WorksheetsWORLD DIABETES DAY 2025
Total questions: 15
Worksheet time: 16mins
A 60-year-old woman on premixed human insulin 38 U pre-breakfast and 30 U pre-dinner has an HbA1c of 10% with FPG <10 mmol/L but pre-dinner glucose >10 mmol/L. What is the next best step?
Increase both premixed insulin doses
Add a pre-lunch short-acting insulin dose
Switch to basal-bolus regimen immediately
Add a DPP4 inhibitor
A 45-year-old woman with T2DM on basal NPH insulin 32 U at night has an HbA1c of 9.2% despite FPG at target. What is the most appropriate next step in her insulin regimen?
Increase the NPH dose further
Add a bolus insulin with the largest meal of the day
Add GLP-1 RA
All answer are correct
A 55-year-old man on iDegAsp 30 U pre-dinner has an HbA1c of 10.2% and SMBG showing fasting and pre-dinner glucose 8–12 mmol/L. What is the most appropriate next step?
Increase the pre-dinner iDegAsp dose
Intensify to iDegAsp twice daily (pre-breakfast and pre-dinner)
Switch to basal-bolus regimen
Add a DPP-4 inhibitor
Which of the following patient scenarios most appropriately supports insulin de-escalation in type 2 diabetes management?
A patient with HbA1c of 9.5% on basal-bolus insulin and no oral agents
A patient with HbA1c of 6.8% on basal insulin and newly initiated GLP-1 receptor agonist
A patient with HbA1c of 8.2% on metformin and prandial insulin only
A patient with HbA1c of 7.5% on basal insulin and SGLT2 inhibitor
What is the most critical consideration when tapering insulin therapy in patients transitioning to GLP-1 RA or SGLT2-i therapy?
Preventing rebound hyperglycemia during dose reduction
Increasing carbohydrate intake to offset reduced insulin
Ensuring complete discontinuation of insulin within 2 weeks
Avoiding weight gain due to reduced insulin
Which factor most strongly contraindicates insulin de-escalation in a patient with type 2 diabetes?
Use of GLP-1 receptor agonist
HbA1c consistently above 9%
History of mild hypoglycemia
BMI above 30 kg/m²
When transitioning from basal-bolus insulin to basal-only therapy, which of the following is most critical to monitor?
HbA1c
Post prandial glucose level
Lipid profile
Renal profile
Which clinical scenario most strongly supports insulin de-escalation in a patient with type 2 diabetes?
HbA1c consistently more than 9%
Frequent hypoglycemic episodes
History of diabetic ketoacidosis
Poor adherence to oral medications
What is the primary goal of insulin de-escalation therapy?
Eliminate insulin use entirely
Achieve normoglycemia without medications
Reduce insulin dose while maintaining glycemic control
During Ramadan fasting, which of the following situations requires a patient with diabetes to immediately break their fast?
Plasma glucose of 4.2 mmol/L after sahur
Plasma glucose of 3.8 mmol/L two hours after the start of the fast
Plasma glucose of 10 mmol/L at midday
Plasma glucose of 5.0 mmol/L before iftar
A 40-year-old woman with type 2 diabetes plans to do a 45-minute aerobics session two hours after lunch. Her plasma glucose before exercise is 4.2 mmol/L. Which of the following is the most appropriate action before starting exercise?
Proceed with exercise as planned
Take 15–20 grams of carbohydrate before exercise
Administer additional insulin to maintain control
Delay exercise until plasma glucose exceeds 11.1 mmol/L
1. Which of the following is a rapid-acting insulin?
NPH insulin
Degludec
Insulin lispro
Insulin glargine
According to the 6th edition T2DM CPG recommendations outlined in the presentation, which of the following patients is the strongest candidate for insulin therapy as an initial pharmacological intervention at the time of diagnosis?
A 45-year-old man with an HbA1c of 9.0% and no symptoms of hyperglycaemia
A 55-year-old woman with an HbA1c of 8.5% and a BMI of 33 kg/m²
A 60-year-old man with an HbA1c of 9.5% and mild polyuria
A 50-year-old man with an HbA1c of 11.5% who reports significant weight loss and profound fatigue
Which is true about Continuous Glucose Monitoring System(CGMS)?
Can alert hypoglycemic. / hyperglycemic episode
Is similar to capillary blood glucose values
Is indicated in pregnancies
Is best applied over muscular area .
CGMS report provides all except
HbA1c
Target in below range
Target in range
Glucose management index
