BCACP Ambulatory Diabetes Management 5

Question 1

A patient with T2DM, obesity (BMI 38), and A1C of 8.5% asks about weight-loss options. Which diabetes medication has the most robust evidence for weight loss and A1C reduction?

Accepted Answer

Semaglutide (Ozempic/Wegovy)

Answer

Semaglutide has demonstrated the greatest weight loss among diabetes medications, with trials showing up to 15% body weight reduction along with significant A1C lowering.

Question 2

Which of the following best describes the rationale for using a fixed-ratio combination of basal insulin and a GLP-1 receptor agonist (e.g., iGlarLixi)?

Accepted Answer

It reduces the number of injections and mitigates GLP-1-related nausea while limiting insulin-induced weight gain

Answer

Fixed-ratio co-formulations like iGlarLixi combine the glycemic benefits of both agents, reduce injection burden, and the GLP-1 component helps offset insulin-related weight gain and nausea.

Question 3

A patient on metformin and glipizide has an A1C of 7.9% and a BMI of 32. She has no cardiovascular or renal disease. Which agent is most appropriate to add for further A1C lowering while promoting weight loss?

Accepted Answer

Exenatide (Byetta)

Answer

A GLP-1 receptor agonist like exenatide is appropriate to add for patients needing further A1C reduction and weight loss in the absence of CVD or CKD indications.

Question 4

What is the time-in-range (TIR) goal recommended by the ADA for adults with diabetes using CGM?

Accepted Answer

>70% of time between 70-180 mg/dL

Answer

The ADA recommends a TIR goal of >70% (more than 16.8 hours/day) within the range of 70-180 mg/dL for most adults with diabetes.

Question 5

A patient newly diagnosed with T2DM asks whether he can reverse his diabetes through lifestyle changes. What is the most accurate pharmacist response?

Accepted Answer

Intensive lifestyle intervention can lead to remission (A1C <6.5% without medications) in some patients, especially early after diagnosis

Answer

Evidence from studies like the DiRECT trial shows intensive lifestyle intervention with significant weight loss can lead to T2DM remission, particularly when achieved early in the disease course.

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP Ambulatory Diabetes Management 5