Certified Diabetes Educator Test Clinical Assessment Flashcards

Per FDA guidance, metformin is contraindicated when eGFR falls below which threshold?

Answer: <30 mL/min/1.73m²

Metformin should be discontinued when eGFR falls below 30 mL/min/1.73m² due to the risk of lactic acidosis from drug accumulation.

Which clinical findings are most suggestive of cardiac autonomic neuropathy in a patient with diabetes?

Answer: Resting tachycardia and orthostatic hypotension

Resting tachycardia and orthostatic hypotension are hallmark signs of cardiac autonomic neuropathy caused by damage to the autonomic nervous system.

For patients with stable, well-controlled diabetes, how frequently should HbA1c be measured?

Answer: Every 6 months (twice yearly)

Stable, well-controlled patients should have HbA1c tested twice yearly; quarterly testing is reserved for those with changing therapy or unmet goals.

Which symptom constellation best characterizes hyperosmolar hyperglycemic state (HHS)?

Answer: Gradual onset, extreme hyperglycemia (>600 mg/dL), minimal ketones, altered consciousness

HHS presents with gradual onset, plasma glucose often exceeding 600 mg/dL, hyperosmolarity, minimal ketones, and altered mental status.

Which waist circumference indicates increased abdominal obesity and cardiometabolic risk in US men?

Answer: >40 inches

A waist circumference greater than 40 inches in men indicates abdominal obesity associated with insulin resistance and increased cardiovascular risk.

Which lipid pattern is the hallmark dyslipidemia of insulin resistance and metabolic syndrome?

Answer: Elevated triglycerides with low HDL cholesterol

Elevated triglycerides combined with low HDL is the characteristic dyslipidemia of insulin resistance and is a major component of metabolic syndrome criteria.