BCACP Ambulatory Diabetes Management 3

Question 1

A 68-year-old patient with T2DM, HFrEF, and eGFR 55 mL/min/1.73m² is on metformin. Which add-on therapy has evidence for both glycemic control and reduction in heart failure hospitalization?

Accepted Answer

Empagliflozin

Answer

SGLT2 inhibitors like empagliflozin have demonstrated significant reduction in heart failure hospitalization and are preferred in T2DM patients with HFrEF per ADA guidelines.

Question 2

Which sulfonylurea is considered lowest risk for hypoglycemia due to its short duration of action and lack of active metabolites?

Accepted Answer

Glipizide

Answer

Glipizide has a short duration of action and no active metabolites, making it the preferred sulfonylurea especially in the elderly and those at risk for hypoglycemia.

Question 3

A patient is starting on a basal-bolus insulin regimen. What is the appropriate starting total daily dose (TDD) for an insulin-naive patient using weight-based dosing?

Accepted Answer

0.5-0.6 units/kg/day

Answer

A common starting TDD for basal-bolus insulin in insulin-naive patients is 0.4-0.6 units/kg/day, with half given as basal and half divided as bolus doses.

Question 4

Which DPP-4 inhibitor requires dose adjustment in renal impairment and has the most documented clinical experience?

Accepted Answer

Sitagliptin

Answer

Sitagliptin was the first DPP-4 inhibitor approved and requires dose reduction in moderate to severe renal impairment; linagliptin is the only DPP-4i that does NOT require renal dose adjustment.

Question 5

A pharmacist reviews a patient's CGM data showing high fasting glucose values. The patient is on basal insulin 20 units at bedtime. What is the best titration strategy?

Accepted Answer

Increase basal dose by 2 units every 3 days if fasting glucose consistently >130 mg/dL

Answer

The treat-to-target approach for basal insulin titration typically involves increasing the dose by 2 units every 3 days when fasting glucose remains above the target threshold.

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP Ambulatory Diabetes Management 3