BC ADM Standards & Best Practices 3 — Questions and Answers
Question 1: According to ADA Standards of Medical Care, how frequently should HbA1c be measured in patients with stable glycemic control who are meeting treatment goals?
- Every month
- Every 3 months
- Every 6 months (Correct answer)
- Every 12 months
Correct answer: Every 6 months
ADA recommends HbA1c testing twice yearly (every 6 months) in patients with stable glycemia who are meeting treatment goals.
Question 2: The AADE7 Self-Care Behaviors framework includes all of the following EXCEPT:
- Healthy eating
- Being active
- Taking medication
- Performing insulin titration independently (Correct answer)
Correct answer: Performing insulin titration independently
The AADE7 includes healthy eating, being active, monitoring, taking medication, problem solving, reducing risks, and healthy coping — independent insulin titration is not one of the seven behaviors.
Question 3: Under ADA standards, which blood pressure target is recommended for most adults with diabetes and hypertension?
- Less than 120/80 mmHg
- Less than 130/80 mmHg (Correct answer)
- Less than 140/90 mmHg
- Less than 150/90 mmHg
Correct answer: Less than 130/80 mmHg
ADA recommends a blood pressure target of less than 130/80 mmHg for most adults with diabetes and hypertension.
Question 4: Which organization's guidelines classify diabetes self-management education and support (DSMES) as a critical element of diabetes care that should be offered at four key times?
- American Heart Association (AHA)
- American Association of Diabetes Care and Education Specialists (ADCES) (Correct answer)
- Centers for Disease Control and Prevention (CDC)
- National Institutes of Health (NIH)
Correct answer: American Association of Diabetes Care and Education Specialists (ADCES)
ADCES identifies four critical times to offer DSMES: at diagnosis, annually, when complicating factors arise, and during transitions in care.
Question 5: A patient with type 2 diabetes has an eGFR of 30 mL/min/1.73m². According to current standards, which medication adjustment is most appropriate?
- Discontinue metformin and initiate insulin
- Continue metformin at the current dose
- Reduce metformin dose to 500 mg daily
- Discontinue metformin due to risk of lactic acidosis (Correct answer)
Correct answer: Discontinue metformin due to risk of lactic acidosis
Metformin is contraindicated when eGFR falls below 30 mL/min/1.73m² due to risk of lactic acidosis accumulation.
Question 6: Which ADA-recommended screening interval applies to dilated eye exams for adults with type 2 diabetes who have had no retinopathy on their initial exam?
- Every 6 months
- Every year
- Every 1–2 years (Correct answer)
- Every 3 years
Correct answer: Every 1–2 years
ADA recommends dilated eye exams every 1–2 years for patients with type 2 diabetes who have no evidence of retinopathy.
Question 7: According to best practice standards, which of the following is the most important factor when individualizing glycemic targets for older adults with diabetes?
- Patient's body weight and BMI
- Patient's functional status, comorbidities, and life expectancy (Correct answer)
- Duration of diabetes since diagnosis
- Preferred route of insulin administration
Correct answer: Patient's functional status, comorbidities, and life expectancy
In older adults, glycemic targets should be individualized based on functional status, cognitive function, comorbidities, and life expectancy to minimize hypoglycemia risk.
BC ADM Standards & Best Practices 3
According to ADA Standards of Medical Care, how frequently should HbA1c be measured in patients with stable glycemic control who are meeting treatment goals?