NAPLEX Diabetes Questions with 100%
Correct Answers
Cause of Diabetes
High BG due to:
-Decreased Insulin secretion
-Decreased Insulin sensitivity
Chronic______________can lead to damage throughout the body including organ damage
Hyperglycemia
Insulin is produced by
Beta cells in Pancreas
Functions of Insulin
Moves glucose into body cells to be used as energy
-Moves BG in muscle cells
-Helps stores BG as Glycogen in liver cells
-Helps stores BG as Fat in Adipose (fat) cells
Glucose is either moved to muscle cells (primarily) for immediate use or stored for later use by the
liver as
Glycogen or adipose
Glucagon is produced by
Alpha cells in pancreas
Glucagon works when
BG is low
Glucagon pulls glucose back into circulation by
Releasing glucose from glycogen
What will glucagon do if glycogen is depleted
signal fat cells to make ketones as an alternative energy source
Type 1 Diabetes
Autoimmune destruction of beta-cells (no insulin is produced in the body)
Initial presentation: DKA
Type 1 Diabetes DKA MOA
Body goes into starvation mode and starts to metabolize fats into ketones to use as an alernative
energy source. High levels of ketones, which are acidic, cause DKA
Type 1 Diabetes in what patients?
Children
,Test used to see if Insulin is produced
C-peptide test
-Diagnosis of Type 1 Diabetes is when there is low C-peptide
Type 2 Diabetes
Due to Insulin resistance
Due to Insulin deficiency
Type 2 Diabetes is strongly associated with
Obesity, physical inactivity, family history
T2DM can be managed with_____________(unlike type 1)
Lifestyle modifications alone
Or in combination with medications [insulin and non, type 1 is only insulin]
Prediabetes
-Increased risk of developing diabetes
-BG higher than normal but not for diagnosis
decrease progression from prediabetes to diabetes
Following dietary and exercise recommendations
Metformin in prediabetes
-help patients w/ BMI ≥ 35 kg/m2
-patients less than 60 years
-women w/ hx of gestational DM
In Prediabetes, monitoring
Annual monitoring for diabetes
Types of Diabetes in Pregnancy
Diabetes b4 being pregnant
Diabetes during pregnancy[GDM]
-BG goals strict in both cases [than nonpregnant goals]
Babies born to hyperglycemic mothers
-Macrosomia
-Risk of obesity and diabetes in later life
Non-pharmacologic therapy for diabetes in pregnancy
-diet & exercise [lifestyle]
-Insulin [if meds are needed, insulin is prefered]
Screening for Diabetes in pregnancy
,-Pregnant women tested at 24-28 weeks, oGTT [oral glucose tolerance test]
Risk factors for T2D
-A1c ≥ 5.7%
-1st-degree relative
-Hx of Gestational DIabetes
-Overweight (BMI ≥ 25 kg/m2 OR ≥23 Asian-Americans)
-Physical inactivity
-Race/ethnicity
Classic symptoms of diabetes
polyuria,
polydipsia,
polyphagia
Fatigue
DKA as initial presentation in T1DM
Screening for DM
risk increases with age
So testing begins at 35 if no RF
Asymptomatic but overweight with 1 or more RF(all ages)
Diagnosis of Diabetes
Hemoglobin A1c - past 3 months
(FPG) test - after 8 hours (fasting plasma glu)
(OGTT) - 2 hours after drinking high glucose liquid
(+) test for Diabetes should be
confirmed w/ 2nd test
Exception: Clear diagnosis (Classical Symptoms of HG + BG (>/=) 200)
Exception to 2nd test
Clear diagnosis (Classical Symptoms of HG + BG (>/=) 200)
Criteria of Diabetes
1. A1C
2. FPG
3. OGTT
-A1c ≥6.5%
-FPG ≥126
-oGTT ≥200
Criteria for prediabetes
1. FPG
2. oGTT
3. A1c
1) Fasting plasma glucose 100-125
2) 2 hr post 75g oGTT 140-199
, 3) A1C 5.7-6.4%
Glycemic goals for Not pregnant
A1c - <7%
Pre-prandial - 80-130
2-hr PPG - <180
Glycemic goals for Pregnant
Pre-prandial - ≤95
1-hr PPG - ≤140
2-hr PPG - ≤120
Provides quick results at the site of patient care
point of care testing
T/F
Patients can monitor their own BG
True
using glucose meter or continuous glucose monitoring devices
Diabetes testing frequency
Q3 months if not at goal
Q6 months if at goal
Estimated Average Glucose (eAG)
translates a patients A1C into a glucose number
A1C of 6% is equivalent to an eAG of ________
=126 mg/dL
Every additional 1% ~28mg/dL increase
so A1c 7%= 126+28= 154 eAG
Lifestyle modifications for Diabetes
Weight loss
Individualized medical nutrition therapy(Natural Carbs, Carb-counting)
Physical activity
Smoking cessation
Lifestyle modifications for Diabetes
Individualized medical nutrition therapy
-Consume only natural forms of carbs (eg fruit)
- T1 diabetics should use carb counting esp for prandial insulin
-A carb serving is 15 grams= 1fruit, or 1 slice of bread, or 1/3 cup coooked rice/pasta
Lifestyle modifications for Diabetes
Correct Answers
Cause of Diabetes
High BG due to:
-Decreased Insulin secretion
-Decreased Insulin sensitivity
Chronic______________can lead to damage throughout the body including organ damage
Hyperglycemia
Insulin is produced by
Beta cells in Pancreas
Functions of Insulin
Moves glucose into body cells to be used as energy
-Moves BG in muscle cells
-Helps stores BG as Glycogen in liver cells
-Helps stores BG as Fat in Adipose (fat) cells
Glucose is either moved to muscle cells (primarily) for immediate use or stored for later use by the
liver as
Glycogen or adipose
Glucagon is produced by
Alpha cells in pancreas
Glucagon works when
BG is low
Glucagon pulls glucose back into circulation by
Releasing glucose from glycogen
What will glucagon do if glycogen is depleted
signal fat cells to make ketones as an alternative energy source
Type 1 Diabetes
Autoimmune destruction of beta-cells (no insulin is produced in the body)
Initial presentation: DKA
Type 1 Diabetes DKA MOA
Body goes into starvation mode and starts to metabolize fats into ketones to use as an alernative
energy source. High levels of ketones, which are acidic, cause DKA
Type 1 Diabetes in what patients?
Children
,Test used to see if Insulin is produced
C-peptide test
-Diagnosis of Type 1 Diabetes is when there is low C-peptide
Type 2 Diabetes
Due to Insulin resistance
Due to Insulin deficiency
Type 2 Diabetes is strongly associated with
Obesity, physical inactivity, family history
T2DM can be managed with_____________(unlike type 1)
Lifestyle modifications alone
Or in combination with medications [insulin and non, type 1 is only insulin]
Prediabetes
-Increased risk of developing diabetes
-BG higher than normal but not for diagnosis
decrease progression from prediabetes to diabetes
Following dietary and exercise recommendations
Metformin in prediabetes
-help patients w/ BMI ≥ 35 kg/m2
-patients less than 60 years
-women w/ hx of gestational DM
In Prediabetes, monitoring
Annual monitoring for diabetes
Types of Diabetes in Pregnancy
Diabetes b4 being pregnant
Diabetes during pregnancy[GDM]
-BG goals strict in both cases [than nonpregnant goals]
Babies born to hyperglycemic mothers
-Macrosomia
-Risk of obesity and diabetes in later life
Non-pharmacologic therapy for diabetes in pregnancy
-diet & exercise [lifestyle]
-Insulin [if meds are needed, insulin is prefered]
Screening for Diabetes in pregnancy
,-Pregnant women tested at 24-28 weeks, oGTT [oral glucose tolerance test]
Risk factors for T2D
-A1c ≥ 5.7%
-1st-degree relative
-Hx of Gestational DIabetes
-Overweight (BMI ≥ 25 kg/m2 OR ≥23 Asian-Americans)
-Physical inactivity
-Race/ethnicity
Classic symptoms of diabetes
polyuria,
polydipsia,
polyphagia
Fatigue
DKA as initial presentation in T1DM
Screening for DM
risk increases with age
So testing begins at 35 if no RF
Asymptomatic but overweight with 1 or more RF(all ages)
Diagnosis of Diabetes
Hemoglobin A1c - past 3 months
(FPG) test - after 8 hours (fasting plasma glu)
(OGTT) - 2 hours after drinking high glucose liquid
(+) test for Diabetes should be
confirmed w/ 2nd test
Exception: Clear diagnosis (Classical Symptoms of HG + BG (>/=) 200)
Exception to 2nd test
Clear diagnosis (Classical Symptoms of HG + BG (>/=) 200)
Criteria of Diabetes
1. A1C
2. FPG
3. OGTT
-A1c ≥6.5%
-FPG ≥126
-oGTT ≥200
Criteria for prediabetes
1. FPG
2. oGTT
3. A1c
1) Fasting plasma glucose 100-125
2) 2 hr post 75g oGTT 140-199
, 3) A1C 5.7-6.4%
Glycemic goals for Not pregnant
A1c - <7%
Pre-prandial - 80-130
2-hr PPG - <180
Glycemic goals for Pregnant
Pre-prandial - ≤95
1-hr PPG - ≤140
2-hr PPG - ≤120
Provides quick results at the site of patient care
point of care testing
T/F
Patients can monitor their own BG
True
using glucose meter or continuous glucose monitoring devices
Diabetes testing frequency
Q3 months if not at goal
Q6 months if at goal
Estimated Average Glucose (eAG)
translates a patients A1C into a glucose number
A1C of 6% is equivalent to an eAG of ________
=126 mg/dL
Every additional 1% ~28mg/dL increase
so A1c 7%= 126+28= 154 eAG
Lifestyle modifications for Diabetes
Weight loss
Individualized medical nutrition therapy(Natural Carbs, Carb-counting)
Physical activity
Smoking cessation
Lifestyle modifications for Diabetes
Individualized medical nutrition therapy
-Consume only natural forms of carbs (eg fruit)
- T1 diabetics should use carb counting esp for prandial insulin
-A carb serving is 15 grams= 1fruit, or 1 slice of bread, or 1/3 cup coooked rice/pasta
Lifestyle modifications for Diabetes
