Diabetes

Question 1

Metformin: MOA
A. Efficacy on A1c reduction? 
B. Hypogylcemia risk?
C. Weight impact:
D. Adverse effects?
E. Cost:
F. Compelling indication:

Answer 1

Insulin sensitizer
A. High
B. Low
C. Neutral/Loss
D. GI upset, don't use if eGFR <30, fragility, advanced age
E. Low
D. First-line Medication

Question 2

TZD (pioglitazone) MOA
A. Efficacy on A1c reduction? 
B. Hypogylcemia risk?
C. Weight impact:
D. Adverse effects?
E. Cost:
F. Compelling indication:

Answer 2

Insulin sensitizer
A. High
B. Low
C. Gain
D. Edema, heart failure-at risk patients, fractures, don't use with nitrates and insulin due to CVD risk
E. Low
F. Low cost, low hypoglycemia risk

Question 3

SU (Glipizide) MOA
A. Efficacy on A1c reduction? 
B. Hypogylcemia risk?
C. Weight impact:
D. Adverse effects?
E. Cost:
F. Compelling indication:

Answer 3

Insulin releaser, constant
A. High
B. Moderate to high
C. Gain
D. Hypoglycemia
E. Low 
F. Low cost

Question 4

DPP-4 Inhibitor (sitagliptin) MOA
A. Efficacy on A1c reduction? 
B. Hypogylcemia risk?
C. Weight impact:
D. Adverse effects?
E. Cost:
F. Compelling indication:

Answer 4

Insulin release, post glucose rise
A. Intermediate
B. Low 
C. Neutral
D. Rare
E. High
F. Low hypoglycemia risk

Question 5

GLP-1 inhibitor (exenatide) MOA
A. Efficacy on A1c reduction? 
B. Hypogylcemia risk?
C. Weight impact:
D. Adverse effects?
E. Cost:
F. Compelling indication:

Answer 5

Insulin release, post glucose rise
A. High
B. Low
C. Loss
D. Gi upset, avoid in gastroparesis or pancreatitis
E. High
D. Proven benefits with use in ASCVD, HF, CKD, low hypoglycemia risk, weight loss

Question 6

SGLT-2 inhibitor (Canaglifozin) MOA
A. Efficacy on A1c reduction? 
B. Hypogylcemia risk?
C. Weight impact:
D. Adverse effects?
E. Cost:
F. Compelling indication:

Answer 6

Glucose offloading, via kidney, excretion post glucose rise
A. Intermediate
B. Low
C. Loss
D. GU Infection (candida, UTI), dehydration, avoid when eGFR<30
E. High
D. Proven benefits with use in ASCVD, HF, CKD, low hypoglycemia risk, weight loss

Question 7

Insulin basal/bolus (glargine/aspart) MOA
A. Efficacy on A1c reduction? 
B. Hypogylcemia risk?
C. Weight impact:
D. Adverse effects?
E. Cost:
F. Compelling indication:

Answer 7

Insulin replacement/supplementation
A. Highest
B. High
C. Gain
D. Hypoglycemia
E. High
D. Used with >2 drugs including insulin releasers no longer adequate to maintain glycemic control

Question 8

When does short acting/rapid acting (Insulin lispro (humalog) or insulin aspart (novolog) peak)?

Answer 8

1 hour

Question 9

When does short-acting insulin (Humulin R, Novolin R) peak?

Answer 9

2-3 hours

Question 10

When does long-acting insulin (Insulin detemir (levemir), insulin glargine (Lantus) peak)?

Answer 10

None

Question 11

When does intermediate acting NPH insulin (Novolin N, Humulin N) peak?

Answer 11

6-14 hours