BCADM Exam
Type 1 Diabetes -ANSWER✅✅✅Due to autoimmune beta cell destruction, usually
leading to absolute insulin deficiency
Type 2 Diabetes -ANSWER✅✅✅Due to progressive loss of adequate beta-cell insulin
secretion frequently on the background of insulin resistance
MODY -ANSWER✅✅✅Maturity Onset Diabetes of Young; shows up when you're an
adolescent or young adult. It's caused by mutations that affect how well your body
makes insulin
LADA -ANSWER✅✅✅Latent autoimmune Diabetes; LADA happens because your
body makes antibodies that cause the immune system to attack the insulin-making cells
of your pancreas.
What A1C diagnoses diabetes? -ANSWER✅✅✅>6.5%
What A1C diagnoses pre-diabetes? -ANSWER✅✅✅>5.4%
What fasting blood glucose diagnoses diabetes? -ANSWER✅✅✅>126
When should you screen a patient for diabetes/pre-diabetes? -ANSWER✅✅✅BMI >25
+ 1 risk factor
At what age should "healthy" patients start being screened? -ANSWER✅✅✅45 years
old
How frequently should patients be tested? -ANSWER✅✅✅Every 3 years
How frequently should well controlled diabetes be checked? -ANSWER✅✅✅Every 6
months
How frequently should uncontrolled diabetes be checked? -ANSWER✅✅✅Every 3
months
At what point should kids be screened for diabetes? -ANSWER✅✅✅>85th percentile +
1 risk factor (FH, GDM mom, etc)
What medications can cause diabetes? -ANSWER✅✅✅Steroids
HIV meds
Atypical antipsychotics
,Thiazide diuretics
What are risk factors for gestational diabetes? -ANSWER✅✅✅Overweight/Obese
FH of diabetes
Previous birth >9 lbs
Age >25
When does gestational diabetes occur? -ANSWER✅✅✅2nd or 3rd trimester
How long after pregnancy should patients be screened for diabetes? -
ANSWER✅✅✅6-12 weeks post partum
How is gestational diabetes diagnosed? -ANSWER✅✅✅50 gram OGTT (BG >140)
What A1C goal should be set for GDM? -ANSWER✅✅✅6%
What blood sugar goals should be set for GDM? -ANSWER✅✅✅<95 mg/dL = fasting
<140 mg/dL = 1 hr PP
<120 mg/dL = 2 hr PP
How many carbs should a GDM patient eat per day? -ANSWER✅✅✅Minimum 175
g/day
How much protein should a GDM patient eat per day? -ANSWER✅✅✅Minimum 71
g/day
How much fiber should a GDM patient eat per day? -ANSWER✅✅✅Minimum 28 g/day
What medications are indicated for GDM? -ANSWER✅✅✅Insulin
Glyburide
Metformin is ok in 1st trimester
What are the 7 AADE self care behaviors? -ANSWER✅✅✅Healthy coping
Healthy eating
Being active
Taking medications
Monitoring
Problem solving
Reducing risk
What factors precipitate DKA/HHS? -ANSWER✅✅✅Infection
Pancreatitis
MI
CVA
Drugs
,New onset Type 1
Elevation in what is diagnostic of DKA? -ANSWER✅✅✅Ketones
What medication can cause euglycemic DKA? -ANSWER✅✅✅SGLT2
How does DKA/HHS present? -ANSWER✅✅✅Dehydration
Tachycardia
Tachypnic
Is DKA or HHS a quicker onset? -ANSWER✅✅✅DKA
Does DKA or HHS have higher blood sugars? -ANSWER✅✅✅HHS
Does DKA or HHS have a higher mortality rate? -ANSWER✅✅✅HHS
What is the first step when treating DKA/HHS? -ANSWER✅✅✅Treat dehydration,
0.9% NaCl with 1-1.5 L within the 1st hour
What maintenance fluids would you use for DKA/HHS? -ANSWER✅✅✅Na low = 0.9%
NaCl
Na normal/elevated = 0.45% NaCl
When should you add D5W to fluids in DKA? -ANSWER✅✅✅When BG is about 200
What insulin should you use in DKA/HHS? -ANSWER✅✅✅Regular insulin at 0.14
units/kg/hour
When should you add D5W to fluids in HHS -ANSWER✅✅✅When BG is about 300
At what potassium level do you hold insulin? -ANSWER✅✅✅<3.3
If you overshoot correcting DKA/HHS what should you do? -ANSWER✅✅✅Use
Octreotide
When can a DKA/HHS patient eat? -ANSWER✅✅✅Once you correct the anion gap
What autoimmune diseases coexist with type 1 diabetes? -ANSWER✅✅✅Celiac
disease
Thyroid disease
What labs are present at presentation of type 1 diabetes? -ANSWER✅✅✅GAD 65
Islet (DISTIGUISHES)
Insulin autoantibodies
, How does type 1 diabetes present? -ANSWER✅✅✅Polyuria
Polydipsia
Polyphagia
Lethargy
Fatigue
DKA
How do you calculate a patients total daily dose? -ANSWER✅✅✅0.5 units/kg/day
How do you calculate a basal/bonus regimen? -ANSWER✅✅✅Take patients total daily
dose...
50% Basal
50% Bolus split in to 3 doses
How do you calculate a correction factor/insulin sensitivity? -ANSWER✅✅✅Tell us the
glucose lowering effect of 1 unit of short acting insulin
Regular insulin = 1500/TDD
Rapid insulin = 1800/TDD
How do you calculate insulin to carbohydrate ratio? -ANSWER✅✅✅Regular insulin =
450/TDD
Rapid insulin = 500/TDD
T/F: hypoglycemia can cause a heart attack -ANSWER✅✅✅True- from the
catecholamine release
How frequently should microalbumin be checked in type 1 diabetics? -
ANSWER✅✅✅Start 5 years after diagnosis and then yearly after that
What counts as 15 grams of simple carbs? -ANSWER✅✅✅1/2 cup juice or soda
1 cup milk
4-5 pieces of hard candy
2-3 glucose tablets
What are the stages of hypoglycemia? -ANSWER✅✅✅<70 = hypoglycemia
<54 = clinically significant
Severe = hypoglycemia + cognitive impairment
What glucagon dose is used for adults? -ANSWER✅✅✅1 mg or 1 mL
What glucagon dose is used for children <6 years old? -ANSWER✅✅✅0.5 mg or 0.5
mL
Type 1 Diabetes -ANSWER✅✅✅Due to autoimmune beta cell destruction, usually
leading to absolute insulin deficiency
Type 2 Diabetes -ANSWER✅✅✅Due to progressive loss of adequate beta-cell insulin
secretion frequently on the background of insulin resistance
MODY -ANSWER✅✅✅Maturity Onset Diabetes of Young; shows up when you're an
adolescent or young adult. It's caused by mutations that affect how well your body
makes insulin
LADA -ANSWER✅✅✅Latent autoimmune Diabetes; LADA happens because your
body makes antibodies that cause the immune system to attack the insulin-making cells
of your pancreas.
What A1C diagnoses diabetes? -ANSWER✅✅✅>6.5%
What A1C diagnoses pre-diabetes? -ANSWER✅✅✅>5.4%
What fasting blood glucose diagnoses diabetes? -ANSWER✅✅✅>126
When should you screen a patient for diabetes/pre-diabetes? -ANSWER✅✅✅BMI >25
+ 1 risk factor
At what age should "healthy" patients start being screened? -ANSWER✅✅✅45 years
old
How frequently should patients be tested? -ANSWER✅✅✅Every 3 years
How frequently should well controlled diabetes be checked? -ANSWER✅✅✅Every 6
months
How frequently should uncontrolled diabetes be checked? -ANSWER✅✅✅Every 3
months
At what point should kids be screened for diabetes? -ANSWER✅✅✅>85th percentile +
1 risk factor (FH, GDM mom, etc)
What medications can cause diabetes? -ANSWER✅✅✅Steroids
HIV meds
Atypical antipsychotics
,Thiazide diuretics
What are risk factors for gestational diabetes? -ANSWER✅✅✅Overweight/Obese
FH of diabetes
Previous birth >9 lbs
Age >25
When does gestational diabetes occur? -ANSWER✅✅✅2nd or 3rd trimester
How long after pregnancy should patients be screened for diabetes? -
ANSWER✅✅✅6-12 weeks post partum
How is gestational diabetes diagnosed? -ANSWER✅✅✅50 gram OGTT (BG >140)
What A1C goal should be set for GDM? -ANSWER✅✅✅6%
What blood sugar goals should be set for GDM? -ANSWER✅✅✅<95 mg/dL = fasting
<140 mg/dL = 1 hr PP
<120 mg/dL = 2 hr PP
How many carbs should a GDM patient eat per day? -ANSWER✅✅✅Minimum 175
g/day
How much protein should a GDM patient eat per day? -ANSWER✅✅✅Minimum 71
g/day
How much fiber should a GDM patient eat per day? -ANSWER✅✅✅Minimum 28 g/day
What medications are indicated for GDM? -ANSWER✅✅✅Insulin
Glyburide
Metformin is ok in 1st trimester
What are the 7 AADE self care behaviors? -ANSWER✅✅✅Healthy coping
Healthy eating
Being active
Taking medications
Monitoring
Problem solving
Reducing risk
What factors precipitate DKA/HHS? -ANSWER✅✅✅Infection
Pancreatitis
MI
CVA
Drugs
,New onset Type 1
Elevation in what is diagnostic of DKA? -ANSWER✅✅✅Ketones
What medication can cause euglycemic DKA? -ANSWER✅✅✅SGLT2
How does DKA/HHS present? -ANSWER✅✅✅Dehydration
Tachycardia
Tachypnic
Is DKA or HHS a quicker onset? -ANSWER✅✅✅DKA
Does DKA or HHS have higher blood sugars? -ANSWER✅✅✅HHS
Does DKA or HHS have a higher mortality rate? -ANSWER✅✅✅HHS
What is the first step when treating DKA/HHS? -ANSWER✅✅✅Treat dehydration,
0.9% NaCl with 1-1.5 L within the 1st hour
What maintenance fluids would you use for DKA/HHS? -ANSWER✅✅✅Na low = 0.9%
NaCl
Na normal/elevated = 0.45% NaCl
When should you add D5W to fluids in DKA? -ANSWER✅✅✅When BG is about 200
What insulin should you use in DKA/HHS? -ANSWER✅✅✅Regular insulin at 0.14
units/kg/hour
When should you add D5W to fluids in HHS -ANSWER✅✅✅When BG is about 300
At what potassium level do you hold insulin? -ANSWER✅✅✅<3.3
If you overshoot correcting DKA/HHS what should you do? -ANSWER✅✅✅Use
Octreotide
When can a DKA/HHS patient eat? -ANSWER✅✅✅Once you correct the anion gap
What autoimmune diseases coexist with type 1 diabetes? -ANSWER✅✅✅Celiac
disease
Thyroid disease
What labs are present at presentation of type 1 diabetes? -ANSWER✅✅✅GAD 65
Islet (DISTIGUISHES)
Insulin autoantibodies
, How does type 1 diabetes present? -ANSWER✅✅✅Polyuria
Polydipsia
Polyphagia
Lethargy
Fatigue
DKA
How do you calculate a patients total daily dose? -ANSWER✅✅✅0.5 units/kg/day
How do you calculate a basal/bonus regimen? -ANSWER✅✅✅Take patients total daily
dose...
50% Basal
50% Bolus split in to 3 doses
How do you calculate a correction factor/insulin sensitivity? -ANSWER✅✅✅Tell us the
glucose lowering effect of 1 unit of short acting insulin
Regular insulin = 1500/TDD
Rapid insulin = 1800/TDD
How do you calculate insulin to carbohydrate ratio? -ANSWER✅✅✅Regular insulin =
450/TDD
Rapid insulin = 500/TDD
T/F: hypoglycemia can cause a heart attack -ANSWER✅✅✅True- from the
catecholamine release
How frequently should microalbumin be checked in type 1 diabetics? -
ANSWER✅✅✅Start 5 years after diagnosis and then yearly after that
What counts as 15 grams of simple carbs? -ANSWER✅✅✅1/2 cup juice or soda
1 cup milk
4-5 pieces of hard candy
2-3 glucose tablets
What are the stages of hypoglycemia? -ANSWER✅✅✅<70 = hypoglycemia
<54 = clinically significant
Severe = hypoglycemia + cognitive impairment
What glucagon dose is used for adults? -ANSWER✅✅✅1 mg or 1 mL
What glucagon dose is used for children <6 years old? -ANSWER✅✅✅0.5 mg or 0.5
mL
