1. Specific geriatric syndromes that have been identified in guidelines as barriers to effective treatment of type 2 diabetes include:
A. Depression
B. Cognitive impairment
C. Both
D. Neither
2. Which of the following are risk factors for hypoglycemia in older adults with type 2 diabetes?
A. Cardiovascular disease
B. Osteoporosis
C. Both
D. Neither
3. Cognitive impairment has been shown to be associated with:
A. Hyperglycemia but not hypoglycemia
B. Hypoglycemia but not hyperglycemia
C. Both hypoglycemia and hyperglycemia
D. Neither hypoglycemia nor hyperglycemia
4. Which of the following medications has the least likelihood of causing hypoglycemia?
A. DPP-4 inhibitors
B. Sulfonylureas
C. Insulin
D. Glinides
5. The ACCORD study showed:
A. Decreased mortality risk with intensive glycemic control
B. Increased mortality risk with intensive glycemic control
C. Decreased morbidity risk with intensive glycemic control
D. Increased morbidity risk with intensive glycemic control
6. Which of the following statements is true based on evidence from clinical trials?
A. Long-term thiazolidinedione use increases the risk of fractures among women with type 2 diabetes
B. Long-term thiazolidinedione use reduces the risk of fractures among women with type 2 diabetes
C. Long-term sulfonylurea use increases the risk of fractures among women with type 2 diabetes
D. Long-term sulfonylurea use reduces the risk of fractures among women with type 2 diabetes
7. A study that evaluated symptomatic and counterregulatory responses to hypoglycemia in older and younger nondiabetic patient groups found that, compared with younger subjects:
A. Older subjects were more likely to experience hypoglycemia unawareness and delayed hormonal responses
B. Older subjects were more likely to experience hypoglycemia unawareness but not delayed hormonal responses
C. Older subjects were less likely to experience hypoglycemia unawareness and delayed hormonal responses
D. Older subjects were less likely to experience hypoglycemia unawareness and more likely to experience delayed hormonal responses
8. Which of the medications below control hyperglycemia by augmenting the incretin response?
A. GLP-1 agonists
B. DPP-4 inhibitors
C. Both
D. Neither
9. Of the medications listed below, which has the lowest risk of hypoglycemia?
A. Thiazolidinediones
B. Basal insulins
C. Sulfonylureas
D. Glinides
10. In older women, type 2 diabetes is associated with:
A. Lower bone density and higher risk for fracture
B. Higher bone density and higher risk for fracture
C. Lower bone density and lower risk for fracture
D. Higher bone density and lower risk for fracture
11. In addition to logging blood glucose levels, older adults with type 2 diabetes should also be encouraged to record:
A. Physical activity levels
B. Meal times and food intake details
C. Both
D. Neither
12. When setting glycemic goals in older adults with type 2 diabetes, the most important considerations include:
A. Disease duration
B. Life expectancy
C. Both
D. Neither
13. Which sulfonylurea medication has been shown to have a relative higher risk of hypoglycemia?
A. Glimepiride
B. Glyburide
C. Both have been shown to have an equal risk of hypoglycemia
D. There is no evidence that either has a relative higher risk of hypoglycemia
14. The DECODE study found that in older adults with type 2 diabetes compared with younger patients with type 2 diabetes:
A. 2-hour postprandial hyperglycemia tends to rise in a linear manner
B. Fasting plasma glucose tends to rise in a linear manner
C. 2-hour postprandial hyperglycemia tends to fall in a linear manner
D. Fasting plasma glucose tends to fall in a linear manner
15. Which of the following are risk factors for hypoglycemia in older adults with type 2 diabetes?
A. Renal impairment
B. Endocrine deficiency
C. Both
D. Neither
16. A clinical strategy for setting glycemic goals in older adults with type 2 diabetes that is based on findings from a post-hoc analysis of the ACCORD study is:
A. Even if it is difficult to lower A1C despite best attempts, continued efforts should be made
B. If it is difficult to lower A1C despite best attempts, it may be best to relax A1C goals
C. Even if it is difficult to lower A1C despite best attempts, combination therapy should be avoided
D. If it is difficult to lower A1C despite best attempts, combination therapy should be initiated
17. A less stringent A1C target may be desirable in older patients with type 2 diabetes with:
A. History of severe hypoglycemia
B. History of advanced cardiovascular disease
C. Both
D. Neither
18. In an older patient with type 2 diabetes, an elevated A1C along with fasting glucose levels at target would indicate that:
A. Postprandial glucose levels may be high
B. Renal function should be tested
C. Fasting glucose targets should be lowered
D. Fasting glucose targets should be raised
19. According to the current metformin label, it should be discontinued if:
A. Creatinine is >1.6 in a woman or >1.5 in a man
B. Creatinine is >1.5 in a woman or >1.6 in a man
C. Creatinine is >1.5 in a woman or >1.4 in a man
D. Creatinine is >1.4 in a woman or >1.5 in a man
20. Based on a Cochrane database review, in patients with type 2 diabetes receiving metformin therapy with a glomerular filtration rate (GFR) of <45 to <30 mL/ min/1.73 m2 , renal function should be monitored:
A. Every month
B. Every 3 months
C. Every 6 months
D. Every 9 months
