CDCES Pathophysiology of Diabetes

Question 1

Which autoantibody is most specific for type 1 diabetes and is present in approximately 70-80% of newly diagnosed patients?

Accepted Answer

Glutamic acid decarboxylase antibody (GADA)

Answer

GADA (anti-GAD65) is the most commonly detected and most specific autoantibody in type 1 diabetes, present in 70-80% of new-onset patients.

Question 2

In type 2 diabetes, which physiological defect is considered the PRIMARY initiating mechanism in the majority of patients?

Accepted Answer

Peripheral insulin resistance with compensatory hyperinsulinemia

Answer

Type 2 diabetes is initiated by peripheral insulin resistance (primarily in muscle, liver, and adipose tissue) with compensatory beta-cell hyperinsulinemia that eventually fails.

Question 3

The incretin effect refers to which physiological phenomenon?

Accepted Answer

Enhanced insulin secretion in response to oral glucose compared to IV glucose due to gut hormones

Answer

The incretin effect is the amplification of postprandial insulin secretion triggered by gut hormones (GLP-1, GIP) released after oral glucose ingestion, beyond what IV glucose alone would stimulate.

Question 4

Which statement about gestational diabetes mellitus (GDM) pathophysiology is correct?

Accepted Answer

GDM results from placental hormones increasing insulin resistance, unmasking inadequate beta-cell reserve

Answer

Placental hormones (hPL, progesterone, cortisol) progressively increase insulin resistance during pregnancy, and women with insufficient beta-cell reserve cannot compensate, resulting in GDM.

Question 5

Diabetic ketoacidosis (DKA) occurs primarily because of which underlying pathophysiological mechanism?

Accepted Answer

Absolute or near-absolute insulin deficiency combined with counter-regulatory hormone excess driving unregulated lipolysis and ketogenesis

Answer

DKA is caused by absolute or severe insulin deficiency plus glucagon/cortisol/catecholamine excess, which drives unregulated lipolysis, fatty acid release, and hepatic ketogenesis.

(CDCES) Certified Diabetes Care and Education Specialist Practice Test

(CDCES) Certified Diabetes Care and Education Specialist Practice Test

CDCES Pathophysiology of Diabetes