CSOWM exam prep with questions
and well verified answers actual
exam!!! 2026
Physical Activity for Children/Adolescents with DM (1 & 2) & Pre-DM - ANSWER -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 - ANSWER -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 - ANSWER -Retinopathy (risk of
vitreous hemorrhage or retinal detachment)
,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 - ANSWER -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 - ANSWER -1. At diagnosis
2. Annually
3. When complications arise
4. When transitions in care occur
Pharmacotherapy for type 2 DM - ANSWER -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
DPP-4 inhibitors - ANSWER -weight neutral type II DM medication
ends in -gliptin
(Januvia)
Better GI tolerability over Metformin
Type II DM Meds that cause weight gain - ANSWER -Thiazolidinediones (low cost)
Sulfonylureas (Glyburide, Glipizide, Glimepiride) (low cost)
Insulin
,Behavior Management for Diabetics - ANSWER -DSMES
MNT
Physical Activity
Smoking cessation
Psychosocial care
GLP-1 Agonists - ANSWER -Liraglutide (Victoza, Saxenda)
Semaglutide (Ozempic, Wegovy)
Exenatide
Dulaglutide (Trulicity)
Injections that affect POMC neurons and cause satiety
SGLT2 inhibitors - ANSWER -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 - ANSWER -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)
For pt's with high weight-related stress, special accommodations should be made to ensure
privacy
Obesity Management in Type II DM (short-term) - ANSWER -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) - ANSWER -For >/= 1 year weight
maintenance:
- minimum monthly contact
- 200-300 min/wk of physical activity
-self-monitoring
Look AHEAD Trial - ANSWER -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 - ANSWER -Metformin
Alpha-glucosidase inhibitors
SGLT-2 inhibitors
GLP-1 agonsits
Amylin mimetics (Pramlintide)
Metabolic Surgery for Type II DM - ANSWER -BMI >/= 35 (Asian Americans >/= 32.5)
Pts who do not achieve durable weight loss and improvement in comorbidities with
nonsurgical methods
and well verified answers actual
exam!!! 2026
Physical Activity for Children/Adolescents with DM (1 & 2) & Pre-DM - ANSWER -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 - ANSWER -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 - ANSWER -Retinopathy (risk of
vitreous hemorrhage or retinal detachment)
,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 - ANSWER -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 - ANSWER -1. At diagnosis
2. Annually
3. When complications arise
4. When transitions in care occur
Pharmacotherapy for type 2 DM - ANSWER -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
DPP-4 inhibitors - ANSWER -weight neutral type II DM medication
ends in -gliptin
(Januvia)
Better GI tolerability over Metformin
Type II DM Meds that cause weight gain - ANSWER -Thiazolidinediones (low cost)
Sulfonylureas (Glyburide, Glipizide, Glimepiride) (low cost)
Insulin
,Behavior Management for Diabetics - ANSWER -DSMES
MNT
Physical Activity
Smoking cessation
Psychosocial care
GLP-1 Agonists - ANSWER -Liraglutide (Victoza, Saxenda)
Semaglutide (Ozempic, Wegovy)
Exenatide
Dulaglutide (Trulicity)
Injections that affect POMC neurons and cause satiety
SGLT2 inhibitors - ANSWER -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 - ANSWER -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)
For pt's with high weight-related stress, special accommodations should be made to ensure
privacy
Obesity Management in Type II DM (short-term) - ANSWER -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) - ANSWER -For >/= 1 year weight
maintenance:
- minimum monthly contact
- 200-300 min/wk of physical activity
-self-monitoring
Look AHEAD Trial - ANSWER -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 - ANSWER -Metformin
Alpha-glucosidase inhibitors
SGLT-2 inhibitors
GLP-1 agonsits
Amylin mimetics (Pramlintide)
Metabolic Surgery for Type II DM - ANSWER -BMI >/= 35 (Asian Americans >/= 32.5)
Pts who do not achieve durable weight loss and improvement in comorbidities with
nonsurgical methods
