BC ADM Comprehensive Diabetes Assessment & Diagnosis 3

Question 1

A 34-year-old non-obese woman of South Asian descent is diagnosed with diabetes. GCK mutation is identified on genetic testing. Which subtype does she have?

Accepted Answer

MODY 2 (GCK-MODY)

Answer

GCK-MODY (MODY 2) is caused by heterozygous glucokinase mutations that raise the glucose set-point, causing mild stable hyperglycemia that rarely requires pharmacotherapy.

Question 2

Which symptom is most characteristic of hyperosmolar hyperglycemic state (HHS) at presentation compared to diabetic ketoacidosis?

Accepted Answer

Profound dehydration with minimal to no ketosis

Answer

HHS is characterized by extreme hyperglycemia (often >600 mg/dL), severe dehydration, and hyperosmolality without significant ketoacidosis.

Question 3

Which HbA1c value meets the ADA diagnostic threshold for diabetes in the absence of hyperglycemic symptoms?

Accepted Answer

≥6.5%

Answer

HbA1c ≥6.5% on two separate tests (or once with confirmatory testing) meets ADA criteria for diagnosing diabetes.

Question 4

A patient reports episodes of sweating, tremor, and confusion 3 hours after meals. Post-prandial glucose at 3 hours is 48 mg/dL. What condition should be evaluated?

Accepted Answer

Reactive hypoglycemia / postprandial hypoglycemia

Answer

Reactive hypoglycemia presents with adrenergic and neuroglycopenic symptoms 2–5 hours after a meal, confirmed by low glucose during symptoms.

Question 5

Which laboratory finding distinguishes latent autoimmune diabetes in adults (LADA) from classic type 2 diabetes?

Accepted Answer

Presence of GAD65 autoantibodies with low C-peptide

Answer

Positive GAD65 autoantibodies combined with declining C-peptide distinguishes LADA from type 2 diabetes and signals eventual insulin dependence.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Comprehensive Diabetes Assessment & Diagnosis 3