CV Complications of DM

Question 1

What are modifiable risk factors for risk of CV complications of DM?

Answer 1

obesity, HTN, dyslipidemia, hyperglycemia, tobacco use, underuse of antiplatelet therapy

Question 2

Which TZD was implicated in a meta analysis as a drug that increased CV risk is some studies?

Answer 2

Rosiglitazone

Question 3

Which SGLT inhibitors reduce CV risk in people with T2DM and high risk for CVD and reduce rate of hospitalization for HF?

Answer 3

Canagliflozin, empagliflozin.

Empagliflozin significantly reduced all cause mortality in those with DM and established CVD.

Question 4

Which GLP1 receptor agonists have favorable CV and CKD end points?

Answer 4

liraglutide, semaglutide

Question 5

Which DPP4 showed CV benefit in those with acute coronary syndrome?

Answer 5

Sitagliptin.

Saxagliptin and Alogliptin were not of proven CV benefit and may increase hospital admission for HF

Question 6

What is D5 terminolgy?

Answer 6

Communicates goals for glycemia, BP, lipids, tobacco, and aspirin use

Question 7

What are the numeric D5 goals?

Answer 7

BP < 140/90 mg/dL
LDL < 100 mg/dL
A1c <8%
Tobacco free
Aspirin as appropriate

Question 8

Which diet has the strongest evidence to improve CV outcomes?

Answer 8

The Mediterranean diet

DASH diet also has strong evidence to support improvement in CV risk factors

Question 9

When is statin use recommended in patients with DM1 or DM2?

Answer 9

All ages with ASCVD or 10 year ASCVD risk >20% (high intensity)

Pts age 40-75 and over without ASCV disease (moderate intensity)

Question 10

when should screening for lipid abnormalities using a fasting lipid profile be recommended in most adults with DM

Answer 10

At time of DM dx and at least every 5 years (or more if indicated)

Question 11

How should hypertriglyceridemia be addressed?

Answer 11

With diet and lifestyle changes.

Question 12

According to ADA and ACC/AHA guidelines, most pt’s with DM should receive at least ____ statin therapy

Answer 12

Moderate intensity

Question 13

What does the ACC/AHA recommend re: aspirin?

Answer 13

Not be administered routinely for pt’s > 70 or over or among adults of any age who are at increased risk of bleeding

For secondary CV prevention, the benefits of aspirin generally outweigh the risks

Question 14

Per the ADA, what is the optimal dose of aspirin for preventing CVD?

Answer 14

75-162 mg/dL

Question 15

Which medications are recommended for patients with urinary album to prevent progression of renal disease?

Answer 15

ACEi or ARBs

Question 16

How is high BP defined in childhood?

Answer 16

average systolic or diastolic BP >95% for age, sex, and height percentile confirmed on at least three separate days

Question 17

What is the classic symptom for PAD?

Answer 17

Intermittent claudication (pain reoccurs with walking and is relieved by rest)

Different than DPN, which pain is usually exacerbated by rest and relieved by walking

Question 18

True or false: Management of CV risk factors is as important as glycemic management for pt’s with DM?

Answer 18

True