CSG Chronic Disease Management 2

Question 1

Per ADA Standards of Care, what is a reasonable A1C goal for a healthy older adult with few coexisting chronic illnesses and intact cognition?

Accepted Answer

<7.0-7.5%

Answer

The ADA suggests an A1C goal of <7.0-7.5% for healthy older adults with long life expectancy.

Question 2

An 82-year-old with diabetes, moderate cognitive impairment, and three chronic illnesses would most appropriately have which A1C goal?

Accepted Answer

<8.0%

Answer

Older adults with complex or intermediate health status warrant a less stringent goal of <8.0% to reduce hypoglycemia risk.

Question 3

For a nursing home resident with very complex health and limited life expectancy, what is the primary glycemic management priority?

Accepted Answer

Avoiding hypoglycemia and symptomatic hyperglycemia

Answer

In very complex or end-of-life patients, glycemic care focuses on avoiding hypoglycemia and symptomatic hyperglycemia rather than A1C targets.

Question 4

Which diabetes medication is listed on the AGS Beers Criteria as one to avoid in older adults because of prolonged hypoglycemia risk?

Accepted Answer

Glyburide

Answer

Long-acting sulfonylureas such as glyburide cause prolonged hypoglycemia and are listed for avoidance in older adults.

Question 5

An older adult on long-term metformin reports numbness in the feet and fatigue; which nutrient deficiency should be screened for?

Accepted Answer

Vitamin B12

Answer

Long-term metformin use is associated with reduced vitamin B12 absorption and deficiency, which can cause neuropathy.

CSG - Certified Specialist in Gerontological Nutrition Practice Test