WorksheetsDiabetes pt 1
Total questions: 60
Worksheet time: 33mins
Which of the following meets the diagnostic criteria for type 2 diabetes?
FPG 118 mg/dL
A1C 5.9%
2-hr OGTT glucose 205 mg/dL
Random glucose 150 mg/dL without symptoms
Which A1C corresponds to an estimated average glucose (eAG) of approximately 183 mg/dL?
6%
7%
8%
9%
A 17-year-old male presents with polyuria, polydipsia, weight loss, and abdominal pain. Labs show BG 455 mg/dL, positive ketones, and low C-peptide. Which factor most likely contributed to the development of his condition?
Progressive insulin resistance due to visceral adiposity
Autoimmune destruction of pancreatic β-cells
Hormonal changes in late pregnancy
Excess hepatic glucose output due to chronic hypertension
Which medication is most strongly associated with worsening glycemic control and new-onset hyperglycemia?
Lisinopril
Risperidone
Metoprolol
Montelukast
A 54-year-old woman presents with fatigue, blurry vision, and increased thirst for several months. Which additional symptom would strengthen the suspicion for undiagnosed T2DM?
Recurrent urticaria
Weight loss
Decreased urination
Heat intolerance
Which presentation is more characteristic of T2DM than T1DM?
Abrupt onset of symptoms
Lean body type
Gradual onset with mild symptoms
Presence of ketosis at diagnosis
A patient checks glucose twice daily with inconsistent timing. Her A1C is 9.3%. Which limitation of A1C should be considered when assessing her regimen?
A1C identifies the exact cause of hyperglycemia
A1C can rapidly detect changes in glycemic control
A1C does not distinguish fasting vs postprandial hyperglycemia
A1C is unreliable if SMBG values are stable
Which patient should be screened immediately for T2DM according to ADA guidance?
BMI 22, age 45, physically active
BMI 27 with a first-degree relative with T2DM
BMI 25 without risk factors, age 32
Age 34 with no risk factors
A patient has FPG 129 mg/dL on two separate occasions. What is the correct suspicion?
Normal
Prediabetes
Diabetes
Indeterminate—requires OGTT
A 70-year-old patient with multiple comorbidities and high hypoglycemia risk asks about A1C goals. Which is most appropriate?
A1C <6.5%
A1C <7%
A1C <8%
A1C <5.7%
Which values represent ADA-recommended glucose goals for most non-pregnant adults?
FPG <100 mg/dL; PPG <140 mg/dL
FPG 80–130 mg/dL; PPG <180 mg/dL
FPG <110 mg/dL; PPG <140 mg/dL
FPG <150 mg/dL; PPG <200 mg/dL
A patient newly diagnosed with T2DM is counseled on nutrition. Which dietary strategy aligns with ADA recommendations?
Replace whole grains with refined carbohydrates to stabilize BG
Limit carbohydrate intake to 60–75 g per meal for women
Spread carbohydrate intake evenly across meals and snacks
Avoid all fruit due to its natural sugar content
Which exercise recommendation is accurate for improving glycemic control?
60 minutes vigorous exercise once weekly
Resistance training only
≥150 minutes of moderate-intensity exercise weekly, spread over ≥3 days
Exercise only when fasting glucose <100 mg/dL
In gestational diabetes, glucose intolerance most often first appears during which period?
Early first trimester due to increased insulin secretion
Mid-second trimester due to decreased fetal glucose use
Early third trimester due to pregnancy-induced insulin resistance
Final month of pregnancy due to placental glucose depletion
A 30-year-old Asian American patient (BMI 24) has a triglyceride level of 260 mg/dL and HDL 32 mg/dL. How should they be screened?
No screening indicated until age 45
Screen now due to dyslipidemia and high-risk ethnicity
Screen only if symptoms develop
Screen only if BMI ≥ 25 kg/m²
Which vaccination is recommended annually for all patients with diabetes?
Hepatitis B
Influenza
Pneumococcal
Zoster
A patient’s labs show:
• A1C 6.0%
• FPG 108 mg/dL
• OGTT 165 mg/dL
What is the best interpretation?
Normal
Prediabetes
Diabetes
Must repeat OGTT
A thin 21-year-old presents with DKA. Which characteristic best distinguishes T1DM from T2DM in this context?
Gradual onset of symptoms
High C-peptide concentration
Positive autoantibodies
Long-standing mild hyperglycemia
Which symptom is more typical in T2DM than T1DM?
Ketosis at presentation
Rapid onset of symptoms
Gradual fatigue and mild polydipsia
Significant unintentional weight loss
A patient has decreased vibration sense and reduced monofilament sensation bilaterally. What is the primary concern?
Autonomic neuropathy
Increased fracture risk
Peripheral neuropathy
Vitamin B12 deficiency
Which non-insulin therapy carries a high risk of hypoglycemia?
DPP-4 inhibitors
GLP-1 agonists
Sulfonylureas
SGLT2 inhibitors
Which GLP-1 agonist is taken orally and must be taken ≥30 minutes before first food/drink?
Rybelsus
Trulicity
Victoza
Byetta
Which diabetes class is associated with pancreatitis and sever arthralgia?
Thiazolidinediones
DPP-4 inhibitors
SGLT2 inhibitors
Meglitinides
A patient starting pramlintide should have which adjustment made to current insulin therapy?
Increase basal insulin by 10%
Reduce prandial insulin by 50%
Stop basal insulin
Add NPH twice daily
Which drug requires avoiding sucrose-containing products during hypoglycemia treatment?
Acarbose
Linagliptin
Dulaglutide
Sitagliptin
Which of the following is NOT recommended for hypoglycemia management?
4 oz fruit juice
8 oz milk
4 oz regular soda
1 tbsp honey
1-2 glucose tablets
Which insulin is cloudy?
Lispro
Glargine
NPH
Aspart
Organize these options into the right categories
Glargine
Degludec
Lispro
Glulisine
Afrezza
Regular
Novolin R
Humulin R
NPH
Novolin N
Humulin N
Which insulin is contraindicated in COPD or asthma?
Lispro
Afrezza
Basaglar
Novolin N
When converting Toujeo → Lantus, what dose adjustment is needed?
Increase Lantus by 20%
Lantus = Toujeo dose
Lantus = 80% of Toujeo dose
Reduce Toujeo by 50%
A patient has fasting hyperglycemia due to rebound from nighttime hypoglycemia. What condition is this?
Dawn phenomenon
Reactogenic hypoglycemia
Somogyi effect
Insulin stacking
Which drug should be avoided in a patient with a family history of thyroid cancer?
Sitagliptin
Empagliflozin
Dulaglutide
Repaglinide
Which agent is most associated with urinary tract infections and increased urination?
Linagliptin
Pioglitazone
Empagliflozin
Metformin
Which non-insulin agent is most likely to cause bone fractures?
Pioglitazone
Sitagliptin
Metformin
Acarbose
A patient on prandial insulin starts pramlintide without adjusting their insulin dose. They are at highest risk for:
Weight gain
Heart failure
Hypoglycemia
Hyperglycemia
A 58-year-old patient with T2DM (A1C 8.4%) is overweight and has a history of ASCVD. He cannot tolerate metformin due to severe GI issues. He is currently on sitagliptin but has had minimal improvement in A1C. His eGFR is 70.
Which is the BEST next step?
Increase sitagliptin dose
Switch to liraglutide
Switch to glyburide
Switch to pioglitazone
Which insulin is inhaled and has the fastest onset?
Aspart
Regular U-100
Lispro
Afrezza
A patient’s bedtime glucose is normal, but fasting levels are consistently elevated. Overnight readings are normal, and the patient denies hypoglycemia. What is the most likely phenomenon?
Somogyi effect
Dawn phenomenon
Bolus stacking
Carbohydrate overdose
Which insulin can be administered IV during acute illness or DKA?
Lispro
Regular
Glargine
NPH
Which therapy has the highest likelihood of hypoglycemia?
SGLT2 inhibitor
GLP-1 receptor agonist
Sulfonylurea
Metformin
A 64-kg adult is newly diagnosed with T1DM and requires full insulin initiation. What is the recommended TDD?
16 units/day
22 units/day
32 units/day
64 units/day
If a patient's target BG is 120 mg/dL, current BG is 210 mg/dL, and CF = 30, what correction bolus is needed?
1 unit
2 units
3 units
4 units
A patient has TDD = 50 units/day of rapid acting insulin. What is the estimated insulin-to-carbohydrate ratio (ICR)?
1 unit per 5 g carbs
1 unit per 10 g carbs
1 unit per 15 g carbs
1 unit per 20 g carbs
A patient is switched to premixed 70/30 insulin 30 units BID. How many units per dose are basal-equivalent?
21 units
14 units
9 units
6 units
A patient takes Toujeo 75 units daily and must switch to Lantus. What is the correct starting Lantus dose?
45 units
60 units
75 units
90 units
A newly diagnosed adult with T2DM has an A1C >10% and fasting BG >300 mg/dL. According to recommended treatment escalation, which therapy should be initiated?
Metformin alone
Sulfonylurea therapy
GLP-1 agonist monotherapy
Insulin therapy
Which medication class is preferred in overweight or obese patients because of weight-loss benefits?
TZDs
GLP-1 agonists
Sulfonylureas
α-glucosidase inhibitors
Which insulin regimen adjustment is recommended when post-prandial glucose remains elevated even though fasting values are within goal?
Increase basal insulin dose
Switch basal insulin to NPH
Add rapid-acting insulin with meals
Increase daily carbohydrate intake
A patient is switching from Lantus to Toujeo. Which conversion is guideline-appropriate?
Reduce Toujeo to 80% of Lantus dose
Use a 1:1 unit conversion
Increase Toujeo by 50%
Double the Toujeo dose
A 57-year-old with T2DM is obese and wants a medication that improves glycemic control, supports weight reduction, and has low hypoglycemia risk.
Which therapy options meet ALL criteria based on recommended treatment characteristics?
Dulaglutide
Sitagliptin
Empagliflozin
Glyburide
Pioglitazone
Which of the following are contraindications or major caution flags based on medication safety precautions?
Starting dulaglutide in a patient with family history of medullary thyroid cancer
Using Afrezza in patients with lung disease
Continuing metformin during acute dehydration
Adding sulfonylurea in a patient with significant hypoglycemia risk
A 72-kg adult with newly diagnosed T1DM requires insulin initiation.
What is the recommended starting basal dose if using a long-acting analog?
12 units
18 units
24 units
36 units
A 90-kg patient with T2DM must start basal insulin. Use 0.2 units/kg/day to initiate basal.
Which initial dose is appropriate?
9 units
12 units
18 units
30 units
A 54-year-old with T2DM is overweight and has an A1C of 8.6% despite metformin and lifestyle changes. She wants a medication that helps lower A1C, reduce weight, and has low hypoglycemia risk.
Which is the most appropriate recommendation?
Glipizide
Pioglitazone
Dulaglutide
NPH insulin
Which insulin has the fastest onset of action?
Regular insulin
Lispro
Aspart
Afrezza
A 62-year-old with T2DM and recurrent UTI symptoms is currently taking a new medication. Which agent is most likely contributing?
Sitagliptin
Empagliflozin
Liraglutide
Metformin ER
A patient with T1DM has a TDD of 48 units/day with regular insulin. What is the estimated insulin-to-carbohydrate ratio (ICR)?
1 unit per 20 g carbs
1 unit per 15 g carbs
1 unit per 12 g carbs
1 unit per 9 g carbs
A patient’s TDD is 36 units/day. What is their estimated correction factor, assuming rapid-acting insulin?
10 mg/dL/unit
20 mg/dL/unit
30 mg/dL/unit
50 mg/dL/unit
Which insulin has the longest duration of action and provides a very stable 24-plus-hour profile?
Lispro
NPH
Regular U-100
Degludec
A patient is converting from Toujeo to Lantus. Which conversion principle applies?
Convert using 1:1 dosing
Increase Lantus by 20%
Decrease Lantus dose to ~80% of Toujeo dose
Conversion is contraindicated
