ABFM + KSA
DIABETES
Certification Exam
Actual Questions and Answers
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This Exam contains:
100% Guarantee Pass.
Actual Questions and Answers
Multiple choice (single best answer)
Case Studies/Scenario-Based Questions
Verified Rationales
,**True statements regarding nonpharmacologic therapy to reduce
insulin resistance include which of the following? (Mark all that are
true.)**
A. Decreasing caloric intake will increase insulin sensitivity independent of
weight loss
B. Moderate alcohol intake increases insulin resistance
C. Exercise has been shown to enhance insulin action in skeletal muscle
D. A decrease of as little as 5% in body weight can result in a substantial
reduction in insulin resistance
E. If there are no contraindications, patients with insulin resistance
syndrome should be advised to engage in 30 minutes of modest aerobic
exercise at least 4-5 times/week
**Answer**
A, C, D, E
**Rationale:**
Lifestyle interventions play a pivotal role in the management of insulin
resistance syndrome. Losing even 5% of body weight has been shown to
substantially reduce insulin resistance. In addition, insulin sensitivity can be
increased by reducing caloric intake, even if no weight is lost. Exercise is
an important adjunct to weight loss, since it has been shown to enhance
insulin action in skeletal muscle not only during physical activity but for up
to a week following exercise. All patients with insulin resistance syndrome
should be advised to engage in 30 minutes of aerobic exercise at least 4-5
times/week. Moderate alcohol intake lowers insulin resistance.
,---
**Which one of the following neurologic tests is most useful for
predicting the future occurrence of a diabetic foot ulcer?**
A. Pressure sensation with Semmes-Weinstein monofilament (10 g)
B. Deep tendon reflexes of the ankle
C. Proprioception
D. Vibratory sensation with a 128-mHz tuning fork
E. Light touch with a wisp of cotton
**Answer**
A
**Rationale:**
Failure to perceive a pressure sensation produced by Semmes-Weinstein
monofilament indicates a loss of protective sensation in the diabetic foot
and is highly predictive of foot ulceration. Traditional neurologic
examination techniques for evaluating reflexes, proprioception, vibration, or
light touch are highly subjective and less predictive of future ulceration.
---
**Which of the following lipid-lowering agents can worsen glycemic
control? (Mark all that are true.)**
, A. Colestipol (Colestid)
B. Ezetimibe (Zetia)
C. Gemfibrozil (Lopid)
D. Niacin
E. Atorvastatin (Lipitor)
**Answer**
D AND E
**Rationale:**
Niacin is not only the most effective agent for raising HDL-cholesterol,
producing an increase of 15%-35%, it also reduces triglycerides by 20%-
50% and LDL-cholesterol by 5%-25%. Hyperglycemia is a side effect of
niacin therapy, particularly at high doses. A dosage of 750-2000 mg/day is
associated with only moderate rises in blood glucose, and at one time was
considered a treatment option in patients with diabetes, particularly those
with low HDL-cholesterol levels. However, the recommendations for niacin
use were changed as a result of the AIM-HIGH trial (Atherothrombosis
Intervention in Metabolic Syndrome with Low HDL/High Triglycerides:
Impact on Global Health Outcomes), which found no incremental clinical
benefit from the addition of niacin to statin therapy in patients with coronary
heart disease and LDL-cholesterol levels >70 mg/dL. Recent studies
support a link between statin use and the development of diabetes mellitus.
In a meta-analysis of 13 studies, statin therapy was associated with a 9%
increased risk for incident diabetes. Another meta-analysis corroborated
this result and found that intensive-dose statin therapy was associated with
a higher risk of new-onset diabetes compared with moderate-dose statin
therapy. In 2012, the FDA modified the package labeling of statins to
include the risk of increased blood glucose levels and the development of
DIABETES
Certification Exam
Actual Questions and Answers
100% Guarantee Pass.
This Exam contains:
100% Guarantee Pass.
Actual Questions and Answers
Multiple choice (single best answer)
Case Studies/Scenario-Based Questions
Verified Rationales
,**True statements regarding nonpharmacologic therapy to reduce
insulin resistance include which of the following? (Mark all that are
true.)**
A. Decreasing caloric intake will increase insulin sensitivity independent of
weight loss
B. Moderate alcohol intake increases insulin resistance
C. Exercise has been shown to enhance insulin action in skeletal muscle
D. A decrease of as little as 5% in body weight can result in a substantial
reduction in insulin resistance
E. If there are no contraindications, patients with insulin resistance
syndrome should be advised to engage in 30 minutes of modest aerobic
exercise at least 4-5 times/week
**Answer**
A, C, D, E
**Rationale:**
Lifestyle interventions play a pivotal role in the management of insulin
resistance syndrome. Losing even 5% of body weight has been shown to
substantially reduce insulin resistance. In addition, insulin sensitivity can be
increased by reducing caloric intake, even if no weight is lost. Exercise is
an important adjunct to weight loss, since it has been shown to enhance
insulin action in skeletal muscle not only during physical activity but for up
to a week following exercise. All patients with insulin resistance syndrome
should be advised to engage in 30 minutes of aerobic exercise at least 4-5
times/week. Moderate alcohol intake lowers insulin resistance.
,---
**Which one of the following neurologic tests is most useful for
predicting the future occurrence of a diabetic foot ulcer?**
A. Pressure sensation with Semmes-Weinstein monofilament (10 g)
B. Deep tendon reflexes of the ankle
C. Proprioception
D. Vibratory sensation with a 128-mHz tuning fork
E. Light touch with a wisp of cotton
**Answer**
A
**Rationale:**
Failure to perceive a pressure sensation produced by Semmes-Weinstein
monofilament indicates a loss of protective sensation in the diabetic foot
and is highly predictive of foot ulceration. Traditional neurologic
examination techniques for evaluating reflexes, proprioception, vibration, or
light touch are highly subjective and less predictive of future ulceration.
---
**Which of the following lipid-lowering agents can worsen glycemic
control? (Mark all that are true.)**
, A. Colestipol (Colestid)
B. Ezetimibe (Zetia)
C. Gemfibrozil (Lopid)
D. Niacin
E. Atorvastatin (Lipitor)
**Answer**
D AND E
**Rationale:**
Niacin is not only the most effective agent for raising HDL-cholesterol,
producing an increase of 15%-35%, it also reduces triglycerides by 20%-
50% and LDL-cholesterol by 5%-25%. Hyperglycemia is a side effect of
niacin therapy, particularly at high doses. A dosage of 750-2000 mg/day is
associated with only moderate rises in blood glucose, and at one time was
considered a treatment option in patients with diabetes, particularly those
with low HDL-cholesterol levels. However, the recommendations for niacin
use were changed as a result of the AIM-HIGH trial (Atherothrombosis
Intervention in Metabolic Syndrome with Low HDL/High Triglycerides:
Impact on Global Health Outcomes), which found no incremental clinical
benefit from the addition of niacin to statin therapy in patients with coronary
heart disease and LDL-cholesterol levels >70 mg/dL. Recent studies
support a link between statin use and the development of diabetes mellitus.
In a meta-analysis of 13 studies, statin therapy was associated with a 9%
increased risk for incident diabetes. Another meta-analysis corroborated
this result and found that intensive-dose statin therapy was associated with
a higher risk of new-onset diabetes compared with moderate-dose statin
therapy. In 2012, the FDA modified the package labeling of statins to
include the risk of increased blood glucose levels and the development of
