BC ADM Comprehensive Diabetes Assessment & Diagnosis 4

Question 1

Which screening test is recommended by the ADA for detecting peripheral arterial disease in patients with diabetes?

Accepted Answer

Ankle-brachial index (ABI)

Answer

The ABI (ratio of ankle systolic BP to brachial systolic BP) is a validated, non-invasive screening tool for PAD; values ≤0.9 indicate obstruction.

Question 2

A patient with type 2 diabetes and BMI of 42 kg/m² undergoes Roux-en-Y gastric bypass. Post-operatively, blood glucose normalizes without medication. What is the primary mechanism?

Accepted Answer

Enhanced GLP-1 secretion and improved insulin sensitivity

Answer

Bariatric surgery rapidly improves diabetes through increased GLP-1 secretion from the gut, altered bile acid signaling, and weight-independent improvements in insulin sensitivity.

Question 3

When diagnosing gestational diabetes using the one-step OGTT approach (IADPSG criteria), which value meets the threshold at the 2-hour mark?

Accepted Answer

≥153 mg/dL

Answer

IADPSG one-step 75g OGTT thresholds are: fasting ≥92, 1-hour ≥180, and 2-hour ≥153 mg/dL; one abnormal value is sufficient for GDM diagnosis.

Question 4

A patient with type 1 diabetes uses a CGM. Time below range (TBR <70 mg/dL) is 6%. What is the recommended clinical target for TBR?

Accepted Answer

< 4%

Answer

International consensus recommends TBR <4% for time spent below 70 mg/dL in most adults with type 1 or type 2 diabetes on insulin therapy.

Question 5

Which complication of diabetes is most directly linked to the polyol pathway and sorbitol accumulation?

Accepted Answer

Osmotic cataract formation in the lens

Answer

Excess glucose enters the polyol pathway, accumulating sorbitol and fructose in the lens, which draws water in and causes osmotic cataracts.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Comprehensive Diabetes Assessment & Diagnosis 4