NAPLEX Diabetes Questions with 100%
Correct Answers
what is the responsibility of insulin in the body?
moving glucose into cells to be used as energy
what is the function of glucagon?
when BG is low it will transform glycogen back into glucose and release it into the body. if glycogen is
depleted then it will signal fat cells to make adipose as an alternative energy source
how can metformin be used in prediabetes?
it can be useful for patients with a BMI >35 who are <60y. it can also be helpful in women with a hx of
gestational diabetes
which diabetes treatment is preferred in pregnancy?
insulin is preferred. metformin and glyburide are sometimes used
what are the classic sx of diabetes?
polyuria (excessive urination), polyphagia (increased hunger/appetite), polydipsia (excessive thirst)
what does a1c indicate?
BG over the past 3 months
when is fasting plasma glucose taken and what does it tell you?
taken after fasting for 8 hours. tells you the BG at that moment
what does the OGTT tell you?
tells you how well glucose is tolerated. measures the BG 2 hours after drinking something high in
glucose
what is the a1c level for prediabetes? for diabetes?
-prediabetes: 5.7-6.4
-diabetes: 6.5+
what is the a1c goal in non-pregnant pts?
-<7% for most pts
-a more stringent goal of <6.5% for pts who can tolerate it without hypoglycemia
-a less stringent goal of <8% for pts who experience hypoglycemia or in older pts)
how often should a1c be monitored?
every 3 months if not at goal. every 6 months if at goal
what is an a1c of 6% equivalent to in eAG?
~126 mg/dL. each additional 1% increase in a1c increases the eAG by ~28 mg/dL
, what is 15g carbs equal to in food?
1 small piece of fruit, one slice of bread, 1/3 cup of rice or pasta
what are the recommended vaccinations for pts with diabetes?
in addition to the recommended vaccines for children: hbv, flu, ppsv23 between the ages of 2-64y and
then again at 65y+
when would you start 2 drugs at baseline for someone with t2d?
if their a1c is 8.5-10%, or if the pt has ASCVD, HF, or CKD
if a patient is not controlled on metformin monotherapy and has ASCVD or is high risk for ASCVD in
addition to their t2d, what medication second medication should they be started on?
either a sglt2i that has shown benefit (dapagliflozin, empagliflozin, or canagliflozin) or a glp1a with
benefit (liraglutide, dulaglutide, SC semaglutide)
if a patient is not controlled on metformin monotherapy and has HF in addition to their t2d, what
medication second medication should they be started on?
a sglt2i that has shown benefit (dapagliflozin, empagliflozin, or canagliflozin)
if a patient is not controlled on metformin monotherapy and has CKD in addition to their t2d, what
medication second medication should they be started on?
-either a sglt2i that has shown benefit (dapagliflozin, empagliflozin, or canagliflozin) or a glp1a with
benefit (liraglutide, dulaglutide, SC semaglutide)
-sglt2i preferred if albuminuria present
which drugs are best for weight loss in t2d?
glp-1a and sglt2i
what is the usual maintenance dose of metformin?
1000mg bid -- titrate weekly up to this dose
how can you decrease GI upset with metformin?
give it with food
what risk increases with renal impairment or with iodinated contrast media in pts taking metformin?
lactic acidosis
what is a contraindication of metformin?
GFR <30. not recommended to start if GFR 30-45
what is the moa of sglt2i's?
inhibit the sglt2 protein in the proximal renal tubule that is responsible for the reabsorption of
glucose
what are the sglt2i's and their brand names?
Correct Answers
what is the responsibility of insulin in the body?
moving glucose into cells to be used as energy
what is the function of glucagon?
when BG is low it will transform glycogen back into glucose and release it into the body. if glycogen is
depleted then it will signal fat cells to make adipose as an alternative energy source
how can metformin be used in prediabetes?
it can be useful for patients with a BMI >35 who are <60y. it can also be helpful in women with a hx of
gestational diabetes
which diabetes treatment is preferred in pregnancy?
insulin is preferred. metformin and glyburide are sometimes used
what are the classic sx of diabetes?
polyuria (excessive urination), polyphagia (increased hunger/appetite), polydipsia (excessive thirst)
what does a1c indicate?
BG over the past 3 months
when is fasting plasma glucose taken and what does it tell you?
taken after fasting for 8 hours. tells you the BG at that moment
what does the OGTT tell you?
tells you how well glucose is tolerated. measures the BG 2 hours after drinking something high in
glucose
what is the a1c level for prediabetes? for diabetes?
-prediabetes: 5.7-6.4
-diabetes: 6.5+
what is the a1c goal in non-pregnant pts?
-<7% for most pts
-a more stringent goal of <6.5% for pts who can tolerate it without hypoglycemia
-a less stringent goal of <8% for pts who experience hypoglycemia or in older pts)
how often should a1c be monitored?
every 3 months if not at goal. every 6 months if at goal
what is an a1c of 6% equivalent to in eAG?
~126 mg/dL. each additional 1% increase in a1c increases the eAG by ~28 mg/dL
, what is 15g carbs equal to in food?
1 small piece of fruit, one slice of bread, 1/3 cup of rice or pasta
what are the recommended vaccinations for pts with diabetes?
in addition to the recommended vaccines for children: hbv, flu, ppsv23 between the ages of 2-64y and
then again at 65y+
when would you start 2 drugs at baseline for someone with t2d?
if their a1c is 8.5-10%, or if the pt has ASCVD, HF, or CKD
if a patient is not controlled on metformin monotherapy and has ASCVD or is high risk for ASCVD in
addition to their t2d, what medication second medication should they be started on?
either a sglt2i that has shown benefit (dapagliflozin, empagliflozin, or canagliflozin) or a glp1a with
benefit (liraglutide, dulaglutide, SC semaglutide)
if a patient is not controlled on metformin monotherapy and has HF in addition to their t2d, what
medication second medication should they be started on?
a sglt2i that has shown benefit (dapagliflozin, empagliflozin, or canagliflozin)
if a patient is not controlled on metformin monotherapy and has CKD in addition to their t2d, what
medication second medication should they be started on?
-either a sglt2i that has shown benefit (dapagliflozin, empagliflozin, or canagliflozin) or a glp1a with
benefit (liraglutide, dulaglutide, SC semaglutide)
-sglt2i preferred if albuminuria present
which drugs are best for weight loss in t2d?
glp-1a and sglt2i
what is the usual maintenance dose of metformin?
1000mg bid -- titrate weekly up to this dose
how can you decrease GI upset with metformin?
give it with food
what risk increases with renal impairment or with iodinated contrast media in pts taking metformin?
lactic acidosis
what is a contraindication of metformin?
GFR <30. not recommended to start if GFR 30-45
what is the moa of sglt2i's?
inhibit the sglt2 protein in the proximal renal tubule that is responsible for the reabsorption of
glucose
what are the sglt2i's and their brand names?
