Care CEUs

Management of Diabetes in Inmates

1. Which of the following statements is most accurate?

A. An individual may have diabetes if his or her A1C is greater than or equal to 5%. B. An individual may have diabetes if his or her A1C is greater than or equal to 5.7%. C. An individual may have diabetes if his or her A1C is greater than or equal to 6%. D. An individual may have diabetes if his or her A1C is greater than or equal to 6.5%.

2. Routine universal screening of all patients for type 2 diabetes is recommended at age 45.

A. True B. False

3. A fellow health care professional has questions regarding screening intervals for diabetes. Which of the following informational points should be expressed to the fellow health care professional regarding screening intervals for diabetes?

A. Testing may be repeated every 2 years when fasting plasma/serum glucose is ≤ 100 mg/dl or A1C is ≤5.7%. B. Testing may be repeated every 2 years when fasting plasma/serum glucose is ≤ 100 mg/dl or A1C is >5.7%. C. Testing may be repeated every 3 years when fasting plasma/serum glucose is ≤ 100 mg/dl or A1C is ≤5.7%. D. Testing may be repeated every 3 years when fasting plasma/serum glucose is ≤ 100 mg/dl or A1C is >5.7%.

4. A 42-year-old male patient recently started metformin therapy. The patient has questions about metformin. Which of the following counseling points should be expressed to the patient regarding metformin?

A. Metformin does not lead to GI side effects. B. Metformin may lead to GI side effects. C. Stop metformin immediately if side effects are experienced. D. Metformin is associated with hypoglycemia.

5. In patients for whom metformin is contraindicated, sulfonylureas can be prescribed as monotherapy, or they can be combined with other oral agents.

A. True B. False

6. "What is the expected total decrease in A1C (%) associated with glipizide? "

A. 0.5 - 0.8 B. 1 - 1.5 C. 1 - 2 D. 1 - 3

7. GLP-1 agonists are associated with weight gain.

A. True B. False

8. Which of the following statements is most accurate?

A. The combination of insulin and sulfonylureas may increase risk of hyperglycemia. B. The combination of insulin and sulfonylureas may increase risk of hypoglycemia. C. The combination of insulin and sulfonylureas may increase risk of hyperglycemia only in patients over 65 years of age. D. The combination of insulin and sulfonylureas may increase risk of hypoglycemia only in patients under 65 years of age.

9. A female patient was recently initiated on a medication from the thiazolidinediones (TZDs) class. Which of the following counseling points should be expressed to the patient regarding her medication?

A. TZDs may cause excessive weight loss. B. TZDs may cause weight loss, but do not increase the risk of hypoglycemia. C. TZDs may cause weight gain, but do not increase the risk of hypoglycemia. D. TZDs may cause weight gain while increasing the risk of hypoglycemia.

10. Insulin can be titrated often and is the drug most likely to rapidly bring glucose down to target levels.

A. True B. False

11. A male patient is initiated on Humulin R. Which of the following counseling points should be expressed to the patient regarding Humulin R?

A. The typical onset time for Humulin R is 5 - 10 minutes. B. The typical onset time for Humulin R is 10 - 20 minutes. C. The typical onset time for Humulin R is 30 minutes - 1 hour D. The typical onset time for Humulin R is 20 minutes - 2 hours

12. Which of the following statements is most accurate?

A. The peak associated with Lantus is 15 hours. B. The peak associated with Lantus is 18 hours. C. The peak associated with Lantus is 20 hours. D. There is no peak associated with Lantus; Lantus has a duration of approximately 24 hours.

13. Patients who are newly diagnosed with type 1 diabetes ordinarily can be started on a total daily dose of 0.2 to 0.4 units of insulin per kg per day.

A. True B. False

14. Which of the following statements regarding the procedure for mixing regular and NPH insulin is most accurate?

A. NPH should be drawn up first, followed by the regular insulin. B. Regular insulin should be drawn up first, followed by the NPH. C. Regular insulin should be drawn up first, NPH should follow 15 minutes later. D. NPH should be drawn up first, regular insulin should follow 20 minutes later.

15. All pregnant inmates should be assessed for GDM risk factors at the first prenatal visit.

A. True B. False

16. Which of the following statements is most accurate?

A. "The treatment goal for non-pregnant patients with diabetes over the age 18 is a systolic BP of <140 and a diastolic <90 mmHg. " B. "The treatment goal for non-pregnant patients with diabetes over age 18 is a systolic BP of <130 and a diastolic <80 mmHg. " C. " The treatment goal for non-pregnant patients with diabetes over age 18 is a systolic BP of <145 and a diastolic <90 mmHg. " D. "The treatment goal for non-pregnant patients with diabetes over age 18 is a systolic BP of <150 and a diastolic <90 mmHg. "

17. Which of the following statements regarding metformin is most accurate?

A. Doses <1500 mg/day are unlikely to achieve therapeutic effect as monotherapy. B. Doses > 1500 mg/day are unlikely to achieve therapeutic effect as monotherapy. C. Doses > 2000 mg/day are unlikely to achieve therapeutic effect as monotherapy. D. Doses > 2500 mg/day are unlikely to achieve therapeutic effect as monotherapy.

18. What is the recommended maximum dose of glimepiride?

A. 4 mg daily B. 6 mg daily C. 8 mg daily D. 10 mg daily


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