic glycemia.
Conditions that may interfere with A1C accuracy - Correct Answers -Hemoglobin
variants, anemia, pregnancy, HIV, dialysis, and recent blood loss.
Pathophysiology of type 2 diabetes - Correct Answers -Progressive insulin resistance
combined with a relative insulin secretory defect.
Primary cause of type 1 diabetes - Correct Answers -Autoimmune destruction of
pancreatic β-cells, leading to absolute insulin deficiency.
Risk factors for type 2 diabetes - Correct Answers -Overweight/obesity, physical
inactivity, family history, race/ethnicity, hypertension, dyslipidemia, history of GDM or
PCOS.
Significance of early detection of prediabetes - Correct Answers -Enables timely lifestyle
interventions to prevent or delay progression to type 2 diabetes.
Recommended test for postpartum screening in women with GDM - Correct Answers -
75-g OGTT at 4-12 weeks postpartum.
Role of weight management in diabetes prevention - Correct Answers -Weight loss
improves insulin sensitivity and reduces risk of progression from prediabetes to type 2
diabetes.
Limitations of the OGTT - Correct Answers -Requires fasting, is time-consuming, and
results can be affected by recent diet or activity.
Reliability of A1C in certain populations - Correct Answers -Conditions affecting red
blood cell turnover (e.g., anemia, hemoglobinopathies) can distort A1C results.
Monogenic diabetes - Correct Answers -A rare form of diabetes caused by single gene
mutations, often misdiagnosed as type 1 or type 2 diabetes.
ADA's stance on using A1C for screening in children - Correct Answers -A1C is less
sensitive in children; FPG or OGTT may be preferred for accurate diagnosis.
