Reducing Risks

Question 1

For patients using basal insulin, ____ glucose supports informed dose adjustments results in lower A1c

Answer 1

Fasting

Question 2

True or false. A1c has a strong predictive value for DM complications.

Answer 2

True

Question 3

Evidence shows that when A1c levels are closer to target range _____ glucose level has the greatest effect, whereas the farther away from A1c target, ____ glucose has the greatest impact

Answer 3

Postprandial; fasting

Question 4

What are some lifestyle modifications that can be suggested for adults with HTN?

Answer 4

Wt loss, Na+ intake of <2300 mg/day, increasing consumption of F&V (8-10 servings/day), and low fat dairy (2-3 day), avoid excess ETOH and increase physical activity

Question 5

Which HTN drugs have traditionally been recommended as first line therapy i people with DM, due to their kidney protection effects?

Answer 5

ACE inhibitors and Angiotensin receptor blockers (ARBs)

Multiple drug therapy may be needed to achieve optimal BP targets

Question 6

According to the Standards of Care, when should statin therapy be recommended?

Answer 6

In all patients with DM who have overt heart disease, and those over age 40, regardless of CVD status

Question 7

According to the standards of care, when should persons with DM have an initial dilated and comprehensive eye exam by an optometrist?

Answer 7

DM1-w/in 5 years after onset of dx

DM2-at time of DM dx

Question 8

What is a normal eGFR?

Answer 8

> 60 ml/min/1.73 m

Question 9

When should patients be assessed for DPN?

Answer 9

At dx of DM2 and 5 years after dx of DM1, then at least annually

Question 10

In patient’s with peripheral neuropathy, what other etiologies (bedside DM) should be assessed for?

Answer 10

B12 or other vitamin deficiencies, ETOH use disorder, hypothyroidism, and/or exposure to heavy metal or toxins

Question 11

what is the most effective way for a person with DM to protect feet from loss of protective sensation?

Answer 11

Daily self inspection

Question 12

Up to 2/3rds of ppl with DM are affected with some level of _____ impairment

Answer 12

hearing

Question 13

How often should pregnant women dx’d with DM be screened for retinopathy?

Answer 13

Prior to pregnancy/in the first trimester, every trimester of pregnancy, and 1 year postpartum

Question 14

What are the three areas that may prevent a challenge to DSMES?

Answer 14

physical limitations, psychosocial, and social factors