Which of the following are part of the "ominous octet" associated with the pathogenesis of type 2 diabetes? Select more than one if apply

What does glucagon promote in the liver

Untreated hypoglycaemia may lead to

All the following T2DM therapies are weight neutral/providing weight benefit except

The hormones released under stress conditions are

What is Somogyi effect?

GLP-1 is a natural incretin hormone secreted by in response to food intake.

Glucose dependant secretion of insulin in response to nutrient intake is called

GLP-1 stimulates insulin secretion and suppresses glucagon secretion, but only when glucose levels are elevated, thus protecting against hypoglycaemia

GLP-1 mediates its effects via receptors called . These receptors are found in pancreatic islets and various other organ throughout the body, including the brain, kidney, liver & heart

GLP-1 delays stomach emptying and reduces appetite, resulting in satiety (feeling of fullness) and contributing to weight loss

Native GLP-1 has limited potential as a treatment for T2D; as it is rapidly degraded by enzyme resulting in a half-life of approx.

GLP-1-based therapies with have, been developed to clinically benefit from the positive effects of GLP-1 Receptor Activation.

Incretin based therapies include

Multiple physiological effects of GLP-1 RA, makes it an attractive Type 2 Diabetes therapy:

ADA 2024, guidelines recommends GLP-1 RA as the injectable if ASCVD / Indicators of higher CVD risk exists:

GLP-1RAs reduce cardiovascular risk by modifying the progression of atherosclerosis (the build-up of fatty deposits in the arteries):

GLP-1RAs are recommended by guidelines in patients with ASCVD (Atherosclerotic Cardiovascular Disease)

Semaglutide is a , with homology to native GLP-1 hormone

Modifications to the native GLP-1 molecule makes Semaglutide increase its albumin affinity and stability against metabolic degradation by DPP-4, giving it a half-life of approx. , making it suitable for administration.

Ozempic® (Semaglutide) is administered subcutaneously (abdomen, thigh, or upper arm), once weekly (OW) on the same day each week, at any time of the day, with or without meals:

Ozempic® (Semaglutide) is available in Pakistan as:

If Ozempic® dose is missed, it should be administered as soon as possible and within days after the missed dose.

SUSTAIN PHASE 3, clinical trial programme stands for

SUSTAIN clinical trial programme was designed to evaluate the efficacy and safety of Semaglutide across the continuum of care in patients with Type 1 diabetes

Across the SUSTAIN series, the max HbA1c reduction attained on an average was:

In SUSTAIN series, there was consistent reductions in body weight and BMI, and higher proportions of subjects achieving weight-loss responses (≥5%, ≥10%) with Semaglutide vs comparators

Injection should be done at ….degree angle with the skin if the needle is short i.e …. mm or less

Kidney disease is one of the risk factors of Obesity?

If you always inject in the same spot you will see swelling and depressed areas. Doctors call these

Effects of Semaglutide includes: (Select Apply that apply)

In SUSTAIN VII, Semaglutide-treated patients had double the weight loss observed as compared to dulaglutide-treated patients at Week 40:

In SUSTAIN VII, subjects achieving HbA1c <7.0% without severe or Blood Glucose-confirmed symptomatic hypoglycaemia or weight gain were more with Dulaglutide versus Semaglutide.

The primary endpoint of SUSTAIN 7 was change in from baseline:

Duration of SUSTAIN VII was ;

SUSTAIN VI is a long-term, global trial examining the:

Subjects enrolled in SUSTAIN VI had T2D with a baseline of:

In SUSTAIN VI, The ………………………. % risk reduction in the primary outcome (MACE) was seen with Semaglutide:

The key contributor of 3-point MACE reduction in Sustain VI was ………...

What was the treatment duration during the SUSTAIN VI trial?

The risk of diabetes retinopathy complications was comparable with semaglutide vs placebo. TRUE or FALSE?

The change from baseline in HbA1c was with was significant vs placebo in SUSTAIN 6. TRUE or FALSE?

In SUSTAIN VI, both doses of Semaglutide were associated with significantly greater changes from baseline in body weight vs placebo. TRUE or FALSE?

Therapeutic experience of Ozempic® in patients aged of age is limited

Match the Columns: In SUSTAIN VII HbA1c reduction with Ozempic® (1mg dose) was % VS Dulaglutide (1.5mg dose) %.

Effects of Semaglutide includes: Choose the best answer

SUSTAIN clinical trial programme was designed to evaluate the efficacy and safety of Semaglutide across the continuum of care in patients with Type 1 diabetes

Which of the following recommendations is true?

Both doses of Semaglutide (0.5 mg & 1 mg) were compared with DPP4i (Sitagliptin 100 mg) in SUSTAIN II. True or False?

How much risk reduction was seen with Semaglutide in SUSTAIN VI for renal outcomes?

What are Semaglutide's key modifications as compared to native GLP-1? Select the best answer.

Management of Diabetes include:

Insulin sensitizers includes. Select the best answer.

During digestion, are broken down into which provides for the cells.

The pancreas releases insulin when:

How do type 1 and type 2 diabetes differ? Question options:

If you haven't eaten all day, what hormone is your pancreas most likely secreting?

Which of the following are symptoms of diabetes?

The organ stores glycogen is:

When may a person develop gestational diabetes?

Which is the Acute complication of diabetes?

What is HHS stands for?

What is the normal fasting blood sugar level range?

Which is the test that measures the amount of glycated hemoglobin?

Higher values of HbA1c (above 6%) indicate that your risk of suffering from diabetic complications is:

Someone with an HbA1c of 5.3% may be:

Gestational Diabetes increases risk of diabetes.

The aim of the SUSTAIN 4 trial was to compare the effect of once-weekly semaglutide with once-daily insulin glargine (Iglar U100) on glycaemic control, weight loss and other efficacy and safety parameters, in subjects with

In SUSTAIN IV trial, both doses of Semaglutide once weekly (0.5mg & 1mg) were compared with insulin. TRUE or FALSE?

At the end of SUSTAIN IV trial, both semaglutide doses achieved superiority to comparator after 30 weeks in

In SUSTAIN IV trial, there were fewer hypoglycemic events with Semaglutide once weekly compared to insulin and majority of the events were in subjects on background SU medication. TRUE or FALSE?

With which Insulin was Semaglutide compared with in SUSTAIN IV?

What is the pharmacokinetic profile of Semaglutide at steady state T1/2 (min - max)?

The SUSTAIN programme covers all aspects of the T2D patient care continuum, including? Check all that apply.

What was the HbA1c reduction (%) and weight reduction (kg) in Semaglutide 1 mg arm in SUSTAIN7?

Both doses of Semaglutide (0.5 mg & 1 mg) were compared with DPP4i (Sitagliptin 100 mg) in SUSTAIN 2. True or False?

MACE reduction in T2DM with CVD in SUSTAIN 6 was by % and in REWIND trial by % vs placebo and standard of care. Choose the right answer.

Superiority in glycaemic control and weight loss was NOT confirmed with both doses of semaglutide over: placebo, DPP-4 inhibitor, other GLP-1RAs and basal insulin in SUSTAIN clinical trial program. True or False?

Mark the correct statement(s).

Several GLP-1RAs, including semaglutide and liraglutide, have demonstrated cardioprotective effects via reductions in HbA1c, body weight, blood pressure and Triglycerides. True or False?

Most potent stimulant for release of GLP 1 is-------

In SUSTAIN VI, both doses of Ozempic were associated with significantly greater changes from baseline in body weight vs placebo. TRUE or FALSE?

An optimal diabetes therapy would provide improved glycaemic control with minimal risk of hypoglycaemia, improve beta-cell function, and target other associated pathological defects of T2DM such as , & .

GLP stands for:

The first phase of GLP-1 secretion occurs within (a) of food ingestion, as a result of neural and (b) stimulation

Why use of Ozempic in severe renal impairment is limited

Regarding SUSTAIN II;