Question 1

Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:

Accepted Answer

Metformin primarily works by decreasing the amount of glucose produced by the liver (glycogenolysis) and by improving insulin sensitivity, which enhances peripheral glucose uptake and utilization. It does not substitute for insulin, significantly increase insulin release from beta cells, or decrease peripheral glucose utilization.

Question 2

When is metformin typically initiated for glucose metabolism issues?

Accepted Answer

B

Question 3

Long-term injection site skin changes are called:

Accepted Answer

Lipodystrophy refers to changes in the skin and underlying tissue that occur at injection sites over time, often seen in individuals who repeatedly inject medications (such as insulin) into the same site.

Question 4

Prior to prescribing metformin, the provider should:

Accepted Answer

Metformin is contraindicated in patients with renal impairment due to the risk of lactic acidosis. Assessing renal function through a serum creatinine test before prescribing metformin is essential to ensure it is safe for the patient.

Question 5

When blood glucose levels are difficult to control in type 2 diabetes, some form of insulin may be added to the treatment regimen to control blood glucose and limit complication risks. Which of the following statements is accurate based on research?

Accepted Answer

The answer of When blood glucose levels are difficult to...

Question 6

When given subcutaneously, how long until neutral protamine Hagedorn (NPH) insulin begins to take effect (onset of action) after administration?

Accepted Answer

NPH insulin typically begins to take effect within 60 to 90 minutes after subcutaneous administration, marking the onset of its action.

Question 7

Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:

Accepted Answer

Nonselective beta blockers can mask the signs and symptoms of hypoglycemia (altered glucose levels), such as tachycardia and tremors, making it difficult for patients, especially those with diabetes, to recognize when their blood sugar is low. This can be particularly dangerous as it prevents timely intervention to correct hypoglycemia.

Question 8

Administration of exenatide is by subcutaneous injection:

Accepted Answer

Exenatide should be administered sixty minutes prior to the morning and evening meal, not right before or after a meal, to ensure proper absorption and effectiveness.

Question 9

GLP-1 agonists:

Accepted Answer

The answer of GLP-1 agonists:
...

Question 10

Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include:

Accepted Answer

Hypoglycemia, or low blood sugar, can lead to symptoms such as dizziness, confusion, sweating (diaphoresis), and a rapid heartbeat (tachycardia). These symptoms occur as the body tries to respond to the lack of glucose available for energy.

Question 11

Which characteristic of metformin makes it a popular selection for diabetes care?

Accepted Answer

Metformin is popular in diabetes care primarily because it only rarely causes hypoglycemia, making it safer in terms of avoiding dangerously low blood sugar levels compared to some other diabetes medications.

Question 12

The decision may be made to switch from twice daily NPH insulin to insulin glargine to improve glycemia control throughout the day. If this is done:

Accepted Answer

When switching from twice daily NPH insulin to insulin glargine, it is common to reduce the initial dose of glargine by 20% to avoid hypoglycemia. This is because glargine has a longer duration of action and a more predictable absorption profile, which can increase the risk of hypoglycemia if the same dose of NPH is used.

Question 13

The action of gliptins is different from other antidiabetic agents because they:

Accepted Answer

Gliptins, also known as DPP-4 inhibitors, work by inhibiting the enzyme dipeptidyl peptidase-4, which increases the levels of incretin hormones. This action enhances insulin secretion in response to meals, distinguishing them from other antidiabetic agents.

Question 14

All of the following are options for insulin injections when each dose is close to 100 units except:

Accepted Answer

Stopping injectable insulin and changing to oral methods only is not a viable option for managing diabetes when each dose is close to 100 units. This is because high-dose insulin requirements typically indicate a level of insulin resistance or deficiency that oral medications alone cannot effectively manage. Options like split dosing, moving to insulin pen use, or changing to U500 insulin are practical approaches to manage high insulin doses.

Question 15

Sitagliptin has been approved for:

Accepted Answer

Sitagliptin has been approved for both monotherapy in once-daily doses and as part of combination therapy with metformin, making both statements A and B correct.

Question 16

Angiotensin-converting enzyme (ACE) inhibitors are considered renal-protective in DM; however, they must be reduced and/or discontinued when:

Accepted Answer

ACE inhibitors are renal-protective but need to be reduced or discontinued in stage 3 CKD to prevent further kidney damage, as their use in advanced kidney disease can lead to worsening renal function and hyperkalemia.

Question 17

Avoid concurrent administration of exenatide with which of the following drugs?

Accepted Answer

Exenatide can slow gastric emptying, potentially affecting the absorption and consequently the effectiveness of other orally administered drugs such as digoxin, warfarin, and lovastatin. Therefore, concurrent administration with these drugs should be avoided or closely monitored.

Question 18

Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this form of insulin is NOT true?

Accepted Answer

Duration of action is not increased when the dose is increased.

Quiz 18: Drugs Affecting the Endocrine System: Antidiabetic Drugs