Question 1

Type 1 diabetes results from autoimmune destruction of the beta cells. Eighty-five to ninety percent of type 1 diabetics have:

Accepted Answer

Type 1 diabetes is characterized by the presence of autoantibodies against components of the beta cells, including tyrosine phosphatases IA-2 and IA-2β, which are involved in the autoimmune destruction of these cells.

Question 2

Diagnostic criteria for diabetes include:

Accepted Answer

The diagnostic criteria for diabetes include symptoms of diabetes plus a casual blood glucose greater than 200 mg/dL. Fasting blood glucose greater than 126 mg/dL on two occasions is also a criterion, but not 140 mg/dL.

Question 3

Type 2 diabetes is a complex disorder involving:

Accepted Answer

Type 2 diabetes involves a suboptimal response of insulin-sensitive tissues, particularly in the liver, muscle, and fat tissue, to insulin. This condition is known as insulin resistance. Unlike type 1 diabetes, which involves an absence of insulin production, type 2 diabetes is characterized by the body's ineffective use of insulin.

Question 4

Establishing glycemic targets is the first step in treatment of both types of diabetes. For type 1 diabetes:

Accepted Answer

The answer of Establishing glycemic targets is the first step...

Question 5

Before prescribing metformin, the provider should:

Accepted Answer

Metformin is contraindicated in patients with renal impairment due to the increased risk of lactic acidosis. Therefore, assessing renal function through a serum creatinine level before prescribing metformin is essential. Trying the patient on insulin or prescribing a thyroid preparation for weight loss are not prerequisites for initiating metformin therapy.

Question 6

Diabetes screening for children who meet the following criteria should begin at age 10 and occur every three years thereafter:

Accepted Answer

Diabetes screening for children is recommended to begin at age 10 and occur every three years if they meet certain risk factors. These risk factors include having a BMI above the 85th percentile for age and sex, a family history of diabetes in a first- or second-degree relative, or hypertension based on criteria for children. Therefore, any of these conditions (A, B, or C) would qualify a child for screening, making D the correct choice.

Question 7

Treatment with insulin for type 1 diabetics:

Accepted Answer

The initial total daily dose of insulin for type 1 diabetics typically starts at 0.2 to 0.4 units per kilogram of body weight. This dose is then adjusted based on individual needs and blood glucose monitoring.

Question 8

Unlike most type 2 diabetics where obesity is a major issue, older adults with low body weight have higher risks for morbidity and mortality. The most reliable indicator of poor nutritional status in older adults is:

Accepted Answer

Involuntary loss of 10% of body weight in less than six months is a significant indicator of poor nutritional status and potential health issues in older adults, signaling possible malnutrition or underlying disease.

Question 9

The drugs recommended by the American Academy of Pediatrics for use in children with diabetes (depending upon type of diabetes) are:

Accepted Answer

Metformin and insulin are recommended by the American Academy of Pediatrics for use in children with diabetes, depending on the type of diabetes. Metformin is often used for type 2 diabetes, while insulin is essential for type 1 diabetes management.

Question 10

Prevention of conversion from prediabetes to diabetes in young children must take highest priority and should focus on:

Accepted Answer

The answer of Prevention of conversion from prediabetes to diabetes...

Question 11

Adam has type 1 diabetes and plays tennis for his university. He exhibits a knowledge deficit about his insulin and his diagnosis. He should be taught that:

Accepted Answer

Individuals with type 1 diabetes need to adjust their carbohydrate intake during periods of increased physical activity, such as playing tennis, to prevent hypoglycemia. This is because exercise increases insulin sensitivity and glucose uptake by muscles, which can lower blood sugar levels.

Question 12

When the total daily insulin dose is split and given twice daily, which of the following rules may be followed?

Accepted Answer

When splitting the total daily insulin dose into two doses, a common approach is to give two-thirds of the dose in the morning and one-third in the evening.

Question 13

Control targets for patients with diabetes include:

Accepted Answer

The recommended blood pressure target for most patients with diabetes is less than 130/80 mm Hg to reduce the risk of cardiovascular complications.

Question 14

Sulfonylureas may be added to a treatment regimen for type 2 diabetics when lifestyle modifications and metformin are insufficient to achieve target glucose levels. Sulfonylureas have been moved to step 2 therapy because they:

Accepted Answer

The answer of Sulfonylureas may be added to a treatment...

Question 15

Dipeptidyl peptidase-4 inhibitors (gliptins) act on the incretin system to improve glycemic control. Advantages of these drugs include:

Accepted Answer

The answer of Dipeptidyl peptidase-4 inhibitors (gliptins) act on the...

Question 16

The drug of choice for type 2 diabetics is metformin. Metformin:

Accepted Answer

Metformin primarily works by decreasing hepatic glucose production, particularly by inhibiting glycogenolysis and gluconeogenesis in the liver.

Question 17

Studies have shown that control targets that reduce the HbA1C to less than 7% are associated with fewer long-term complications of diabetes. Patients who should have such a target include:

Accepted Answer

Patients with no significant cardiovascular disease are more likely to benefit from tighter glycemic control (HbA1C <7%) to prevent long-term complications of diabetes. This approach is less beneficial and can be harmful due to hypoglycemia risks in patients with long-standing diabetes, older adults, and young children.

Question 18

Insulin preparations are divided into categories based on onset time, duration of action, and intensity of action following subcutaneous injection. Which of the following insulin preparations has the shortest onset and duration of action?

Accepted Answer

The answer of Insulin preparations are divided into categories based...

Question 19

Routine screening of asymptomatic adults for diabetes is appropriate for:

Accepted Answer

Native Americans, African Americans, and Hispanics are at increased risk for diabetes and should be screened regularly, regardless of age or BMI.

Question 20

Insulin is used to treat both types of diabetes. It acts by:

Accepted Answer

Insulin facilitates the uptake of glucose by skeletal muscle and adipose tissue, thereby lowering blood glucose levels. It promotes the storage of glucose in the form of glycogen in liver and muscle cells and inhibits gluconeogenesis, which is the production of glucose from non-carbohydrate sources in the liver.

Quiz 35: Diabetes Mellitus