Diabetes Type 2 Diabetes 2 — Questions and Answers
Question 1: Which oral medication class works by inhibiting SGLT-2 receptors in the kidneys to lower blood glucose?
- Sulfonylureas
- SGLT-2 inhibitors (Correct answer)
- Biguanides
- DPP-4 inhibitors
Correct answer: SGLT-2 inhibitors
SGLT-2 inhibitors (e.g., empagliflozin, dapagliflozin) block glucose reabsorption in the kidneys, causing excess glucose to be excreted in urine.
Question 2: A patient with type 2 diabetes has an eGFR of 30 mL/min/1.73m². Which medication should be avoided?
- Glipizide
- Metformin (Correct answer)
- Sitagliptin
- Pioglitazone
Correct answer: Metformin
Metformin is contraindicated when eGFR falls below 30 due to risk of lactic acidosis from drug accumulation.
Question 3: Which complication of type 2 diabetes is characterized by damage to the small blood vessels supplying the glomeruli?
- Diabetic neuropathy
- Diabetic nephropathy (Correct answer)
- Diabetic retinopathy
- Diabetic cardiomyopathy
Correct answer: Diabetic nephropathy
Diabetic nephropathy involves microvascular damage to the glomeruli, leading to proteinuria and progressive kidney disease.
Question 4: What is the primary mechanism by which GLP-1 receptor agonists lower blood glucose in type 2 diabetes?
- Blocking glucose absorption in the gut
- Stimulating insulin secretion and suppressing glucagon (Correct answer)
- Increasing insulin sensitivity in muscle
- Inhibiting hepatic glucose production only
Correct answer: Stimulating insulin secretion and suppressing glucagon
GLP-1 agonists enhance glucose-dependent insulin secretion, suppress glucagon, and slow gastric emptying to reduce postprandial glucose spikes.
Question 5: Which lifestyle modification has the greatest impact on preventing progression from prediabetes to type 2 diabetes?
- Eliminating all dietary fat
- Achieving 5–7% body weight loss through diet and exercise (Correct answer)
- Taking a daily aspirin
- Avoiding all carbohydrates
Correct answer: Achieving 5–7% body weight loss through diet and exercise
The Diabetes Prevention Program demonstrated that a 5–7% weight loss combined with 150 minutes/week of moderate exercise reduced diabetes incidence by 58%.
Question 6: A patient with type 2 diabetes presents with tingling and numbness in both feet symmetrically. Which complication is most likely?
- Peripheral arterial disease
- Distal symmetric polyneuropathy (Correct answer)
- Charcot arthropathy
- Deep vein thrombosis
Correct answer: Distal symmetric polyneuropathy
Distal symmetric polyneuropathy is the most common form of diabetic nerve damage, causing bilateral tingling, numbness, and pain starting in the feet.
Question 7: Which laboratory test best reflects average blood glucose control over the past 2–3 months?
- Fasting plasma glucose
- 2-hour postprandial glucose
- Hemoglobin A1c (Correct answer)
- Fructosamine
Correct answer: Hemoglobin A1c
HbA1c reflects glycation of hemoglobin over the 2–3 month lifespan of red blood cells, providing an average measure of long-term glycemic control.
Diabetes Type 2 Diabetes 2
Which oral medication class works by inhibiting SGLT-2 receptors in the kidneys to lower blood glucose?