Diabetes Management Quiz
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Questions and Answers

What is the typical range of insulin dosage for individuals based on their weight?

  • 0.2 to 0.5 units/kg/day
  • 0.4 to 1 unit/kg/day (correct)
  • 1 to 1.5 units/kg/day
  • 0.1 to 0.3 units/kg/day

Which insulin type is mentioned as part of the automated insulin delivery (AID) system?

  • Inhaled insulin
  • Short-acting insulin
  • Long-acting analog
  • Ultra-rapid-acting analog (correct)

Which factor may necessitate higher insulin doses according to gluco-regulation processes?

  • Physical activity level
  • Age-related changes
  • Dietary choices
  • Medical illness (correct)

What parameter is critical for determining the adjustment of prandial insulin doses?

<p>Glycemic trends (B)</p> Signup and view all the answers

What does the abbreviation TIR stand for in the context of diabetes management?

<p>Time in range (C)</p> Signup and view all the answers

What is a potential consequence of lipohypertrophy in individuals with type 1 diabetes?

<p>Increased glycemic variability (D)</p> Signup and view all the answers

Which is a requirement for individuals undergoing pancreas transplantation?

<p>Lifelong immunosuppression (B)</p> Signup and view all the answers

What was noted about the use of liraglutide in type 1 diabetes treatment?

<p>Discontinuation leads to worsening C-peptide loss (C)</p> Signup and view all the answers

What is the role of sodium–glucose cotransporter 2 (SGLT2) inhibitors in clinical trials for type 1 diabetes?

<p>They have shown improvements in A1C levels (C)</p> Signup and view all the answers

What is a characteristic of soft, smooth raised areas caused by lipohypertrophy?

<p>They tend to increase over time with injection frequency (C)</p> Signup and view all the answers

What should pancreas transplantation be primarily reserved for?

<p>Those with recurrent ketoacidosis or severe hypoglycemia (D)</p> Signup and view all the answers

Which option reflects a consequence of using longer needles for insulin injections?

<p>Increased chance of lipohypertrophy (A)</p> Signup and view all the answers

What determines the regulation of allogenic islet transplantation worldwide?

<p>It is viewed as an organ transplant (B)</p> Signup and view all the answers

Which site is NOT recommended for insulin administration?

<p>Forearm (A)</p> Signup and view all the answers

What can result from inadvertent intramuscular insulin injection?

<p>Variable effects on glucose (D)</p> Signup and view all the answers

Which of the following treatment combinations showed modest A1C reductions?

<p>Liraglutide with insulin (D)</p> Signup and view all the answers

What outcome was associated with adding metformin to adults with type 1 diabetes?

<p>Reductions in insulin dose (D)</p> Signup and view all the answers

Which of the following therapies is under active investigation for type 1 diabetes?

<p>Menin inhibitors (C)</p> Signup and view all the answers

Delivery of IM insulin is riskier in which population?

<p>Younger, leaner individuals (B)</p> Signup and view all the answers

What is a common outcome associated with glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in adults with type 1 diabetes?

<p>Modest A1C reductions (C)</p> Signup and view all the answers

Which body change is typically associated with the use of liraglutide?

<p>Weight loss (D)</p> Signup and view all the answers

What is the primary benefit of early continuous glucose monitoring for adults with type 1 diabetes?

<p>Improvement of glycemic outcomes and quality of life (A)</p> Signup and view all the answers

Which of the following is a recommended approach for matching mealtime insulin doses?

<p>Consider carbohydrate, fat, protein intake, and concurrent glycemia (B)</p> Signup and view all the answers

How often should insulin treatment plans and behaviors be reevaluated for adults with type 1 diabetes?

<p>Every 3-6 months (D)</p> Signup and view all the answers

Why is insulin therapy essential for individuals with type 1 diabetes?

<p>It compensates for absent or near-absent b-cell function (B)</p> Signup and view all the answers

What should be included in the education for adults with type 1 diabetes to minimize hypoglycemia risk?

<p>Education on carbohydrate counting and insulin dose modification (B)</p> Signup and view all the answers

Automated insulin delivery systems should be offered to which population?

<p>All adults with type 1 diabetes (B)</p> Signup and view all the answers

What specific factors should be considered when adjusting insulin treatment for adults with type 1 diabetes?

<p>Individualized glycemic goals and general health status (C)</p> Signup and view all the answers

Which of the following statements about sick-day management for adults with type 1 diabetes is true?

<p>Sick-day management may require modifications to insulin doses. (B)</p> Signup and view all the answers

What is the primary focus of educational programs regarding insulin administration in diabetes management?

<p>Proper injection site rotation and recognizing lipohypertrophy (D)</p> Signup and view all the answers

Which SGLT2 inhibitor is specifically mentioned for its use in type 1 diabetes despite the risk of DKA?

<p>Sotagliflozin (C)</p> Signup and view all the answers

What significant risk is associated with the use of SGLT2 inhibitors in individuals with type 1 diabetes?

<p>Increased risk of DKA (B)</p> Signup and view all the answers

Which is true regarding the regulation of allogenic islet transplantation in the U.S.?

<p>It is classified as a cell therapy (B)</p> Signup and view all the answers

What key aspect was highlighted in clinical trials for insulin administration sites?

<p>Assessment of administration device use and technique (D)</p> Signup and view all the answers

Which condition was excluded from clinical studies that led to approval for heart failure treatments?

<p>Individuals with type 1 diabetes (A)</p> Signup and view all the answers

What was noted about insulin injection techniques and their potential outcomes?

<p>Proper techniques can significantly improve clinical outcomes (A)</p> Signup and view all the answers

What is the primary indication for donislecel-jujn in diabetes treatment?

<p>For adults unable to reach A1C goals due to severe hypoglycemia (C)</p> Signup and view all the answers

What is the typical starting dose of prandial insulin for adults with type 1 diabetes?

<p>0.5 units/kg/day (B)</p> Signup and view all the answers

Which method may be an alternative for administering prandial insulin in some AID systems?

<p>Simplified meal announcement method (A)</p> Signup and view all the answers

What additional dietary components are recommended for integration when monitoring prandial insulin doses?

<p>Protein and fat, in addition to carbohydrates (A)</p> Signup and view all the answers

In which scenario is CGM integration likely to be more feasible?

<p>For individuals using Continuous Subcutaneous Insulin Infusion (CSII) (C)</p> Signup and view all the answers

What outcome is improved by the use of continuous glucose monitoring shortly after diagnosis in type 1 diabetes?

<p>Improved glycemic outcomes (C)</p> Signup and view all the answers

Flashcards

Continuous Glucose Monitoring (CGM)

Regular monitoring of blood sugar levels using a device that continuously checks glucose levels throughout the day.

Type 1 Diabetes

A type of diabetes where the body's immune system attacks and destroys insulin-producing cells in the pancreas.

Automated Insulin Delivery System

A system that automatically adjusts insulin delivery based on real-time blood sugar readings.

Insulin Dose Adjustment

The process of adjusting insulin dose based on factors like current blood sugar, recent trends, and anticipated activity.

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Hypoglycemia

A state of abnormally low blood sugar levels, which can be dangerous.

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Insulin

The hormone produced in the pancreas that helps regulate blood sugar levels.

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Meal Composition

The amount of carbohydrate, fat, and protein in a meal.

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Treatment Plan Reevaluation

The process of regularly reviewing and making necessary changes to a diabetes treatment plan.

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What is an Automated Insulin Delivery (AID) System?

A type of insulin delivery system that can automatically adjust insulin doses based on real-time blood glucose readings.

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What is Multiple Daily Injections (MDI)?

Insulin injections several times a day, usually before meals.

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What is the Insulin Sensitivity Factor (ISF)?

A person's insulin sensitivity is different depending on how much insulin they need to lower their blood glucose by 1 mmol/L.

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What is the Insulin-to-Carbohydrate Ratio (ICR)?

The amount of insulin needed to cover a specific amount of carbohydrate in a meal.

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What is the Total Daily Insulin Dose (TDD)?

The total amount of insulin a person needs in a day.

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Typical Starting Insulin Dose

A typical starting dose of insulin for adults with type 1 diabetes who are metabolically stable is 0.5 units per kilogram of body weight per day. This is usually split into two types of insulin: prandial, for meals, and basal, for between meals.

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Prandial Insulin Dosing

Adjusting insulin doses to match the amount of carbohydrate, protein, and fat in a meal.

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Continuous Subcutaneous Insulin Infusion (CSII)

A method of insulin delivery that uses a pump to automatically adjust insulin delivery based on real-time blood sugar readings.

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Automated Insulin Delivery (AID)

Automated Insulin Delivery (AID) systems are a type of CSII that also use an algorithm to automatically adjust insulin delivery based on real-time blood sugar readings. This can be especially helpful for managing blood sugar levels after meals.

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Insulin absorption site

Insulin absorption varies depending on where it's injected, subcutaneous or intramuscular.

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IM insulin injection risk

Injecting insulin into muscles can cause unpredictability and potential harm due to fast absorption.

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Factors affecting insulin absorption

Factors like age, body fat and injection location influence insulin absorption.

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Liraglutide and type 1 diabetes

Liraglutide, a GLP-1 RA, helped with A1C, weight, and insulin dose in type 1 diabetes.

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Metformin and type 1 diabetes

Metformin, used for type 2 diabetes, showed some benefits for type 1 diabetes.

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Metformin's limited effect on type 1

Adding metformin to type 1 diabetes treatment improved A1C, but didn't solve all the problems.

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Ongoing research for type 1

Various new treatments for type 1 diabetes are currently in active research and development.

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Pancreas and islet transplantation

Pancreas and islet transplantation can offer a potential cure for type 1 diabetes, but it's a complex procedure.

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Short Needles for Insulin Injections

Short needles (like 4-mm pen needles) are effective and comfortable for people with type 1 diabetes, as well as those with obesity.

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Rotating Injection Sites

Rotating injection sites helps prevent lipohypertrophy, which is a build-up of fat under skin due to repeated insulin injections in the same spot.

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Lipohypertrophy and Insulin Absorption

Lipohypertrophy can affect insulin absorption, leading to unpredictable blood sugar levels.

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GLP-1 Receptor Agonists for Type 1 Diabetes

Semaglutide and tirzepatide are GLP-1 receptor agonists that can help manage blood sugar levels and weight in people with type 1 diabetes, especially those with obesity.

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SGLT2 Inhibitors and Type 1 Diabetes

SGLT2 inhibitors can improve blood sugar control in people with type 1 diabetes, but they're not a first-line treatment.

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Pancreas Transplantation for Type 1 Diabetes

Pancreas transplantation is a complex procedure that requires lifelong immunosuppression to prevent rejection. It's typically reserved for people with severe type 1 diabetes complications.

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Allogenic Islet Transplantation

Allogenic islet transplantation is a process involving transplanting pancreatic islet cells from a donor, requiring lifelong immunosuppression to prevent rejection.

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Injection Site Monitoring

The process of regularly checking insulin injection or infusion sites for signs of lipohypertrophy, assessing injection technique, and ensuring proper device use.

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Lipohypertrophy

A condition characterized by buildup of fat tissue at insulin injection sites, which can affect insulin absorption and blood sugar control.

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Injection Site Rotation

The process of rotating injection or infusion sites to ensure consistent insulin absorption and prevent lipohypertrophy.

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SGLT2 Inhibitor

A type of medication that works by blocking the reabsorption of glucose in the kidneys, helping to lower blood sugar levels.

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Diabetic Ketoacidosis (DKA)

A condition where the body produces ketones due to insufficient insulin, leading to a dangerous increase in blood acidity. It can be more common in people with type 1 diabetes who use SGLT2 inhibitors.

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Islet Cell Transplantation

A type of therapy that aims to replace damaged insulin-producing cells (beta cells) in people with type 1 diabetes using a transplant of pancreatic islet cells from a donor.

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Immunosuppression Therapy

A specific treatment for type 1 diabetes where the body's immune system is suppressed to prevent it from attacking and destroying insulin-producing cells in the pancreas.

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Comprehensive Diabetes Medical Evaluation

A specialized medical evaluation that focuses on assessing the patient's blood sugar control, diabetes management strategies, and areas for potential improvement.

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Study Notes

Pharmacologic Approaches to Glycemic Treatment

  • The American Diabetes Association (ADA) Standards of Care in Diabetes provide clinical practice recommendations, treatment goals, and guidelines.
  • Most adults with type 1 diabetes should use continuous subcutaneous insulin infusion or multiple daily doses of prandial and basal insulin.
  • Insulin analogs are preferred over human insulins for adults with type 1 diabetes to reduce hypoglycemia risk.
  • Continuous glucose monitoring is recommended for adults with type 1 diabetes to improve glycemic outcomes and quality of life.
  • Automated insulin delivery systems should be offered to all adults with type 1 diabetes.
  • Education on matching mealtime insulin doses to carbohydrate, fat, and protein intake is crucial.
  • Insulin treatment plans should be reevaluated regularly and adjusted as needed.
  • Insulin treatment is vital for those with type 1 diabetes due to impaired or absent beta-cell function.

Insulin Therapy

  • Insulin treatment is essential for individuals with type 1 diabetes.
  • The Diabetes Control and Complications Trial (DCCT) showed intensive insulin therapy reduced A1C levels and improved long-term outcomes.
  • Insulin replacement typically involves basal insulin, mealtime insulin, and correction insulin.
  • Basal insulin includes NPH, long-acting insulin analogs (like glargine and degludec), and continuous rapid-acting insulin delivery (via insulin pumps).
  • Analog insulins generally lead to less hypoglycemia and weight gain compared to human insulins.
  • Insulin analogs have quicker onset and peak and shorter duration of action than human insulin.
  • Newer formulations of rapid-acting insulin may cause less hypoglycemia.
  • The optimal time to administer prandial insulin depends on the formulation, pre-meal blood glucose, and carbohydrate consumption.
  • Treatment plans should be tailored to manage diabetic ketoacidosis and hypoglycemia while achieving individual glycemic goals.
  • Insulin treatment cost and complexity need consideration alongside treatment plan benefits and risks.

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Related Documents

Pharmacologic Approaches to Glycemic Treatment PDF (ADA Standards of Care 2025)

Description

Test your knowledge on insulin dosing and management in diabetes. This quiz covers various aspects of insulin types, factors affecting dosage, and crucial parameters for prandial insulin adjustments. Challenge yourself to understand the automated insulin delivery systems and key abbreviations relevant to diabetes.

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