Diabetes and Access to Care

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Questions and Answers

Which option correctly identifies an essential component to achieve treatment goals for people with diabetes?

Regular eye examinations

Cognitive behavioral therapy

Intensive insulin therapy

Diabetes self-management education (correct)

What is one of the four critical times to evaluate the need for diabetes self-management education (DSME)?

Monthly check-ups

At diagnosis (correct)

Bi-annually

After hospitalization

What role do the Pooled Cohort Equations play in diabetes management?

They provide dietary recommendations.

They stratify ASCVD risk based on race and sex. (correct)

They evaluate blood glucose levels.

They assess the need for insulin therapy.

Which of the following should children and adults with diabetes receive vaccinations according to?

Age-specific recommendations Signup and view all the answers

What is a primary goal of diabetes self-management education (DSME)?

To enhance skills mastery for diabetes self-care Signup and view all the answers

What should clinicians and patients assess in addition to diabetes-related complications?

Common comorbidities Signup and view all the answers

Which of the following is NOT considered a key goal of diabetes self-management education (DSME)?

Direct insulin administration Signup and view all the answers

At what point in the diabetes management process is it critical to evaluate the need for diabetes self-management education?

Upon transitioning in care Signup and view all the answers

Which intervention might be beneficial for managing resistant hypertension in adults with type 2 diabetes?

Introducing a corticoid receptor antagonist Signup and view all the answers

What is the recommended LDL cholesterol reduction for patients with diabetes and ASCVD when adding ezetimibe to statin therapy?

By 50% or more Signup and view all the answers

What dietary modification is recommended for patients with diabetes?

Follow a Mediterranean-style eating pattern Signup and view all the answers

Which lipid management approach should be considered for patients diabetes with ASCVD at very high risk?

Adding additional LDL-lowering therapy if LDL cholesterol is ≥ 70 mg/dL Signup and view all the answers

What is the current stance on the cognitive effects of statins?

Cognitive dysfunction concerns should not deter statin treatment Signup and view all the answers

Which lifestyle intervention is most recommended for weight management in diabetes?

Weight loss focusing on dietary adjustments Signup and view all the answers

What is advised for patients who do not tolerate the intended statin intensity?

Use the maximally tolerated statin dose Signup and view all the answers

What dietary component is emphasized for increasing in patients with diabetes management?

Vicious fiber Signup and view all the answers

What social context factors should providers assess when making treatment decisions for diabetes?

Food insecurity, housing stability, and financial barriers Signup and view all the answers

How may misdiagnosis of diabetes occur according to provider recommendations?

The diagnosis may become more apparent over time requiring reevaluation Signup and view all the answers

What role do local community resources play in diabetes management?

They should be referred to patients when available for support Signup and view all the answers

What is identified as a major contributor to health inequality related to diabetes?

Social determinants of health (SDoH) Signup and view all the answers

What screening method is recommended for assessing risk of prediabetes and type 2 diabetes?

Assessment of risk factors through validated tools or informal assessments Signup and view all the answers

What impact does the treatment of diseases of the exocrine pancreas have on diabetes?

Can induce diabetes as a side effect of treatment Signup and view all the answers

What type of support should be provided to patients for self-management of diabetes?

Guidance from lay health coaches, navigators, or community health workers Signup and view all the answers

What is the initial role of assessing the social determinants of health in diabetes diagnosis?

To inform treatment decisions and possible misdiagnosis Signup and view all the answers

What is a key criterion for considering the addition of icosapent ethyl in patients with elevated triglycerides?

Patients should be on a statin with controlled LDL cholesterol. Signup and view all the answers

Which condition is generally not recommended for statin plus niacin combination therapy?

Patients with a high risk of gastrointestinal bleeding. Signup and view all the answers

What is the main adverse effect associated with the use of niacin in combination with statins?

Increased risk of gastro-intestinal bleeding. Signup and view all the answers

In primary prevention with aspirin, which group of patients is recommended for treatment?

Men and women aged 50 years or older with diabetes and one additional major risk factor. Signup and view all the answers

What is the effect of statin use in individuals with diabetes risk factors?

Statins may modestly increase the risk of incident diabetes. Signup and view all the answers

Which therapy combination has not shown to improve ASCVD outcomes?

Statin plus niacin. Signup and view all the answers

What recommendation is made for aspirin use in secondary prevention?

Recommended for patients with previous stroke or myocardial infarction. Signup and view all the answers

What is one of the considerations when prescribing aspirin for primary prevention?

Patients should not have anemia or renal disease. Signup and view all the answers

What is a key reason for referring patients with diabetes to a registered dietitian nutritionist (RD/RDN)?

To develop a personalized meal plan and assess overall nutrition status Signup and view all the answers

Which age group is specifically recommended for screening cognitive impairment and depression among individuals with diabetes?

Older adults aged 65 years and above Signup and view all the answers

What activity duration is recommended for children and adolescents with type 1 or type 2 diabetes?

60 minutes of moderate- to vigorous-intensity aerobic activity daily Signup and view all the answers

What is the minimum recommended amount of moderate- to vigorous-intensity aerobic activity for adults with diabetes per week?

150 minutes spread over at least 3 days Signup and view all the answers

In the management of diabetes, when should the assessment for symptoms of diabetes distress, depression, and anxiety take place?

At the initial visit, intermittently, and upon changes in treatment or circumstances Signup and view all the answers

Which of the following conditions is NOT mentioned as being more common in people with diabetes?

Chronic kidney disease Signup and view all the answers

Which activity should be included at least 3 days a week for children and adolescents with diabetes?

Vigorous muscle-strengthening activities Signup and view all the answers

Why is it crucial to consider the patient's overall quality of life while planning diabetes management?

It includes financial, social, and emotional resources that impact treatment adherence Signup and view all the answers

Study Notes

Access to Care and Quality Improvement

Diabetes classification can be complex; misdiagnosis may occur and should be reevaluated as needed.
Providers should assess social determinants of health (e.g., food insecurity, housing stability) and adapt treatment accordingly.
Referral to community resources can enhance patient care and support.

Screening and Diagnostic Tests for Prediabetes and Type 2 Diabetes

Screening for prediabetes and type 2 diabetes is recommended through informal risk assessment or validated tools in asymptomatic adults.

Immunizations

Individuals with diabetes should receive age-specific vaccinations as per CDC guidelines to ensure comprehensive care.

Assessment of Comorbidities

Clinicians should be aware of common comorbidities that can complicate diabetes management, including autoimmune diseases and other health conditions like cognitive impairment and obstructive sleep apnea.

Physical Activity

Children with diabetes should engage in at least 60 minutes of moderate to vigorous aerobic activity daily, with additional strength and bone-strengthening exercises three times a week.
Adults should aim for a minimum of 150 minutes of moderate to vigorous activity weekly, distributed over at least three days.

Lifestyle Interventions

Weight loss, a Mediterranean or DASH eating pattern, and dietary adjustments (reducing saturated and trans fats) are key to diabetes management.
Increased intake of n-3 fatty acids, viscous fiber, and plant sterols is recommended.

Lipid Management

High-intensity statin therapy is recommended for patients with diabetes and atherosclerotic cardiovascular disease (ASCVD).
Consideration of adding ezetimibe or PCSK9 inhibitors may be warranted in high-risk patients with elevated LDL cholesterol.

Risk Reduction

Aspirin is effective for secondary prevention in high-risk patients with a history of myocardial infarction or stroke but its primary prevention use is controversial.
Recommendations for primary prevention with aspirin include men and women aged 50 and older with diabetes and additional risk factors.

Diabetes Risk with Statin Use

Statin use has been associated with a modestly increased risk of developing diabetes, primarily affecting those with pre-existing risk factors.

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Description

This quiz explores the various aspects of diabetes, including access to care, quality improvement, and the impact of social contexts on treatment. It also covers specific conditions related to the exocrine pancreas and the effects of certain drugs on diabetes management. Test your knowledge on how these factors influence diabetes care.