Diabetes Education Certification Oral & Injectable Medications 3 — Questions and Answers
Question 1: Which type of insulin has the longest duration of action and is typically administered once daily?
- Regular insulin
- NPH insulin
- Insulin glargine (U-100) (Correct answer)
- Insulin aspart
Correct answer: Insulin glargine (U-100)
Insulin glargine (Lantus) provides a peakless, steady 24-hour basal insulin profile when injected once daily.
Question 2: Thiazolidinediones (TZDs) are contraindicated in patients with which condition?
- Mild renal impairment
- NYHA Class III or IV heart failure (Correct answer)
- Controlled hypertension
- Type 1 diabetes with insulin use
Correct answer: NYHA Class III or IV heart failure
TZDs cause fluid retention and are contraindicated in moderate-to-severe heart failure (NYHA Class III/IV) due to risk of worsening edema.
Question 3: When teaching insulin injection technique, what is the recommended needle insertion angle for a standard adult with average BMI using a 4–5 mm pen needle?
- 30 degrees
- 45 degrees
- 60 degrees
- 90 degrees (Correct answer)
Correct answer: 90 degrees
Short pen needles (4–5 mm) can be injected at 90 degrees in most adults without risk of intramuscular injection.
Question 4: Which oral agent should be held 48 hours before iodinated contrast administration?
- Glipizide
- Metformin (Correct answer)
- Sitagliptin
- Pioglitazone
Correct answer: Metformin
Metformin is held before contrast dye due to risk of acute kidney injury, which could lead to metformin accumulation and lactic acidosis.
Question 5: A patient using rapid-acting insulin analog should inject it at what time relative to meals?
- 30–45 minutes before eating
- 0–15 minutes before or immediately after starting a meal (Correct answer)
- Only after finishing the meal
- 2 hours after eating
Correct answer: 0–15 minutes before or immediately after starting a meal
Rapid-acting analogs (lispro, aspart, glulisine) have a rapid onset and should be given just before or at the start of a meal.
Question 6: Which GLP-1 receptor agonist is available in an oral tablet formulation?
- Liraglutide
- Dulaglutide
- Oral semaglutide (Rybelsus) (Correct answer)
- Exenatide
Correct answer: Oral semaglutide (Rybelsus)
Oral semaglutide (Rybelsus) is the first GLP-1 receptor agonist approved in tablet form, taken on an empty stomach.
Question 7: Alpha-glucosidase inhibitors (e.g., acarbose) primarily target which phase of glycemic control?
- Fasting blood glucose
- Postprandial blood glucose (Correct answer)
- Overnight glucose nadirs
- HbA1c reduction over 3 months
Correct answer: Postprandial blood glucose
Acarbose delays carbohydrate digestion in the intestine, specifically blunting postprandial glucose spikes.
Diabetes Education Certification Oral & Injectable Medications 3
Which type of insulin has the longest duration of action and is typically administered once daily?