Injectable Drugs for Diabetes PDF

Injectable Drugs for Diabetes \#\#\# \*\*Slide 2: Regulation of Blood Glucose\*\* 1\. \*\*Which of the following is secreted by the alpha cells of the pancreas?\*\* \- A. Insulin \- B. Glucagon \- C. Amylin \- D. Incretins \*\*Answer:\*\* B. Glucagon 2\. \*\*Which hormone attenuates the larg...

Injectable Drugs for Diabetes \#\#\# \*\*Slide 2: Regulation of Blood Glucose\*\* 1\. \*\*Which of the following is secreted by the alpha cells of the pancreas?\*\* \- A. Insulin \- B. Glucagon \- C. Amylin \- D. Incretins \*\*Answer:\*\* B. Glucagon 2\. \*\*Which hormone attenuates the large increase in plasma glucose that occurs with a meal?\*\* \- A. Insulin \- B. Amylin \- C. GLP-1 \- D. Glucagon \*\*Answer:\*\* C. GLP-1 3\. \*\*Which enzyme is responsible for breaking down GLP-1?\*\* \- A. Amylin \- B. DPP-4 \- C. Glucokinase \- D. Alpha-glucosidase \*\*Answer:\*\* B. DPP-4 \-\-- \#\#\# \*\*Slide 3: Insulin - Indications and Production\*\* 1\. \*\*Which of the following is an indication for insulin therapy?\*\* \- A. Type 1 diabetes only \- B. Gestational diabetes only \- C. Type 1, Type 2, secondary diabetes, and gestational diabetes \- D. Diabetes insipidus \*\*Answer:\*\* C. Type 1, Type 2, secondary diabetes, and gestational diabetes 2\. \*\*Which of the following methods is used to produce modern insulin?\*\* \- A. Extraction from pork pancreas \- B. Recombinant DNA technology \- C. Bovine insulin extraction \- D. Synthetic analogs from human stem cells \*\*Answer:\*\* B. Recombinant DNA technology 3\. \*\*Why is insulin from recombinant DNA technology preferred over animal-based insulin?\*\* \- A. It is cheaper to produce \- B. It reduces the risk of antibody formation and allergic reactions \- C. It lasts longer in the body \- D. It is less potent \*\*Answer:\*\* B. It reduces the risk of antibody formation and allergic reactions \-\-- \#\#\# \*\*Slide 5: Insulin - Effects on the Body\*\* 1\. \*\*Which of the following tissues does insulin have an effect on?\*\* \- A. Skeletal muscle \- B. Adipose tissue \- C. Liver \- D. All of the above \*\*Answer:\*\* D. All of the above 2\. \*\*Insulin promotes the storage of glucose in the liver by converting it to which of the following?\*\* \- A. Fatty acids \- B. Amino acids \- C. Glycogen \- D. Uric acid \*\*Answer:\*\* C. Glycogen 3\. \*\*How does insulin affect triglycerides (TG) and very low-density lipoproteins (VLDL)?\*\* \- A. It increases triglyceride breakdown \- B. It increases triglyceride synthesis and VLDL formation \- C. It decreases VLDL synthesis but increases triglyceride synthesis \- D. It decreases both triglyceride and VLDL synthesis \*\*Answer:\*\* B. It increases triglyceride synthesis and VLDL formation \-\-- \#\#\# \*\*Slide 6: Insulin Degradation and Metabolism\*\* 1\. \*\*What percentage of insulin is deactivated by the liver?\*\* \- A. 5-10% \- B. 20-50% \- C. 70-80% \- D. 90-100% \*\*Answer:\*\* B. 20-50% 2\. \*\*Which of the following organs is primarily responsible for the metabolism of insulin besides the liver?\*\* \- A. Lungs \- B. Kidneys \- C. Pancreas \- D. Spleen \*\*Answer:\*\* B. Kidneys 3\. \*\*In patients with end-stage renal disease (ESRD), insulin dosing should be:\*\* \- A. Increased due to decreased clearance \- B. Decreased due to decreased clearance \- C. Increased due to increased clearance \- D. Maintained at the same dose \*\*Answer:\*\* B. Decreased due to decreased clearance \-\-- \#\#\# \*\*Slide 6: Insulin Administration and Absorption\*\* 1\. \*\*Which form of insulin administration is typically used for patients with very uncontrolled diabetes in a hospital setting?\*\* \- A. Subcutaneous injections \- B. Continuous subcutaneous insulin infusion \- C. Intravenous infusion \- D. Inhaled insulin \*\*Answer:\*\* C. Intravenous infusion 2\. \*\*Which site provides the most rapid absorption of subcutaneous insulin?\*\* \- A. Thigh \- B. Abdomen \- C. Arm \- D. Buttock \*\*Answer:\*\* B. Abdomen 3\. \*\*Rotating insulin injection sites within a particular area helps prevent which of the following complications?\*\* \- A. Insulin resistance \- B. Lipodystrophy \- C. Hyperglycemia \- D. Weight gain \*\*Answer:\*\* B. Lipodystrophy \-\-- \#\#\# \*\*Slide 7: Lipoatrophy\*\* 1\. \*\*Lipoatrophy is a form of lipodystrophy that results in:\*\* \- A. Increased subcutaneous fat at the injection site \- B. Loss of subcutaneous fat at the injection site \- C. Scarring at the injection site \- D. Pigmentation changes at the injection site \*\*Answer:\*\* B. Loss of subcutaneous fat at the injection site 2\. \*\*Which of the following is a cause of lipoatrophy in diabetic patients?\*\* \- A. Repeated injections at the same site \- B. Use of outdated insulin products \- C. Overuse of long-acting insulin \- D. Incorrect needle size \*\*Answer:\*\* A. Repeated injections at the same site 3\. \*\*Newer insulin analogs have been shown to reduce the incidence of which injection site reaction?\*\* \- A. Lipohypertrophy \- B. Lipoatrophy \- C. Injection site infections \- D. Painful injections \*\*Answer:\*\* B. Lipoatrophy \-\-- \#\#\# \*\*Slide 8: Lipohypertrophy\*\* 1\. \*\*What is lipohypertrophy?\*\* \- A. Loss of muscle tissue due to insulin injections \- B. Growth of tissue at insulin injection sites \- C. Scarring from repeated insulin injections \- D. Inflammation at the injection site \*\*Answer:\*\* B. Growth of tissue at insulin injection sites 2\. \*\*Which of the following contributes to the development of lipohypertrophy in insulin-treated patients?\*\* \- A. Injection of insulin into the same site repeatedly \- B. Using a short needle for injections \- C. Use of inhaled insulin \- D. Alternating injection sites too frequently \*\*Answer:\*\* A. Injection of insulin into the same site repeatedly 3\. \*\*Which action can reduce the risk of lipohypertrophy?\*\* \- A. Using a smaller needle size \- B. Increasing insulin dose \- C. Rotating injection sites \- D. Using only short-acting insulin \*\*Answer:\*\* C. Rotating injection sites \-\-- \#\#\# \*\*Slide 9: Insulin Syringe Size\*\* 1\. \*\*Which of the following is true about insulin syringe markings?\*\* \- A. They are marked in 5-unit intervals \- B. They are marked in 1-2 unit intervals \- C. They are marked in 10-unit intervals \- D. They have no markings for units \*\*Answer:\*\* B. They are marked in 1-2 unit intervals 2\. \*\*Which of the following insulin syringe sizes would be used to administer a 50-unit dose?\*\* \- A. 0.3 mL syringe \- B. 0.5 mL syringe \- C. 1 mL syringe \- D. 1.5 mL syringe \*\*Answer:\*\* B. 0.5 mL syringe 3\. \*\*What is the needle gauge range used for insulin syringes?\*\* \- A. 18-22 gauge \- B. 24-26 gauge \- C. 28-32 gauge \- D. 34-36 gauge \*\*Answer:\*\* C. 28-32 gauge \-\-- \#\#\# \*\*Slide 10: Insulin Pen Needle Size\*\* 1\. \*\*Which of the following is true regarding insulin pens and their needles?\*\* \- A. Insulin pens come with attached needles \- B. Needles for insulin pens must be ordered separately \- C. Insulin pens are used without needles \- D. The needle gauge for insulin pens is larger than for syringes \*\*Answer:\*\* B. Needles for insulin pens must be ordered separately 2\. \*\*Which needle length is commonly used for insulin pen needles?\*\* \- A. 4-12.7 mm \- B. 18-24 mm \- C. 8-10 mm \- D. 2-6 mm \*\*Answer:\*\* A. 4-12.7 mm 3\. \*\*The higher the gauge number of an insulin pen needle, the:\*\* \- A. Thicker the needle \- B. Thinner the needle \- C. Longer the needle \- D. Shorter the needle \*\*Answer:\*\* B. Thinner the needle \#\#\# \*\*Slide 5: Insulin - Effects on the Body (Additional Questions)\*\* 1\. \*\*Which transporter is responsible for insulin-mediated glucose uptake in skeletal muscle and adipose tissue?\*\* \- A. GLUT1 \- B. GLUT2 \- C. GLUT4 \- D. SGLT2 \*\*Answer:\*\* C. GLUT4 2\. \*\*Which of the following is an effect of insulin on skeletal muscle?\*\* \- A. Decreased protein synthesis \- B. Increased protein synthesis \- C. Decreased glycogen synthesis \- D. Increased glucose breakdown only \*\*Answer:\*\* B. Increased protein synthesis 3\. \*\*Insulin promotes the storage of triglycerides in which of the following tissues?\*\* \- A. Liver \- B. Skeletal muscle \- C. Adipose tissue \- D. Brain \*\*Answer:\*\* C. Adipose tissue 4\. \*\*What effect does insulin have on protein catabolism in the body?\*\* \- A. It increases protein catabolism \- B. It decreases protein catabolism \- C. It has no effect on protein catabolism \- D. It increases protein catabolism only in the liver \*\*Answer:\*\* B. It decreases protein catabolism 5\. \*\*How does insulin affect the synthesis of triglycerides and very low-density lipoproteins (VLDL)?\*\* \- A. It decreases triglyceride synthesis but increases VLDL synthesis \- B. It decreases both triglyceride and VLDL synthesis \- C. It increases both triglyceride and VLDL synthesis \- D. It has no effect on triglycerides or VLDL \*\*Answer:\*\* C. It increases both triglyceride and VLDL synthesis 6\. \*\*Which tissue is involved in insulin-mediated glycogen synthesis?\*\* \- A. Liver \- B. Pancreas \- C. Adrenal glands \- D. Lungs \*\*Answer:\*\* A. Liver 7\. \*\*What is the primary role of insulin in the liver?\*\* \- A. To promote glucose breakdown \- B. To increase glucose storage as glycogen \- C. To increase protein breakdown \- D. To increase fatty acid oxidation \*\*Answer:\*\* B. To increase glucose storage as glycogen 8\. \*\*In the presence of insulin, skeletal muscle will:\*\* \- A. Increase fatty acid oxidation \- B. Decrease glucose uptake \- C. Increase glycogen synthesis \- D. Decrease protein synthesis \*\*Answer:\*\* C. Increase glycogen synthesis 9\. \*\*Which early sign of diabetes can be observed due to insulin\'s effect on triglycerides and VLDL?\*\* \- A. Decreased triglycerides and VLDL \- B. Increased triglycerides and VLDL \- C. Increased protein synthesis \- D. Decreased glucose storage \*\*Answer:\*\* A. Decreased triglycerides and VLDL \#\#\# \*\*Slide 11: Types of Insulin\*\* 1\. \*\*What characteristic distinguishes short-acting insulin from long-acting insulin?\*\* \- A. Onset of action \- B. Route of administration \- C. Side effect profile \- D. Cost \*\*Answer:\*\* A. Onset of action 2\. \*\*Which insulin concentration is the most commonly used?\*\* \- A. U-100 \- B. U-200 \- C. U-300 \- D. U-500 \*\*Answer:\*\* A. U-100 3\. \*\*Which of the following insulins would be used to control fasting blood glucose levels?\*\* \- A. Regular insulin \- B. Rapid-acting insulin \- C. Long-acting insulin \- D. Inhaled insulin \*\*Answer:\*\* C. Long-acting insulin \-\-- \#\#\# \*\*Slide 12: Endogenous Insulin Production\*\* 1\. \*\*At what blood glucose level does the pancreas begin to release insulin?\*\* \- A. 80 mg/dL \- B. 100 mg/dL \- C. 140 mg/dL \- D. 180 mg/dL \*\*Answer:\*\* C. 140 mg/dL 2\. \*\*How long after a meal does insulin secretion begin in response to increased blood glucose?\*\* \- A. 10 seconds \- B. 30 seconds \- C. 90 seconds \- D. 2 minutes \*\*Answer:\*\* C. 90 seconds 3\. \*\*Which of the following most accurately describes insulin production?\*\* \- A. Insulin production is constant and independent of meals \- B. Insulin is produced only in response to fasting \- C. Insulin is produced based on food intake and blood glucose levels \- D. Insulin production occurs only during physical activity \*\*Answer:\*\* C. Insulin is produced based on food intake and blood glucose levels \-\-- \#\#\# \*\*Slide 13: Common Types of Insulin\*\* 1\. \*\*Which of the following is an example of a rapid-acting insulin?\*\* \- A. Humulin R \- B. Lantus \- C. Humalog \- D. Tresiba \*\*Answer:\*\* C. Humalog 2\. \*\*Which type of insulin is typically used at mealtimes to control postprandial glucose levels?\*\* \- A. Short-acting insulin \- B. Rapid-acting insulin \- C. Intermediate-acting insulin \- D. Long-acting insulin \*\*Answer:\*\* B. Rapid-acting insulin 3\. \*\*Which type of insulin is categorized as \"basal\" insulin?\*\* \- A. Intermediate-acting insulin \- B. Rapid-acting insulin \- C. Long-acting insulin \- D. Short-acting insulin \*\*Answer:\*\* C. Long-acting insulin \-\-- \#\#\# \*\*Slide 16: Rapid-Acting Insulin\*\* 1\. \*\*Which of the following insulins has the fastest onset of action?\*\* \- A. Apidra \- B. Humulin N \- C. Lantus \- D. Tresiba \*\*Answer:\*\* A. Apidra 2\. \*\*Rapid-acting insulin should be injected at which of the following times?\*\* \- A. 30 minutes before a meal \- B. 15 minutes before a meal \- C. 1 hour after a meal \- D. At bedtime only \*\*Answer:\*\* B. 15 minutes before a meal 3\. \*\*What is the approximate duration of action for rapid-acting insulin like NovoLog?\*\* \- A. 1-3 hours \- B. 3-5 hours \- C. 5-8 hours \- D. 8-10 hours \*\*Answer:\*\* B. 3-5 hours \-\-- \#\#\# \*\*Slide 18: Short-Acting Insulin\*\* 1\. \*\*Which of the following insulins is a short-acting insulin?\*\* \- A. Humalog \- B. Humulin R \- C. Tresiba \- D. Lantus \*\*Answer:\*\* B. Humulin R 2\. \*\*Short-acting insulin, such as Regular insulin, has an onset of action within:\*\* \- A. 10-15 minutes \- B. 30-60 minutes \- C. 1-2 hours \- D. 2-3 hours \*\*Answer:\*\* B. 30-60 minutes 3\. \*\*In the hospital setting, Regular insulin is often administered intravenously to manage:\*\* \- A. Diabetic ketoacidosis (DKA) \- B. Hypoglycemia \- C. Hyperlipidemia \- D. Postoperative pain \*\*Answer:\*\* A. Diabetic ketoacidosis (DKA) \-\-- \#\#\# \*\*Slide 19: Intermediate-Acting Insulin (NPH)\*\* 1\. \*\*Which insulin is classified as intermediate-acting?\*\* \- A. Humulin N \- B. Lantus \- C. Apidra \- D. Tresiba \*\*Answer:\*\* A. Humulin N 2\. \*\*How should NPH insulin be handled before injection?\*\* \- A. Shake vigorously \- B. Leave undisturbed for 10 minutes \- C. Gently roll the vial to distribute the suspension \- D. Inject immediately without any preparation \*\*Answer:\*\* C. Gently roll the vial to distribute the suspension 3\. \*\*Intermediate-acting insulin, like NPH, typically reaches its peak effect within:\*\* \- A. 1-2 hours \- B. 4-10 hours \- C. 12-16 hours \- D. 24-36 hours \*\*Answer:\*\* B. 4-10 hours \-\-- \#\#\# \*\*Slide 21: Long-Acting Insulin\*\* 1\. \*\*Which long-acting insulin is considered \"peakless\" and mimics basal insulin production?\*\* \- A. Lantus \- B. Humulin N \- C. Apidra \- D. NovoLog \*\*Answer:\*\* A. Lantus 2\. \*\*Which long-acting insulin has the longest duration of action, lasting up to 42 hours?\*\* \- A. Lantus \- B. Tresiba \- C. Levemir \- D. Humalog \*\*Answer:\*\* B. Tresiba 3\. \*\*Why should long-acting insulins, such as Lantus or Tresiba, not be mixed with other insulins in the same syringe?\*\* \- A. They will become too potent \- B. Mixing them with other insulins inactivates the long-acting insulin \- C. They cause an immediate release of insulin \- D. There is a risk of overdose \*\*Answer:\*\* B. Mixing them with other insulins inactivates the long-acting insulin \-\-- \#\#\# \*\*Slide 20: NPH Insulin (Additional)\*\* 1\. \*\*Which insulin has a milky appearance and requires rolling before injection?\*\* \- A. NPH insulin \- B. Rapid-acting insulin \- C. Long-acting insulin \- D. Regular insulin \*\*Answer:\*\* A. NPH insulin 2\. \*\*How often is NPH insulin typically administered?\*\* \- A. Once daily \- B. Twice daily \- C. After every meal \- D. Once weekly \*\*Answer:\*\* B. Twice daily 3\. \*\*Which of the following is a common complication with the use of NPH insulin?\*\* \- A. Hypoglycemia \- B. Hyperglycemia \- C. Weight loss \- D. Insulin resistance \*\*Answer:\*\* A. Hypoglycemia \#\#\# \*\*Slide 17: Rapid-Acting Insulin - Vial & Pen Forms\*\* 1\. \*\*Which of the following is an example of a rapid-acting insulin?\*\* \- A. Apidra (insulin glulisine) \- B. Humulin N \- C. Lantus \- D. Tresiba \*\*Answer:\*\* A. Apidra (insulin glulisine) 2\. \*\*What is the typical onset of action for rapid-acting insulins such as Humalog or NovoLog?\*\* \- A. 10-30 minutes \- B. 30-60 minutes \- C. 1-2 hours \- D. 3-5 hours \*\*Answer:\*\* A. 10-30 minutes 3\. \*\*How long does rapid-acting insulin typically last in the body?\*\* \- A. 1-2 hours \- B. 3-5 hours \- C. 5-8 hours \- D. 12-24 hours \*\*Answer:\*\* B. 3-5 hours 4\. \*\*When should rapid-acting insulin be administered in relation to meals?\*\* \- A. 30 minutes before meals \- B. 15 minutes before meals or immediately after \- C. 1 hour after meals \- D. Only at bedtime \*\*Answer:\*\* B. 15 minutes before meals or immediately after 5\. \*\*Rapid-acting insulin is most commonly used in which of the following therapeutic settings?\*\* \- A. Basal insulin therapy \- B. Postprandial glucose control \- C. Fasting glucose control \- D. Management of insulin resistance \*\*Answer:\*\* B. Postprandial glucose control 6\. \*\*In which forms can rapid-acting insulin be administered?\*\* \- A. Subcutaneous (via insulin pump) and intravenous (IV) infusion \- B. Subcutaneous injection only \- C. Intramuscular injection only \- D. Oral tablets and subcutaneous injection \*\*Answer:\*\* A. Subcutaneous (via insulin pump) and intravenous (IV) infusion 7\. \*\*Which of the following rapid-acting insulins is available in both vial and pen forms?\*\* \- A. Apidra (insulin glulisine) \- B. NPH insulin \- C. Levemir \- D. Tresiba \*\*Answer:\*\* A. Apidra (insulin glulisine) 8\. \*\*Why is it important to eat soon after injecting rapid-acting insulin?\*\* \- A. To avoid hyperglycemia \- B. To prevent hypoglycemia \- C. To increase the insulin\'s duration of action \- D. To improve insulin absorption \*\*Answer:\*\* B. To prevent hypoglycemia Slide 21: Long-Acting Insulin Which of the following insulins is classified as long-acting? A. Lantus (insulin glargine) B. Humalog C. NPH D. Regular insulin\ Answer: A. Lantus (insulin glargine) What is the duration of action for Lantus (insulin glargine)? A. 12-16 hours B. 20-24 hours C. 8-10 hours D. 42 hours\ Answer: B. 20-24 hours Why should long-acting insulins not be mixed with other insulin types in the same syringe? A. It increases the risk of hypoglycemia B. It inactivates the long-acting insulin C. It reduces insulin absorption D. It prolongs the onset of action\ Answer: B. It inactivates the long-acting insulin Slide 22: Long-Acting Insulin Duration Toujeo (insulin glargine U-300) has a duration of action that can last for: A. 18-20 hours B. 20-24 hours C. 24-36 hours D. 42 hours\ Answer: C. 24-36 hours Which of the following long-acting insulins has the longest duration of action, up to 42 hours? A. Lantus B. Tresiba (insulin degludec) C. Levemir D. Humulin R\ Answer: B. Tresiba (insulin degludec) Which of the following best describes the clinical importance of the onset time for long-acting insulin? A. Critical to control postprandial glucose B. Not clinically important for basal insulin therapy C. Important for nocturnal hypoglycemia prevention D. Essential for bolus insulin administration\ Answer: B. Not clinically important for basal insulin therapy Slide 23: Basal Insulin Titration When initiating basal insulin therapy with Lantus, the starting dose is generally: A. 0.5-1 units/kg at bedtime B. 10 units or 0.1-0.2 units/kg at bedtime C. 20 units before each meal D. 5 units per kilogram of body weight\ Answer: B. 10 units or 0.1-0.2 units/kg at bedtime For basal insulin titration, what dose adjustment should be made if the fasting blood glucose is 140-180 mg/dL? A. Increase by 2 units B. Increase by 4 units C. Increase by 6 units D. Increase by 8 units\ Answer: C. Increase by 6 units In basal insulin titration, if hypoglycemia occurs and no clear cause is found, how should the insulin dose be adjusted? A. Reduce by 2 units B. Reduce by 4 units or 10-20% C. Reduce by 10 units D. No dose adjustment needed\ Answer: B. Reduce by 4 units or 10-20% Slide 24: Combination Products What is the typical composition of combination insulin products like Humalog Mix 75/25? A. 75% regular insulin / 25% NPH B. 75% insulin lispro protamine / 25% insulin lispro C. 75% insulin aspart / 25% insulin glulisine D. 75% insulin glargine / 25% insulin detemir\ Answer: B. 75% insulin lispro protamine / 25% insulin lispro Combination insulin products are typically used to control which blood glucose levels? A. Fasting glucose levels only B. Postprandial glucose levels only C. Both fasting and postprandial glucose levels D. Glucose levels during exercise\ Answer: C. Both fasting and postprandial glucose levels Glargine/Lixisenatide combination insulin therapy involves which of the following mechanisms? A. Long-acting insulin with a GLP-1 receptor agonist B. Rapid-acting insulin with a DPP-4 inhibitor C. Intermediate-acting insulin with amylin analog D. Short-acting insulin with a sulfonylurea\ Answer: A. Long-acting insulin with a GLP-1 receptor agonist Slide 25: Inhaled Insulin (Afrezza) Inhaled insulin (Afrezza) is used primarily to control: A. Fasting glucose levels B. Postprandial hyperglycemia C. Hypoglycemia D. Nocturnal hypoglycemia\ Answer: B. Postprandial hyperglycemia What is a major contraindication for the use of inhaled insulin? A. Type 1 diabetes B. COPD or asthma C. Pregnancy D. Obesity\ Answer: B. COPD or asthma Inhaled insulin carries a boxed warning for which of the following conditions? A. Acute bronchospasm in patients with asthma or COPD B. Hypoglycemia in patients with type 2 diabetes C. Ketoacidosis in patients with type 1 diabetes D. Weight gain in insulin-dependent patients\ Answer: A. Acute bronchospasm in patients with asthma or COPD \-\-- \#\#\# \*\*Slide 26: Insulin Adverse Effects\*\* 1\. \*\*What is the most common adverse effect of insulin therapy?\*\* \- A. Weight loss \- B. Hypoglycemia \- C. Hyperglycemia \- D. Hypotension \*\*Answer:\*\* B. Hypoglycemia 2\. \*\*Which insulin-related complication is associated with excessive weight gain?\*\* \- A. Ketoacidosis \- B. Lipohypertrophy \- C. Hypoglycemia \- D. Hyperkalemia \*\*Answer:\*\* B. Lipohypertrophy 3\. \*\*How can insulin-induced hypoglycemia be prevented?\*\* \- A. Reducing basal insulin doses only \- B. Providing appropriate meal timing for bolus and NPH insulin \- C. Administering insulin at irregular times \- D. Increasing the frequency of insulin doses \*\*Answer:\*\* B. Providing appropriate meal timing for bolus and NPH insulin \-\-- \#\#\# \*\*Slide 27: Insulin Absorption\*\* 1\. \*\*Which factor can affect the rate of insulin absorption at the injection site?\*\* \- A. Insulin concentration \- B. Needle length \- C. Injection site rotation \- D. All of the above \*\*Answer:\*\* D. All of the above 2\. \*\*Which insulin injection site is associated with the most consistent and rapid absorption?\*\* \- A. Thigh \- B. Arm \- C. Abdomen \- D. Buttock \*\*Answer:\*\* C. Abdomen 3\. \*\*Why should insulin injection sites be rotated?\*\* \- A. To avoid developing insulin resistance \- B. To prevent tissue reactions such as lipodystrophy \- C. To increase insulin potency \- D. To improve insulin production \*\*Answer:\*\* B. To prevent tissue reactions such as lipodystrophy \-\-- \#\#\# \*\*Slide 28: Insulin Therapy\*\* 1\. \*\*What is the primary goal of basal insulin therapy?\*\* \- A. To manage postprandial glucose spikes \- B. To maintain glucose control between meals and overnight \- C. To increase insulin secretion during exercise \- D. To manage acute hypoglycemia \*\*Answer:\*\* B. To maintain glucose control between meals and overnight 2\. \*\*Which type of insulin is used as part of bolus insulin therapy to manage postprandial glucose levels?\*\* \- A. Long-acting insulin \- B. Intermediate-acting insulin \- C. Rapid-acting insulin \- D. Regular insulin \*\*Answer:\*\* C. Rapid-acting insulin 3\. \*\*Basal insulin aims to provide a:\*\* \- A. Continuous release of insulin to control fasting glucose levels \- B. Spike in insulin levels after meals \- C. Rapid response to carbohydrate intake \- D. Short-term correction of blood glucose levels \*\*Answer:\*\* A. Continuous release of insulin to control fasting glucose levels \-\-- \#\#\# \*\*Slide 29: Monitoring Blood Glucose\*\* 1\. \*\*In which of the following situations is frequent blood glucose monitoring especially important?\*\* \- A. During pregnancy \- B. When starting or changing diabetes medications \- C. During illness \- D. All of the above \*\*Answer:\*\* D. All of the above 2\. \*\*What is a potential downside of frequent blood glucose monitoring?\*\* \- A. Increased accuracy of glucose control \- B. High cost and potential for patient depression \- C. Reduced ability to track hypoglycemia \- D. Decreased motivation for patients \*\*Answer:\*\* B. High cost and potential for patient depression 3\. \*\*How often should patients on multiple daily injections of insulin check their blood glucose?\*\* \- A. Once daily \- B. Before and after every meal \- C. At least four times a day (qACHS) \- D. Only at bedtime \*\*Answer:\*\* C. At least four times a day (qACHS) \-\-- \#\#\# \*\*Slide 30: Insulin Therapy -- Bolus vs Basal\*\* 1\. \*\*What is the main function of bolus insulin in diabetes therapy?\*\* \- A. To manage blood glucose levels between meals \- B. To control glucose spikes after meals and snacks \- C. To replace basal insulin \- D. To prevent nocturnal hypoglycemia \*\*Answer:\*\* B. To control glucose spikes after meals and snacks 2\. \*\*Basal insulin is essential for controlling glucose during which periods?\*\* \- A. After meals \- B. Between meals and overnight \- C. During exercise \- D. Immediately before breakfast \*\*Answer:\*\* B. Between meals and overnight 3\. \*\*When should bolus insulin typically be administered in relation to meals?\*\* \- A. 1 hour after a meal \- B. 30-60 minutes before a meal \- C. 15-30 minutes before a meal \- D. Right after waking up \*\*Answer:\*\* C. 15-30 minutes before a meal \-\-- \#\#\# \*\*Slide 30: Insulin Therapy -- Bolus vs. Basal Insulin (Additional Questions)\*\* 1\. \*\*Which type of insulin is primarily used to control fasting blood glucose levels?\*\* \- A. Bolus insulin \- B. Basal insulin \- C. Rapid-acting insulin \- D. Intermediate-acting insulin \*\*Answer:\*\* B. Basal insulin 2\. \*\*Which insulin type is most commonly used to cover mealtime glucose spikes?\*\* \- A. Long-acting insulin \- B. NPH insulin \- C. Rapid-acting insulin \- D. Mixed insulin \*\*Answer:\*\* C. Rapid-acting insulin 3\. \*\*In a patient using both basal and bolus insulin, how does the basal insulin function throughout the day?\*\* \- A. It provides a continuous, steady release of insulin to maintain blood glucose between meals \- B. It peaks during meals to prevent postprandial hyperglycemia \- C. It acts as a backup for missed bolus doses \- D. It increases blood glucose levels to avoid hypoglycemia \*\*Answer:\*\* A. It provides a continuous, steady release of insulin to maintain blood glucose between meals \-\-- \#\#\# \*\*Slide 31: Blood Glucose Monitoring (Benefits)\*\* 1\. \*\*Which of the following is a key benefit of frequent blood glucose monitoring for patients with diabetes?\*\* \- A. It reduces the need for insulin therapy \- B. It helps patients track how diet and exercise impact blood sugar levels \- C. It prevents diabetic ketoacidosis (DKA) \- D. It eliminates the risk of hypoglycemia \*\*Answer:\*\* B. It helps patients track how diet and exercise impact blood sugar levels 2\. \*\*Frequent blood glucose monitoring may motivate patients by:\*\* \- A. Reducing the total daily insulin dose \- B. Showing immediate results of their lifestyle choices \- C. Lowering the cost of diabetes management \- D. Replacing the need for insulin therapy \*\*Answer:\*\* B. Showing immediate results of their lifestyle choices 3\. \*\*What is a potential psychological downside of frequent blood glucose monitoring?\*\* \- A. Depression due to constant focus on diabetes management \- B. Increased risk of hyperglycemia \- C. Development of insulin resistance \- D. Reduced accuracy of glucose readings \*\*Answer:\*\* A. Depression due to constant focus on diabetes management \-\-- \#\#\# \*\*Slide 32: When to Monitor Blood Glucose\*\* 1\. \*\*During which of the following situations is it most important to monitor blood glucose levels?\*\* \- A. While fasting or during an illness \- B. After every meal \- C. Only when switching from oral medication to insulin \- D. Only when hyperglycemia symptoms are present \*\*Answer:\*\* A. While fasting or during an illness 2\. \*\*Why should blood glucose be monitored more closely during pregnancy?\*\* \- A. To prevent hypoglycemia \- B. To detect gestational diabetes and prevent complications \- C. To lower the dose of insulin needed \- D. To stop all diabetes medications \*\*Answer:\*\* B. To detect gestational diabetes and prevent complications 3\. \*\*Which patient occupation may require more frequent blood glucose monitoring to reduce the risk of hypoglycemia while working?\*\* \- A. Office worker \- B. Truck driver \- C. Schoolteacher \- D. Software engineer \*\*Answer:\*\* B. Truck driver \-\-- \#\#\# \*\*Slide 33: Insulin Pump Therapy\*\* 1\. \*\*Which of the following is an advantage of using an insulin pump for diabetes management?\*\* \- A. Fewer daily blood glucose tests required \- B. More flexibility in daily activities like meals and exercise \- C. Reduced risk of diabetic ketoacidosis (DKA) \- D. Does not require insulin dosage adjustments \*\*Answer:\*\* B. More flexibility in daily activities like meals and exercise 2\. \*\*What type of insulin is used in insulin pumps for both basal and bolus delivery?\*\* \- A. Intermediate-acting insulin \- B. Long-acting insulin \- C. Rapid-acting insulin \- D. Inhaled insulin \*\*Answer:\*\* C. Rapid-acting insulin 3\. \*\*Which of the following is a potential downside of insulin pump therapy?\*\* \- A. Increased risk of diabetic retinopathy \- B. More frequent blood glucose testing \- C. Increased risk of catheter site infections \- D. Reduced control over glucose levels \*\*Answer:\*\* C. Increased risk of catheter site infections \-\-- \#\#\# \*\*Slide 34: Insulin Pump Mechanics\*\* 1\. \*\*What is the primary function of continuous subcutaneous insulin infusion (CSII) devices?\*\* \- A. To provide a basal dose of long-acting insulin \- B. To deliver individualized basal and bolus insulin doses based on self-monitored blood glucose levels \- C. To administer rapid-acting insulin in fixed doses \- D. To eliminate the need for carbohydrate counting \*\*Answer:\*\* B. To deliver individualized basal and bolus insulin doses based on self-monitored blood glucose levels 2\. \*\*Which type of insulin is specifically approved for use in insulin pumps due to favorable pharmacokinetics?\*\* \- A. Insulin glargine \- B. Insulin lispro \- C. Insulin detemir \- D. NPH insulin \*\*Answer:\*\* B. Insulin lispro 3\. \*\*How often should the catheter site be changed when using an insulin pump?\*\* \- A. Every 24 hours \- B. Every 7 days \- C. Every 3 days \- D. Every 12 hours \*\*Answer:\*\* C. Every 3 days \-\-- \#\#\# \*\*Slide 35: Continuous Glucose Monitoring (CGM)\*\* 1\. \*\*Which of the following is an advantage of continuous glucose monitoring (CGM) over traditional fingerstick blood glucose testing?\*\* \- A. Provides real-time glucose readings \- B. Requires less frequent calibration \- C. Eliminates the need for insulin adjustments \- D. Has fewer costs compared to traditional testing \*\*Answer:\*\* A. Provides real-time glucose readings 2\. \*\*Which of the following is a key parameter measured by continuous glucose monitoring (CGM)?\*\* \- A. Average daily insulin dose \- B. Time in range (TIR) \- C. Fasting glucose average \- D. Peak postprandial glucose \*\*Answer:\*\* B. Time in range (TIR) 3\. \*\*Which type of continuous glucose monitoring (CGM) device provides intermittent scanning of glucose levels?\*\* \- A. Intermittent scanned CGM (isCGM) \- B. Real-time CGM (rtCGM) \- C. Closed-loop system \- D. Self-monitoring blood glucose (SMBG) \*\*Answer:\*\* A. Intermittent scanned CGM (isCGM) \-\-- \#\#\# \*\*Slide 36: Glucose Monitoring Trends\*\* 1\. \*\*What is the benefit of tracking "time in range" (TIR) in diabetes management?\*\* \- A. It provides insight into the effectiveness of insulin therapy over time \- B. It predicts the long-term insulin needs of patients \- C. It measures how well the body is absorbing insulin \- D. It eliminates the need for HbA1c testing \*\*Answer:\*\* A. It provides insight into the effectiveness of insulin therapy over time 2\. \*\*What does the parameter "TAR" refer to in glucose monitoring?\*\* \- A. Time above range \- B. Total absorption rate \- C. Time for action of rapid insulin \- D. Titrated action of insulin \*\*Answer:\*\* A. Time above range 3\. \*\*Continuous glucose monitoring (CGM) has shown significant benefits in which of the following?\*\* \- A. Reducing the cost of diabetes management \- B. Improving glycemic control without increasing hypoglycemia risk \- C. Eliminating the need for bolus insulin \- D. Preventing weight gain in insulin-dependent patients \*\*Answer:\*\* B. Improving glycemic control without increasing hypoglycemia risk \#\#\# \*\*Slide 37: Continuous Glucose Monitoring (CGM)\*\* 1\. \*\*What is the purpose of continuous glucose monitoring (CGM) in diabetes management?\*\* \- A. To replace insulin therapy \- B. To provide real-time glucose levels and trends throughout the day \- C. To reduce the need for daily insulin injections \- D. To measure insulin resistance \*\*Answer:\*\* B. To provide real-time glucose levels and trends throughout the day 2\. \*\*Which parameter in CGM refers to the percentage of time that glucose levels are within the target range?\*\* \- A. Time above range (TAR) \- B. Time in range (TIR) \- C. Average daily glucose (ADG) \- D. Fasting blood glucose (FBG) \*\*Answer:\*\* B. Time in range (TIR) 3\. \*\*CGM is particularly beneficial for which patient group?\*\* \- A. Patients using multiple daily insulin injections \- B. Patients with prediabetes \- C. Patients with well-controlled type 2 diabetes on oral medications only \- D. Patients with no history of hypoglycemia \*\*Answer:\*\* A. Patients using multiple daily insulin injections \-\-- \#\#\# \*\*Slide 38: Monitoring Blood Glucose (Test Strips)\*\* 1\. \*\*What is an important consideration when ordering supplies for self-monitoring of blood glucose (SMBG)?\*\* \- A. Test strips should be compatible with the glucose meter \- B. Test strips should be used only once weekly \- C. Test strips are interchangeable between different devices \- D. Test strips should be shared among family members \*\*Answer:\*\* A. Test strips should be compatible with the glucose meter 2\. \*\*Why is it important to ensure patients have an adequate supply of test strips for SMBG?\*\* \- A. To reduce the risk of hyperglycemia \- B. To improve patient compliance and glycemic control \- C. To replace the need for insulin therapy \- D. To increase the effectiveness of oral diabetes medications \*\*Answer:\*\* B. To improve patient compliance and glycemic control 3\. \*\*Which of the following factors can affect the accuracy of blood glucose test strips?\*\* \- A. Storage temperature \- B. Frequency of use \- C. Type of insulin administered \- D. Time of day the test is performed \*\*Answer:\*\* A. Storage temperature \-\-- \#\#\# \*\*Slide 39: Hypoglycemia\*\* 1\. \*\*What is the first step in treating hypoglycemia in a diabetic patient?\*\* \- A. Administering glucagon immediately \- B. Identifying and addressing the underlying cause of hypoglycemia \- C. Increasing the insulin dose \- D. Withholding all diabetes medications \*\*Answer:\*\* B. Identifying and addressing the underlying cause of hypoglycemia 2\. \*\*Which of the following is a common cause of insulin-induced hypoglycemia?\*\* \- A. Overeating carbohydrates \- B. Skipping meals after insulin administration \- C. Performing regular exercise \- D. Taking oral diabetes medications \*\*Answer:\*\* B. Skipping meals after insulin administration 3\. \*\*In the absence of a clear cause of hypoglycemia, how should the insulin dose be adjusted?\*\* \- A. Reduce the dose by 4 units or 10-20% \- B. Increase the dose by 2 units \- C. Stop insulin therapy temporarily \- D. Switch to oral medications \*\*Answer:\*\* A. Reduce the dose by 4 units or 10-20% \-\-- \#\#\# \*\*Slide 40: Glucagon in Hypoglycemia\*\* 1\. \*\*What is the role of glucagon in the treatment of severe hypoglycemia?\*\* \- A. It stimulates the liver to release stored glucose \- B. It inhibits insulin secretion \- C. It reduces the rate of glucose absorption \- D. It increases insulin sensitivity \*\*Answer:\*\* A. It stimulates the liver to release stored glucose 2\. \*\*What is the typical onset time for glucagon\'s effect after administration?\*\* \- A. 1-2 hours \- B. 10-20 minutes \- C. 30-60 minutes \- D. 2-4 hours \*\*Answer:\*\* B. 10-20 minutes 3\. \*\*For a child under 6 years of age or weighing less than 25 kg, what is the recommended dose of glucagon for hypoglycemia?\*\* \- A. 1 mg \- B. 0.5 mg \- C. 2 mg \- D. 0.1 mg \*\*Answer:\*\* B. 0.5 mg \-\-- \#\#\# \*\*Slide 41: Glucagon Administration\*\* 1\. \*\*Glucagon can be administered via which of the following routes?\*\* \- A. Oral \- B. Intravenous (IV), intramuscular (IM), and subcutaneous (SC) \- C. Transdermal patch \- D. Inhalation \*\*Answer:\*\* B. Intravenous (IV), intramuscular (IM), and subcutaneous (SC) 2\. \*\*When is intranasal glucagon considered for use in patients with hypoglycemia?\*\* \- A. When IV access is unavailable \- B. As a routine replacement for SC glucagon \- C. Only in cases of hyperglycemia \- D. When oral glucose is not tolerated \*\*Answer:\*\* A. When IV access is unavailable 3\. \*\*If a patient does not respond to the initial dose of glucagon, when can the dose be repeated?\*\* \- A. 10 minutes later \- B. 15-20 minutes later \- C. 30 minutes later \- D. After 1 hour \*\*Answer:\*\* B. 15-20 minutes later \-\-- \#\#\# \*\*Slide 42: Incretins Overview\*\* 1\. \*\*What is the role of GLP-1 (glucagon-like peptide-1) in glucose metabolism?\*\* \- A. It stimulates insulin secretion and inhibits glucagon release \- B. It increases glucagon secretion and decreases insulin secretion \- C. It increases the absorption of glucose in the intestines \- D. It accelerates gastric emptying \*\*Answer:\*\* A. It stimulates insulin secretion and inhibits glucagon release 2\. \*\*Which enzyme breaks down GLP-1 in the body, reducing its activity?\*\* \- A. Amylase \- B. DPP-4 (dipeptidyl peptidase-4) \- C. GLP-2 \- D. Alpha-glucosidase \*\*Answer:\*\* B. DPP-4 (dipeptidyl peptidase-4) 3\. \*\*GLP-1 agonists are used in diabetes management to:\*\* \- A. Increase hepatic glucose production \- B. Decrease food intake and promote satiety \- C. Increase glucagon secretion \- D. Speed up the breakdown of insulin \*\*Answer:\*\* B. Decrease food intake and promote satiety \-\-- \#\#\# \*\*Slide 43: GLP-1 Agonists (Mechanism of Action)\*\* 1\. \*\*How do GLP-1 agonists help manage blood glucose levels in type 2 diabetes?\*\* \- A. They increase insulin secretion and decrease glucagon secretion \- B. They increase glucagon secretion and reduce insulin resistance \- C. They promote the breakdown of glycogen in the liver \- D. They reduce hepatic glucose production only \*\*Answer:\*\* A. They increase insulin secretion and decrease glucagon secretion 2\. \*\*Which of the following is a benefit of GLP-1 agonist therapy?\*\* \- A. Weight loss \- B. Weight gain \- C. Increased insulin resistance \- D. Increased triglyceride production \*\*Answer:\*\* A. Weight loss 3\. \*\*GLP-1 agonists help reduce hemoglobin A1C by approximately:\*\* \- A. 0.5% \- B. 1% \- C. 2% \- D. 3% \*\*Answer:\*\* B. 1% \#\#\# \*\*Slide 44: GLP-1 Agonists (Medications)\*\* 1\. \*\*Which of the following GLP-1 agonists is derived from the saliva of the Gila monster lizard?\*\* \- A. Liraglutide (Victoza®) \- B. Exenatide (Byetta®) \- C. Dulaglutide (Trulicity®) \- D. Semaglutide (Ozempic®) \*\*Answer:\*\* B. Exenatide (Byetta®) 2\. \*\*Which GLP-1 agonist has been proven to reduce major cardiovascular events and mortality in patients with type 2 diabetes?\*\* \- A. Exenatide (Byetta®) \- B. Liraglutide (Victoza®) \- C. Dulaglutide (Trulicity®) \- D. Semaglutide (Ozempic®) \*\*Answer:\*\* B. Liraglutide (Victoza®) 3\. \*\*Which of the following is a once-weekly GLP-1 agonist used for type 2 diabetes and cardiovascular risk reduction?\*\* \- A. Exenatide (Byetta®) \- B. Liraglutide (Victoza®) \- C. Dulaglutide (Trulicity®) \- D. Insulin glargine (Lantus®) \*\*Answer:\*\* C. Dulaglutide (Trulicity®) \-\-- \#\#\# \*\*Slide 45: Semaglutide (Ozempic, Rybelsus, Wegovy)\*\* 1\. \*\*What is the oral form of semaglutide used for the treatment of type 2 diabetes?\*\* \- A. Ozempic® \- B. Rybelsus® \- C. Wegovy® \- D. Byetta® \*\*Answer:\*\* B. Rybelsus® 2\. \*\*Which form of semaglutide is approved for weight management in patients with obesity and cardiovascular disease?\*\* \- A. Ozempic® \- B. Rybelsus® \- C. Wegovy® \- D. Victoza® \*\*Answer:\*\* C. Wegovy® 3\. \*\*What is the dual action mechanism of tirzepatide (Mounjaro®)?\*\* \- A. GLP-1 receptor agonist and GIP receptor agonist \- B. GLP-1 receptor agonist and DPP-4 inhibitor \- C. GLP-1 receptor agonist and alpha-glucosidase inhibitor \- D. GIP receptor agonist and insulin sensitizer \*\*Answer:\*\* A. GLP-1 receptor agonist and GIP receptor agonist \-\-- \#\#\# \*\*Slide 46: Cardiovascular Effects of GLP-1 Agonists\*\* 1\. \*\*Which of the following cardiovascular effects is associated with GLP-1 agonist therapy?\*\* \- A. Increased systolic blood pressure \- B. Decreased triglyceride levels by 20% or more \- C. Increased heart rate and triglyceride levels \- D. Decreased insulin sensitivity \*\*Answer:\*\* B. Decreased triglyceride levels by 20% or more 2\. \*\*GLP-1 agonists improve endothelial function by promoting which of the following?\*\* \- A. Vasoconstriction \- B. Vasodilation \- C. Decreased heart rate \- D. Decreased production of nitric oxide \*\*Answer:\*\* B. Vasodilation 3\. \*\*Which of the following markers of cardiovascular health are reduced by GLP-1 agonists?\*\* \- A. LDL cholesterol \- B. C-reactive protein (CRP) \- C. HDL cholesterol \- D. Apolipoprotein B \*\*Answer:\*\* B. C-reactive protein (CRP) \-\-- \#\#\# \*\*Slide 47: GLP-1 Agonists (Indications)\*\* 1\. \*\*Which of the following is an indication for GLP-1 agonist therapy?\*\* \- A. Type 2 diabetes only \- B. Type 1 and type 2 diabetes \- C. Gestational diabetes \- D. Pre-diabetes \*\*Answer:\*\* A. Type 2 diabetes only 2\. \*\*GLP-1 agonists may be combined with which of the following to help manage postprandial glucose control?\*\* \- A. Basal insulin and metformin \- B. Sulfonylureas only \- C. Insulin pumps only \- D. DPP-4 inhibitors \*\*Answer:\*\* A. Basal insulin and metformin 3\. \*\*Which of the following is a benefit of using GLP-1 agonists in patients with type 2 diabetes?\*\* \- A. Weight gain \- B. Decreased postprandial glucose levels \- C. Increased insulin resistance \- D. Increased triglycerides \*\*Answer:\*\* B. Decreased postprandial glucose levels \-\-- \#\#\# \*\*Slide 48: GLP-1 Agonist Adverse Effects\*\* 1\. \*\*Which gastrointestinal side effect is most commonly associated with GLP-1 agonist therapy?\*\* \- A. Diarrhea \- B. Nausea \- C. Vomiting \- D. Constipation \*\*Answer:\*\* B. Nausea 2\. \*\*What percentage of patients may experience nausea as a side effect of GLP-1 agonist therapy?\*\* \- A. 1-10% \- B. 11-50% \- C. 51-75% \- D. \>75% \*\*Answer:\*\* B. 11-50% 3\. \*\*Which of the following is a rare but serious adverse effect associated with GLP-1 agonists?\*\* \- A. Hypoglycemia \- B. Pancreatitis \- C. Hepatitis \- D. Renal failure \*\*Answer:\*\* B. Pancreatitis \-\-- \#\#\# \*\*Slide 49: GLP-1 Agonists -- Contraindications\*\* 1\. \*\*Which of the following is a contraindication for GLP-1 agonist therapy?\*\* \- A. Type 2 diabetes \- B. Gastroparesis \- C. Hyperthyroidism \- D. Chronic obstructive pulmonary disease \*\*Answer:\*\* B. Gastroparesis 2\. \*\*In patients with a history of pancreatitis, what is the appropriate action regarding GLP-1 agonist therapy?\*\* \- A. It should be initiated with close monitoring \- B. It is contraindicated and should be avoided \- C. The dose should be reduced \- D. It should be combined with DPP-4 inhibitors \*\*Answer:\*\* B. It is contraindicated and should be avoided 3\. \*\*For patients with renal insufficiency, which GLP-1 agonist should be used with caution due to potential gastrointestinal side effects?\*\* \- A. Exenatide \- B. Dulaglutide \- C. Liraglutide \- D. Semaglutide \*\*Answer:\*\* A. Exenatide \-\-- \#\#\# \*\*Slide 50: Amylin Analog (Pramlintide)\*\* 1\. \*\*Pramlintide (Symlin®) is an analog of which naturally occurring hormone?\*\* \- A. GLP-1 \- B. Insulin \- C. Amylin \- D. Glucagon \*\*Answer:\*\* C. Amylin 2\. \*\*Pramlintide is indicated for use in which group of patients?\*\* \- A. Type 1 and type 2 diabetes patients already on insulin \- B. Type 2 diabetes patients on oral medications only \- C. Patients with gestational diabetes \- D. Patients with pre-diabetes \*\*Answer:\*\* A. Type 1 and type 2 diabetes patients already on insulin 3\. \*\*What is a major side effect of pramlintide (Symlin®) therapy, leading to a boxed warning?\*\* \- A. Severe hypoglycemia \- B. Hyperkalemia \- C. Weight gain \- D. Hypertension \*\*Answer:\*\* A. Severe hypoglycemia 4\. \*\*When starting pramlintide, how should mealtime insulin doses be adjusted?\*\* \- A. Increased by 50% \- B. Decreased by 50% \- C. Maintained at the same dose \- D. Completely discontinued \*\*Answer:\*\* B. Decreased by 50% \#\#\# \*\*Slide 51: Amylin Analog (Pramlintide)\*\* 1\. \*\*Which of the following best describes the mechanism of action of pramlintide (Symlin®)?\*\* \- A. It increases insulin secretion from beta cells \- B. It slows gastric emptying and reduces postprandial glucose spikes \- C. It promotes glucagon release from alpha cells \- D. It enhances hepatic glucose production \*\*Answer:\*\* B. It slows gastric emptying and reduces postprandial glucose spikes 2\. \*\*Pramlintide is administered via which route?\*\* \- A. Oral \- B. Intravenous (IV) \- C. Subcutaneous (SC) injection \- D. Inhalation \*\*Answer:\*\* C. Subcutaneous (SC) injection 3\. \*\*In addition to reducing postprandial glucose, what other effect does pramlintide have?\*\* \- A. Increases insulin secretion \- B. Reduces caloric intake and may lead to weight loss \- C. Enhances absorption of glucose from the intestines \- D. Increases hepatic glucose production \*\*Answer:\*\* B. Reduces caloric intake and may lead to weight loss \-\-- \#\#\# \*\*Slide 52: Pramlintide (Symlin®) Side Effects\*\* 1\. \*\*What is a common side effect of pramlintide (Symlin®) therapy?\*\* \- A. Severe hypoglycemia \- B. Weight gain \- C. Hyperglycemia \- D. Renal dysfunction \*\*Answer:\*\* A. Severe hypoglycemia 2\. \*\*Due to the risk of hypoglycemia, what modification should be made when starting pramlintide therapy in insulin-treated patients?\*\* \- A. Increase the insulin dose by 50% \- B. Decrease mealtime insulin doses by 50% \- C. Maintain the current insulin dose \- D. Discontinue basal insulin \*\*Answer:\*\* B. Decrease mealtime insulin doses by 50% 3\. \*\*Which of the following strategies should be used to minimize the risk of hypoglycemia when initiating pramlintide therapy?\*\* \- A. Increase the frequency of meals \- B. Adjust meal timing to coincide with insulin peaks \- C. Closely monitor blood glucose levels after meals \- D. Administer pramlintide only before bedtime \*\*Answer:\*\* C. Closely monitor blood glucose levels after meals \-\-- \#\#\# \*\*Slide 53: Pramlintide - Indications and Considerations\*\* 1\. \*\*Pramlintide is indicated for use in which of the following patient populations?\*\* \- A. Patients with type 1 and type 2 diabetes who are already using insulin \- B. Patients with gestational diabetes \- C. Patients with type 2 diabetes not using insulin \- D. Patients with prediabetes \*\*Answer:\*\* A. Patients with type 1 and type 2 diabetes who are already using insulin 2\. \*\*What is the primary therapeutic role of pramlintide in diabetes management?\*\* \- A. To replace insulin therapy \- B. To reduce postprandial glucose excursions and improve glycemic control \- C. To enhance the effect of oral hypoglycemic agents \- D. To prevent diabetic ketoacidosis \*\*Answer:\*\* B. To reduce postprandial glucose excursions and improve glycemic control 3\. \*\*Which of the following is a key consideration when prescribing pramlintide for a patient already on insulin therapy?\*\* \- A. Pramlintide should be started at the same dose as insulin \- B. Pramlintide requires an increase in basal insulin dose \- C. Mealtime insulin should be reduced by 50% to prevent hypoglycemia \- D. Pramlintide should be administered intravenously \*\*Answer:\*\* C. Mealtime insulin should be reduced by 50% to prevent hypoglycemia