Diabetes Type 2 Diabetes 4 — Questions and Answers
Question 1: A patient with type 2 diabetes has proliferative diabetic retinopathy. Which treatment is most commonly used to prevent vision loss?
- Oral corticosteroids
- Pan-retinal laser photocoagulation (Correct answer)
- Intravitreal methotrexate
- Surgical vitrectomy alone
Correct answer: Pan-retinal laser photocoagulation
Pan-retinal photocoagulation (PRP) laser therapy destroys peripheral retinal tissue to reduce angiogenic signals and prevent progression of proliferative retinopathy.
Question 2: Which ethnic group in the United States has the highest prevalence of type 2 diabetes?
- Non-Hispanic White adults
- Asian Americans
- American Indian/Alaska Native adults (Correct answer)
- Non-Hispanic Black adults
Correct answer: American Indian/Alaska Native adults
American Indian and Alaska Native populations have the highest prevalence of type 2 diabetes in the US, exceeding 14% in some communities.
Question 3: What physiological change primarily explains why postprandial glucose spikes are higher in type 2 diabetes compared to healthy individuals?
- Increased glucagon secretion after meals
- Impaired first-phase insulin secretion (Correct answer)
- Reduced intestinal glucose absorption
- Excessive renal glucose reabsorption
Correct answer: Impaired first-phase insulin secretion
In type 2 diabetes, the rapid first-phase insulin burst that normally blunts postprandial glucose is blunted or absent, causing exaggerated glucose peaks after eating.
Question 4: Which medication used to treat type 2 diabetes is associated with weight gain and fluid retention?
- Metformin
- Liraglutide
- Pioglitazone (Correct answer)
- Sitagliptin
Correct answer: Pioglitazone
Thiazolidinediones like pioglitazone activate PPAR-gamma receptors, causing fluid retention, weight gain, and an increased risk of heart failure.
Question 5: Which test is used to diagnose type 2 diabetes based on a 75-gram glucose load given after fasting?
- Random plasma glucose test
- Fasting plasma glucose test
- Oral glucose tolerance test (Correct answer)
- Insulin tolerance test
Correct answer: Oral glucose tolerance test
The oral glucose tolerance test (OGTT) measures plasma glucose 2 hours after a 75g glucose load; a result ≥200 mg/dL confirms diabetes.
Question 6: A 55-year-old with type 2 diabetes develops a painless foot ulcer. Which factor most likely contributed to its development?
- Hyperglycemia causing acute infection
- Peripheral neuropathy reducing pain sensation (Correct answer)
- Severe peripheral arterial disease alone
- Venous insufficiency causing skin breakdown
Correct answer: Peripheral neuropathy reducing pain sensation
Peripheral neuropathy eliminates protective pain sensation, allowing repeated trauma and pressure to cause ulcers without the patient noticing injury.
Question 7: Which dietary index is recommended by the ADA for patients with type 2 diabetes to guide healthy eating patterns?
- A carbohydrate-free carnivore diet
- Individualized medical nutrition therapy with no single prescribed diet (Correct answer)
- A strict 800-calorie very low calorie diet
- The DASH diet exclusively
Correct answer: Individualized medical nutrition therapy with no single prescribed diet
The ADA supports individualized medical nutrition therapy (MNT) tailored to each patient's preferences and metabolic goals rather than a single universal diet.
Diabetes Type 2 Diabetes 4
A patient with type 2 diabetes has proliferative diabetic retinopathy.
Which treatment is most commonly used to prevent vision loss?