Diabetes Education Certification Diabetes Chronic Complications Prevention & Management 2 — Questions and Answers
Question 1: Which symptom is a hallmark of autonomic neuropathy affecting the gastrointestinal tract in diabetes?
- Rapid gastric emptying with early satiety
- Gastroparesis with delayed gastric emptying (Correct answer)
- Chronic diarrhea only
- Esophageal spasm
Correct answer: Gastroparesis with delayed gastric emptying
Gastroparesis is a form of autonomic neuropathy causing delayed gastric emptying, leading to symptoms such as nausea, vomiting, bloating, and erratic postprandial glucose levels.
Question 2: What foot care practice should a diabetes educator strongly reinforce to reduce the risk of diabetic foot ulcers?
- Walking barefoot indoors to toughen the skin
- Daily inspection of feet including the soles and between toes (Correct answer)
- Soaking feet daily in hot water
- Trimming calluses at home with razors
Correct answer: Daily inspection of feet including the soles and between toes
Daily foot inspection is critical because peripheral neuropathy reduces pain sensation, allowing unnoticed wounds to progress to serious infections or ulcers.
Question 3: Which lipid abnormality is most characteristically associated with poorly controlled type 2 diabetes?
- Elevated LDL-C with normal triglycerides
- Elevated triglycerides with low HDL-C (Correct answer)
- Isolated low total cholesterol
- Very high LDL-C with normal HDL-C
Correct answer: Elevated triglycerides with low HDL-C
The dyslipidemia of type 2 diabetes typically features elevated triglycerides and low HDL-C, driven by insulin resistance and increased hepatic VLDL production.
Question 4: In patients with diabetic retinopathy, what is the primary modifiable risk factor that most strongly predicts progression?
- Body weight
- Glycemic control (HbA1c) (Correct answer)
- Dietary fat intake
- Sleep duration
Correct answer: Glycemic control (HbA1c)
Sustained hyperglycemia, reflected by elevated HbA1c, is the strongest modifiable predictor of diabetic retinopathy onset and progression.
Question 5: A patient with diabetes and CKD stage 3 should have their eGFR and UACR monitored at what minimum frequency?
- Every 5 years
- Every 2 years
- At least annually (Correct answer)
- Every 6 months only if proteinuria is absent
Correct answer: At least annually
The ADA recommends at least annual monitoring of eGFR and UACR in patients with diabetes and established CKD to track progression and adjust therapy.
Question 6: Which class of antihypertensive medications is preferred for people with diabetes who have albuminuria to slow kidney disease progression?
- Beta-blockers
- Calcium channel blockers
- ACE inhibitors or ARBs (Correct answer)
- Diuretics only
Correct answer: ACE inhibitors or ARBs
ACE inhibitors and ARBs are the preferred antihypertensives for people with diabetes and albuminuria because they reduce intraglomerular pressure and slow CKD progression.
Diabetes Education Certification Diabetes Chronic Complications Prevention & Management 2
Which symptom is a hallmark of autonomic neuropathy affecting the gastrointestinal tract in diabetes?