Apply your knowledge of important studies in the field to real world clinical cases.
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A 47-year-old woman with a 1-year history of uncontrolled type 2 diabetes mellitus, hypertension, and hyperlipidemia presents to the diabetes practice. Her glycated hemoglobin A1C is 6.0% (goal of diabetes treatment is less than 7%) on metformin. She does not have any history of coronary artery disease, peripheral vascular disease, or stroke. Her 10g monofilament test for neuropathy was normal. She does not have any evidence of retinopathy on fundoscopy. Urine microalbumin was normal. The patient wants to know if aggressive treatment of her type 2 diabetes will reduce her risk for coronary artery disease and stroke.
Apply the results of the UKPDS33 study
A 21-year-old man was diagnosed with type 1 diabetes mellitus a month before presenting to your primary care practice. His continuous glucose monitor (CGM) shows excellent glycemic control, with a glucose management indicator (GMI) of 6.1% (GMI is a CGM measure that predicts a patient’s anticipated glycated hemoglobin A1C). Which of these microvascular complications is he less likely to have if he maintained excellent diabetes control for the next 5 years?
Recall the results of the DCCT study
A 60-year-old woman with known coronary artery disease and type 2 diabetes mellitus has a tightly controlled glycated hemoglobin A1C ranging between 5.9 and 6.3% over the past four years. Which of these statements is true.
Recall the results of the ADVANCE study.
A 68-year-old man with uncontrolled type 2 diabetes mellitus, hypertension, congestive heart failure, hyperlipidemia, ischemic heart disease, and gout is referred to your practice for diabetes management. His recent A1C was 9.8% in spite of his compliance with therapy. He is on Lantus 45units daily, Novolog 15units with meals three times daily, metformin 2grams twice a day. His estimated glomerular filtration rate is 65. Which of these diabetes medications is likely to reduce his risk for myocardial infarction (a macrovascular complication of diabetes)
Recall the results of the LEADER study
A 24-year-old man with morbid obesity, hypertriglyceridemia, and recently diagnosed impaired fasting glucose reports to the diabetes practice. His A1C is 5.9%, consistent with prediabetes. He would like to know the best means of reducing his risk of progression of prediabetes to full-blown diabetes. What advice would your offer him?
Recall the results of the DPP study