Diabetes Education Certification Diabetes Chronic Complications Prevention & Management 1 — Questions and Answers
Question 1: Which chronic complication of diabetes specifically affects the small blood vessels and is classified as a 'microvascular' complication?
- Coronary artery disease
- Peripheral artery disease
- Diabetic nephropathy (Correct answer)
- Stroke
Correct answer: Diabetic nephropathy
Diabetic nephropathy is a microvascular complication caused by damage to the small blood vessels in the kidneys, leading to progressive kidney disease.
Question 2: What is the first-line recommended screening test for diabetic kidney disease (nephropathy)?
- 24-hour urine creatinine
- Urine albumin-to-creatinine ratio (UACR) (Correct answer)
- Serum BUN only
- Kidney biopsy
Correct answer: Urine albumin-to-creatinine ratio (UACR)
The urine albumin-to-creatinine ratio (UACR) is the recommended first-line screening test for diabetic nephropathy, with a value ≥30 mg/g indicating albuminuria.
Question 3: Annual dilated eye exams are recommended for people with type 2 diabetes starting at which point?
- Only after 10 years with diabetes
- At the time of diagnosis (Correct answer)
- After the first hypoglycemic episode
- When HbA1c exceeds 9%
Correct answer: At the time of diagnosis
People with type 2 diabetes should have a dilated eye exam at the time of diagnosis because retinopathy may already be present due to undetected hyperglycemia.
Question 4: Which class of medications has demonstrated both cardiovascular and kidney-protective benefits in people with type 2 diabetes and is now recommended early in therapy?
- Sulfonylureas
- SGLT2 inhibitors (Correct answer)
- Alpha-glucosidase inhibitors
- Meglitinides
Correct answer: SGLT2 inhibitors
SGLT2 inhibitors have demonstrated significant cardioprotective and nephroprotective effects in clinical trials and are recommended early in type 2 diabetes management when these risks are present.
Question 5: Peripheral diabetic neuropathy most commonly presents with symptoms in which pattern?
- Proximal weakness in thighs only
- Stocking-and-glove distribution starting at the feet (Correct answer)
- Unilateral facial numbness
- Sudden complete loss of sensation in one limb
Correct answer: Stocking-and-glove distribution starting at the feet
Peripheral diabetic neuropathy typically presents in a stocking-and-glove distribution, beginning symmetrically in the feet and progressing upward.
Question 6: What is the recommended target blood pressure for most adults with diabetes to reduce the risk of cardiovascular and renal complications?
- Less than 160/100 mmHg
- Less than 140/90 mmHg
- Less than 130/80 mmHg (Correct answer)
- Less than 120/70 mmHg
Correct answer: Less than 130/80 mmHg
The ADA recommends a blood pressure target of less than 130/80 mmHg for most adults with diabetes to reduce cardiovascular and kidney disease progression.
Diabetes Education Certification Diabetes Chronic Complications Prevention & Management 1
Which chronic complication of diabetes specifically affects the small blood vessels and is classified as a 'microvascular' complication?