BC ADM Insulin Therapy 2

Question 1

A patient on U-500 regular insulin requires dose conversion when switching to U-100 insulin. Which statement is correct regarding this transition?

Accepted Answer

Divide the U-500 dose by 5 to get the equivalent U-100 units

Answer

U-500 is 5 times more concentrated than U-100, so dividing the U-500 unit dose by 5 gives the equivalent number of units in U-100.

Question 2

Which insulin formulation provides the most consistent and predictable absorption with the least intra-patient variability?

Accepted Answer

Insulin glargine U-300

Answer

Insulin glargine U-300 (Toujeo) demonstrates the least intra-patient pharmacokinetic variability among basal insulins due to its concentrated depot formation.

Question 3

A patient with type 1 diabetes uses a total daily dose (TDD) of 40 units. Using the 500 rule, what is the estimated insulin sensitivity factor (ISF)?

Accepted Answer

12.5 mg/dL per unit

Answer

The 500 rule: 500 ÷ TDD = ISF; 500 ÷ 40 = 12.5 mg/dL drop per unit of rapid-acting insulin.

Question 4

When initiating basal insulin in a person with type 2 diabetes, which titration approach is supported by clinical evidence?

Accepted Answer

Increase by 2 units every 3 days until fasting glucose is 80–130 mg/dL

Answer

The treat-to-target approach of increasing basal insulin by 2 units every 3 days until fasting glucose reaches 80–130 mg/dL is well-validated (e.g., INSIGHT trial).

Question 5

A patient develops lipohypertrophy at their preferred injection site. Which consequence is most clinically relevant?

Accepted Answer

Unpredictable insulin absorption causing glucose variability

Answer

Lipohypertrophy alters insulin absorption kinetics, resulting in erratic uptake and unpredictable blood glucose excursions.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Insulin Therapy 2