Types of Diabetes and Diagnosis Flashcards
Question 1 of 9
You are responsible for patient teaching at a primary care office. You will be providing patient education for Henry Thomas, a 58-year-old attorney who is coming in for a follow-up visit. To prepare, you review Mr. Thomas’ file. Over the past few years, his weight has steadily increased. Prior to his last physical exam (2 weeks ago), his PCP ordered multiple laboratory tests, including fasting blood glucose, urinalysis, and cholesterol screening.
You take a careful look at Mr. Thomas’ physical exam findings and lab results. Which of the following results lead you to suspect that he has metabolic syndrome? Select all that apply. Blood pressure: 118/80 mm Hg Waist circumference: 41 inches Triglycerides: 155 mg/dL HDL cholesterol: 37 mg/dL Fasting glucose: 105 mg/dL
Waist circumference: 41 inches
Triglycerides: 155 mg/dL
HDL cholesterol: 37 mg/dL
Fasting glucose: 105 mg/dL
Metabolic syndrome is the presence of three or more of the following:
Elevated waist circumference (≥ 40 inches in men; ≥ 35 inches in women)
Elevated triglycerides (≥ 150 mg/dL)
Reduced HDL cholesterol (< 40 mg/dL in men; < 50 mg/dL in women)
Elevated blood pressure (≥ 130/85 mm Hg)
Elevated fasting glucose level (≥ 100 mg/dL)
Question 2 of 9
Worried that Mr. Thomas may have type 2 diabetes mellitus (DM), the PCP orders two follow-up tests: a(n) \_\_\_\_\_\_\_\_\_\_\_\_ to test postprandial glycemic control and a(n) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ to evaluate glycemic control during the prior 3 months. Which tests did the physician order? ICAs, A1c C-peptide, A1c OGTT, C-peptide OGTT, A1c
OGTT, A1c
OGTT, or oral glucose tolerance test, assesses glycemic control after an individual ingests a standard amount of glucose. A1c measures glycated hemoglobin. Glucose in the blood attaches to hemoglobin in red blood cells (RBCs). As glucose levels increase, so does glycation of RBCs. This measurement reflects blood glucose levels over the prior 3 months. ICAs measure islet cell autoantibodies and are used to assess type 1 DM due to autoimmune disease. C-peptide is an indicator of insulin production and can help differentiate type 1 and type 2 DM.
Question 3 of 9
Based on Mr. Thomas’ results, the diagnosis for type 2 DM was confirmed by both tests. Which of the results below confirm DM for an OGTT and A1c test, respectively? ≤140 mg/dL, ≥ 6.5% ≥126 mg/dL, ≥ 7.4% ≥200 mg/dL, ≥ 6.5% ≥160 mg/dL, ≥ 7.4%
≥200 mg/dL, ≥ 6.5%
The American Diabetes Association classifies an OGTT result of ≥200 mg/dL as diabetes. Values of ≤ 199 mg/dL to ≥140 mg/dL are considered to be prediabetes. An A1c result of ≥6.5% is indicative of diabetes.
Question 4 of 9
An education plan for diabetes is developed for Mr. Thomas. You present him with information on the importance of postprandial glycemic control. Postprandial blood glucose levels should be obtained \_\_\_\_\_\_\_\_\_\_ after eating and should be \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. immediately, ≤ 100 mg/dL 30 minutes, ≤ 100 mg/dL 2 hours, ≤ 100 mg/dL 2 hours, ≤ 180 mg/dL
2 hours, ≤ 180 mg/dL
For consistency, postprandial blood glucose levels should be measured 2 hours after eating and be less than 180 mg/dL. Postprandial blood glucose levels are important indicators of glycemic control. This information helps the patient and clinician monitor glycemic control in response to food and/or beverage intake. Modifications in dietary choices and medications can be made based on postprandial results.
Question 5 of 9
You advise Mr. Thomas about his diet: \_\_\_\_\_\_\_\_\_\_\_\_\_ percent of total calories should come from carbohydrates. 0 25 40 50
50
The recommended diet for an individual with type 2 DM is 50% of total calories from carbohydrates, 25% to 30% of calories from fat (with less than 7% of total calories from saturated fats), and 20% of total calories from proteins.
Question 6 of 9
Three months later, Mr. Thomas appears for a scheduled follow-up appointment. He reports significant changes in his diet and exercise. He has been self-monitoring his blood glucose levels and reports an average blood glucose of 150 mg/dL preprandial. Mr. Thomas is confused when you tell him that his values seem a bit high. What is the recommended range for preprandial blood glucose levels in DM? 80 to 130 mg/dL < 100 mg/dL 140 to 180 mg/dL 120 to 180 mg/dL
80 to 130 mg/dL
Recommended preprandial blood glucose levels for patients with diabetes are between 80 to 130 mg/dL. Preprandial blood glucose is the level of glucose in the blood prior to eating. This baseline level helps the clinician and patient know how effective glycemic control is prior to a meal. The increase in blood glucose with food and beverage ingestion can then be determined.
Question 7 of 9
The physician recommends that Mr. Thomas begin taking an oral antidiabetic medication. The physician wants to choose a pharmacological agent that stimulates insulin secretion from the pancreas. Which medication will stimulate insulin secretion? Thiazolidinediones Meglitinides Biguanides Alpha-glucosidase inhibitors
Meglitinides.
Meglitinides are a classification of medications that stimulate the pancreas to produce insulin. Thiazolidinediones and biguanides work to increase cell sensitivity to insulin, while alpha-glucoside inhibitors decrease intestinal absorption of carbohydrates.
Question 8 of 9
Sometimes monotherapy for type 2 DM does not effectively manage blood glucose levels. During Mr. Thomas’ next appointment, his PCP adds a second oral medication.
Although Mr. Thomas continued to work diligently on his diet, exercise, and medication protocols, his glycemic control was not at the desired level.
Concerned, the PCP prescribes insulin for Mr. Thomas. Mr. Thomas receives \_\_\_\_\_\_\_\_\_\_, a synthetic preparation that mimics physiological insulin, although its structure differs from the natural form. conventional insulin insulin analogue endogenous insulin unconventional insulin
insulin analogue
Insulin analogues are synthetic preparation that more closely mimic physiological insulin. Conventional insulins are synthetic human insulins. Endogenous insulin refers to insulin made by one’s own body. Unconventional insulin is not a form of insulin used clinically.
Question 9 of 9
Insulin regimens are modified for each patient’s needs. Mr. Thomas begins the \_\_\_\_\_\_\_\_\_\_\_\_\_\_ regimen, which requires once daily injection of long-lasting insulin with subsequent rapid-acting insulin for postmeal glycemic control. basal-bolus constant-duration peak-valley intermittent-rotation
basal-bolus
The basal-bolus regimen is the most common insulin regimen for patients. It involves a once-daily injection of long-acting insulin to control fasting blood glucose levels (basal) and additional rapid-acting insulin (bolus) to manage postprandial glucose elevations. The other answers are not typical insulin regimens.
Question 1 of 5
Which hormone released by the pancreas causes the liver to release glucose in the blood to counteract hypoglycemia?
Glucagon
Insulin
Cortisol
Epinephrine
Glucagon
Question 3 of 5
Which of the following statements about type 1 and type 2 diabetes are correct?
Individuals with type 1 diabetes are required to take insulin. Insulin is not always required for individuals with type 2 diabetes.
In both type 1 and type 2 diabetes, cells are resistant to insulin.
Treatments for type 1 and type 2 diabetes are essentially the same.
Type 2 diabetes is a condition of hypoglycemia, whereas type 1 diabetes is a condition of hyperglycemia.
Individuals with type 1 diabetes are required to take insulin. Insulin is not always required for individuals with type 2 diabetes.
Question 4 of 5
Your aunt has recently been diagnosed with type 2 diabetes. Which test enables her clinician to assess glycemic control over the preceding 3 months?
Postprandial glucose
Fasting blood glucose
Oral glucose tolerance test
A1c
A1C
Question 5 of 5
A patient with type 2 DM has decided to modify her lifestyle habits to help regulate her blood glucose levels. Which of the following lifestyle changes would you recommend? Select all that apply.
Select meals with simple carbohydrates with a high glycemic value to provide immediate energy.
Self-monitor blood glucose levels at least once a week.
Follow a regular meal schedule with meals containing low glycemic carbohydrates, proteins, and fats.
Eat one large meal for lunch and a snack for breakfast and dinner.
Complete a moderate daily exercise program.
Follow a regular meal schedule with meals containing low glycemic carbohydrates, proteins, and fats.
Complete a moderate daily exercise program.
Question 5 of 5
Treatment of type 2 diabetes often involves a stepwise approach. Place the treatment options in the order in which they are commonly utilized.
Insulin Monotherapy of oral antidiabetic agent Combination of oral antidiabetic agents Lifestyle modifications 4, 2, 3, 1 1, 2, 3, 4 2, 3, 1, 4 1, 4, 2, 3
4,2,3,1,
