Diabetes Education Certification Oral & Injectable Medications 2 — Questions and Answers
Question 1: Which class of oral diabetes medication works by inhibiting sodium-glucose cotransporter-2 (SGLT-2) in the kidneys?
- Sulfonylureas
- SGLT-2 inhibitors (Correct answer)
- DPP-4 inhibitors
- Alpha-glucosidase inhibitors
Correct answer: SGLT-2 inhibitors
SGLT-2 inhibitors (e.g., empagliflozin, canagliflozin) block glucose reabsorption in the proximal tubule, causing glucosuria.
Question 2: A patient on a sulfonylurea skips a meal. What is the most likely adverse effect to monitor for?
- Hyperglycemia
- Lactic acidosis
- Hypoglycemia (Correct answer)
- Pancreatitis
Correct answer: Hypoglycemia
Sulfonylureas stimulate insulin secretion regardless of food intake, so skipping meals can cause hypoglycemia.
Question 3: Which GLP-1 receptor agonist is available as a once-weekly subcutaneous injection?
- Exenatide twice daily
- Liraglutide
- Semaglutide weekly (Correct answer)
- Albiglutide (Tanzeum)
Correct answer: Semaglutide weekly
Semaglutide (Ozempic) is administered once weekly subcutaneously and has strong evidence for cardiovascular benefit.
Question 4: Metformin is contraindicated in patients with an eGFR below which threshold per current guidelines?
- < 60 mL/min/1.73m²
- < 45 mL/min/1.73m²
- < 30 mL/min/1.73m² (Correct answer)
- < 15 mL/min/1.73m²
Correct answer: < 30 mL/min/1.73m²
Metformin is contraindicated when eGFR falls below 30 mL/min/1.73m² due to risk of lactic acidosis from drug accumulation.
Question 5: Which injectable non-insulin diabetes medication also acts as an amylin analog to slow gastric emptying?
- Exenatide
- Pramlintide (Correct answer)
- Liraglutide
- Dulaglutide
Correct answer: Pramlintide
Pramlintide (Symlin) is a synthetic amylin analog that slows gastric emptying and suppresses post-meal glucagon.
Question 6: DPP-4 inhibitors lower blood glucose primarily by which mechanism?
- Increasing insulin sensitivity in muscle
- Preventing breakdown of endogenous GLP-1 and GIP (Correct answer)
- Blocking hepatic glucose production
- Stimulating pancreatic beta cells directly
Correct answer: Preventing breakdown of endogenous GLP-1 and GIP
DPP-4 inhibitors prolong the action of incretin hormones GLP-1 and GIP by blocking the enzyme that degrades them.
Question 7: A patient reports genital mycotic infections since starting a new diabetes medication. Which drug class is most likely responsible?
- Biguanides
- Thiazolidinediones
- SGLT-2 inhibitors (Correct answer)
- Alpha-glucosidase inhibitors
Correct answer: SGLT-2 inhibitors
SGLT-2 inhibitors increase urinary glucose excretion, creating a favorable environment for genital yeast infections.
Diabetes Education Certification Oral & Injectable Medications 2
Which class of oral diabetes medication works by inhibiting sodium-glucose cotransporter-2 (SGLT-2) in the kidneys?