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1. Which of the following statements is the most accurate concerning GLP-1 receptor agonists and DPP-4 inhibitors?

A. DPP-4 inhibitors are over ten times less likely to cause nausea than GLP-1 receptor agonists B. GLP-1 receptor agonists are less likely to cause nausea than DPP-4 inhibitors C. Both GLP-1 receptor agonists and DPP-4 inhibitors are appropriate treatment if after lifestyle and metformin treatment the patient has not reached adequate glucose control D. Neither GLP-1 receptor agonists and DPP-4 inhibitors are appropriate treatment if after lifestyle and metformin treatment the patient has not reached adequate glucose control

2. What is one of the positive effects that GLP-1 receptor agonist therapy can have for the majority of patients?

A. Weight loss due to nausea B. Weight loss independent of nausea C. Abdominal fat loss D. Prevention of weight gain with insulin

3. Which of the following is a contraindication to starting some of the medications within the GLP-1 receptor agonist class?

A. The patient has a history of irritable bowel syndrome B. The patient has a history of medullary carcinoma of the thyroid C. The patient has a history of invasive ductal carcinoma in situ D. The patient has a history of gastroesophageal reflux disease

4. Which of the following statements is the most accurate about insulin therapy when used with incretin therapy?

A. Insulin is only approved for use with DPP-4 inhibitors and not with GLP-1 receptor agonists B. Only long-acting (basal) insulin is approved for use with incretin therapy C. Insulin therapy can be used with an incretin only if the patient has not had any episodes of hypoglycemia with an incretin therapy D. Incretin therapy should be started after insulin therapy for the maximum benefit

5. Which of the following statements is the most accurate in regards to incretin therapy, whether DPP-4 inhibitors or GLP-1 receptor agonists?

A. Both types of incretin therapy have a high rate of hypoglycemia B. Both types of incretin therapy work well with metformin C. Neither type of incretin therapy has gastrointestinal side effects D. Neither type of incretin therapy has any cardiovascular benefits

6. When adding an incretin therapy to insulin therapy in your practice, it is best to:

A. Halve the incretin therapy and then titrate it along with the insulin to achieve the target A1c B. Switch from a long-acting insulin to a rapid-acting insulin when starting an incretin therapy and return to a long-acting insulin once glucose levels are within the target glucose range C. Use a specific and simple reduction in insulin for the patient when starting the incretin therapy and increase the insulin dose as needed for appropriate glucose control D. Stop the incretin therapy once target glucose control has been achieved and then titrate the insulin regimen further for glucose control

7. Which of the following is the most accurate statement to make in regards to managing side effects with incretin and long-acting insulin therapies?

A. Both the incretin therapy and insulin therapy should be started simultaneously to minimize hypoglycemia B. If a patient experiences hypoglycemia while on incretin and insulin combination therapy, reducing the dose of insulin is an appropriate next step C. If a patient has any gastrointestinal side effects within the first week of incretin therapy, the incretin therapy should be discontinued and insulin therapy initiated D. Combining incretin therapy with insulin therapy has been shown to magnify side effects, including nausea and hypoglycemia, by more than ten-fold compared to using either therapy alone

8. Based on current American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD) and American Association of Clinical Endocrinologists (AACE) recommendations, incretin therapies can be used at what point of therapy?

A. After a patient has tried and failed therapy with at least two other agents B. After a patient has tried and failed therapy with at least three other agents C. Once a patient has tried insulin therapy and requires additional glucose control D. As monotherapy or as a second-line agent in combination with a different medication

9. The current ADA/EASD and AACE recommendations suggest that an incretin therapy may be useful for patients who are:

A. Concerned about weight gain and hypoglycemia B. Afraid of needles and do not want to start insulin C. Likely to forget to take medication that is needed more than once a day D. Trying to lower their systolic blood pressure by more than 10 mm HG

10. Which of the following statements most accurately describes how agents of the incretin class work?

A. Insulin-secretion is enhanced in a glucose-dependent manner B. Insulin-secretion is enhanced in a glucose-independent manner C. Glucagon-secretion is enhanced in a glucose-independent manner D. Gastric emptying is increased