BC ADM Medication & Therapeutic Interventions 4

Question 1

A patient with T2DM, obesity (BMI 38), and an A1C of 9.1% is seeking the most effective dual therapy for both glycemic control and weight loss. The best combination is:

Accepted Answer

Metformin + semaglutide

Answer

Semaglutide (GLP-1 RA) combined with metformin provides superior A1C reduction and significant weight loss (6–14%) compared to other add-on agents, making it the preferred choice for this patient profile.

Question 2

The 'correction factor' (insulin sensitivity factor) is used in intensive insulin therapy to:

Accepted Answer

Estimate how much 1 unit of rapid-acting insulin will lower blood glucose

Answer

The correction factor (e.g., 1 unit lowers glucose by 50 mg/dL) is calculated from the total daily insulin dose and guides supplemental bolus dosing to bring elevated glucose back to target.

Question 3

A patient with long-standing T1DM develops recurrent unexplained hypoglycemia and loss of hypoglycemia awareness. The most appropriate therapeutic adjustment is:

Accepted Answer

Raising glycemic targets temporarily and using CGM with alerts

Answer

Hypoglycemia unawareness requires relaxing glycemic targets to allow glucose levels to run higher temporarily, combined with real-time CGM alarms to alert the patient, which can restore awareness over weeks.

Question 4

Which statement about U-500 regular insulin is correct?

Accepted Answer

It is 5 times more concentrated and has a longer duration of action than U-100 regular

Answer

U-500 regular insulin is 500 units/mL (5× U-100) and due to depot formation has a duration of action of 17–24 hours, behaving more like an intermediate-acting insulin despite being 'regular' type.

Question 5

When educating a patient about DPP-4 inhibitors, which adverse effect requires specific counseling?

Accepted Answer

Possible joint pain (arthralgia) which should prompt reporting

Answer

The FDA has issued a warning about severe, disabling, and potentially persistent arthralgia associated with DPP-4 inhibitors; patients should be counseled to report new or unusual joint pain.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Medication & Therapeutic Interventions 4