BC ADM Complications Management 4

Question 1

A diabetic patient with gastroparesis has erratic postprandial glucose levels. Which insulin timing strategy is most appropriate?

Accepted Answer

Administer rapid-acting insulin after meals once food intake is confirmed

Answer

Post-meal rapid-acting insulin administration avoids hypoglycemia from unpredictable gastric emptying causing delayed glucose absorption.

Question 2

Which test is considered the gold standard for diagnosing diabetic gastroparesis?

Accepted Answer

Gastric emptying scintigraphy at 4 hours

Answer

4-hour solid-phase gastric emptying scintigraphy is the gold standard, with retention >10% at 4 hours confirming gastroparesis.

Question 3

A patient with long-standing T1DM reports orthostatic dizziness. Blood pressure drops 28 mmHg systolic upon standing. What is the recommended initial management?

Accepted Answer

Increase fluid and salt intake, compression stockings, and head-of-bed elevation

Answer

Non-pharmacological measures (fluid/salt loading, compression, head-of-bed elevation) are first-line for diabetic autonomic orthostatic hypotension.

Question 4

Which finding on nerve conduction study confirms diabetic peripheral neuropathy?

Accepted Answer

Reduced sural nerve sensory conduction velocity and amplitude

Answer

Reduced sural nerve sensory conduction velocity and amplitude are the earliest and most sensitive NCS findings in diabetic neuropathy.

Question 5

A patient with diabetic nephropathy is on an ACE inhibitor but still has urine ACR of 380 mg/g. Adding which drug class provides additional renoprotection per 2024 ADA guidelines?

Accepted Answer

Finerenone (non-steroidal MRA)

Answer

Finerenone, a non-steroidal mineralocorticoid receptor antagonist, provides additional kidney and cardiovascular protection in CKD with T2DM on top of RAS blockade.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Complications Management 4