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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

  1. A patient with T2DM, obesity (BMI 38), and A1C of 8.5% asks about weight-loss options. Which diabetes medication has the most robust evidence for weight loss and A1C reduction?

    Answer: Semaglutide (Ozempic/Wegovy)

    Semaglutide has demonstrated the greatest weight loss among diabetes medications, with trials showing up to 15% body weight reduction along with significant A1C lowering.

  2. Which of the following best describes the rationale for using a fixed-ratio combination of basal insulin and a GLP-1 receptor agonist (e.g., iGlarLixi)?

    Answer: It reduces the number of injections and mitigates GLP-1-related nausea while limiting insulin-induced weight gain

    Fixed-ratio co-formulations like iGlarLixi combine the glycemic benefits of both agents, reduce injection burden, and the GLP-1 component helps offset insulin-related weight gain and nausea.

  3. A patient on metformin and glipizide has an A1C of 7.9% and a BMI of 32. She has no cardiovascular or renal disease. Which agent is most appropriate to add for further A1C lowering while promoting weight loss?

    Answer: Exenatide (Byetta)

    A GLP-1 receptor agonist like exenatide is appropriate to add for patients needing further A1C reduction and weight loss in the absence of CVD or CKD indications.

  4. What is the time-in-range (TIR) goal recommended by the ADA for adults with diabetes using CGM?

    Answer: >70% of time between 70-180 mg/dL

    The ADA recommends a TIR goal of >70% (more than 16.8 hours/day) within the range of 70-180 mg/dL for most adults with diabetes.

  5. A patient newly diagnosed with T2DM asks whether he can reverse his diabetes through lifestyle changes. What is the most accurate pharmacist response?

    Answer: Intensive lifestyle intervention can lead to remission (A1C <6.5% without medications) in some patients, especially early after diagnosis

    Evidence from studies like the DiRECT trial shows intensive lifestyle intervention with significant weight loss can lead to T2DM remission, particularly when achieved early in the disease course.

  6. When should an ambulatory care pharmacist recommend a glucagon emergency kit for a patient with diabetes?

    Answer: For any patient on insulin or sulfonylureas who is at significant risk for severe hypoglycemia

    Glucagon emergency kits should be prescribed to patients on insulin or insulin secretagogues (sulfonylureas, meglitinides) who are at risk for severe hypoglycemia, and caregivers should be trained on its use.

  7. A patient with T2DM and diabetic peripheral neuropathy reports burning and tingling in his feet. Which medication is considered a first-line option for diabetic peripheral neuropathic pain?

    Answer: Duloxetine or pregabalin

    Duloxetine (an SNRI) and pregabalin (a calcium channel alpha-2-delta ligand) are FDA-approved first-line treatments for diabetic peripheral neuropathic pain.