Ambulatory Diabetes Management Flashcards
7 cards from real BCACP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Ambulatory Diabetes Management flashcards as text
A 68-year-old patient with T2DM, HFrEF, and eGFR 55 mL/min/1.73m² is on metformin. Which add-on therapy has evidence for both glycemic control and reduction in heart failure hospitalization?
Answer: Empagliflozin
SGLT2 inhibitors like empagliflozin have demonstrated significant reduction in heart failure hospitalization and are preferred in T2DM patients with HFrEF per ADA guidelines.
Which sulfonylurea is considered lowest risk for hypoglycemia due to its short duration of action and lack of active metabolites?
Answer: Glipizide
Glipizide has a short duration of action and no active metabolites, making it the preferred sulfonylurea especially in the elderly and those at risk for hypoglycemia.
A patient is starting on a basal-bolus insulin regimen. What is the appropriate starting total daily dose (TDD) for an insulin-naive patient using weight-based dosing?
Answer: 0.5-0.6 units/kg/day
A common starting TDD for basal-bolus insulin in insulin-naive patients is 0.4-0.6 units/kg/day, with half given as basal and half divided as bolus doses.
Which DPP-4 inhibitor requires dose adjustment in renal impairment and has the most documented clinical experience?
Answer: Sitagliptin
Sitagliptin was the first DPP-4 inhibitor approved and requires dose reduction in moderate to severe renal impairment; linagliptin is the only DPP-4i that does NOT require renal dose adjustment.
A pharmacist reviews a patient's CGM data showing high fasting glucose values. The patient is on basal insulin 20 units at bedtime. What is the best titration strategy?
Answer: Increase basal dose by 2 units every 3 days if fasting glucose consistently >130 mg/dL
The treat-to-target approach for basal insulin titration typically involves increasing the dose by 2 units every 3 days when fasting glucose remains above the target threshold.
Which of the following is a contraindication to the use of a GLP-1 receptor agonist?
Answer: Personal or family history of medullary thyroid carcinoma
GLP-1 receptor agonists are contraindicated in patients with a personal or family history of medullary thyroid carcinoma or MEN type 2 due to thyroid C-cell tumor risk seen in animal studies.
A patient with T2DM has persistent microalbuminuria (UACR 120 mg/g) despite optimized blood pressure control. Which drug class should be added or ensured is part of the regimen?
Answer: ACE inhibitors or ARBs
ACE inhibitors and ARBs have proven nephroprotective effects in diabetes and are first-line agents for reducing diabetic nephropathy progression in patients with microalbuminuria.