1. The goal glucose in non-critically ill hospitalized patients on insulin therapy, defined by the American Association of Clinical Endocrinologists (AACE) and the American Diabetes Association (ADA) consensus statement on inpatient glycemic control published in 2009, should be:
A. Less than 140 mg/dL as possible prior to meals
B. Between 140 mg/dL and 180 mg/dL
C. Achieved using a sliding-scale subcutaneous (SC) insulin regimen
D. Less than 200 mg/dL
2. Most patients will require ___ insulin orders to effectively attain ADA and AACE glycemic goals while minimizing the risk of hypoglycemia.
A. 1
B. 2
C. 3
D. 4
3. Although the insulin required for patients varies substantially, when initiating SC insulin therapy for most patients in the inpatient setting, a conservative standard starting estimate for a total daily dose is:
A. 0.1 – 0.3 U/kg
B. 0.2 – 0.5 U/kg
C. 0.5 – 1.0 U/kg
D. 0 – 1.5 U/kg
4. When initiating SC insulin therapy in the inpatient setting, it is important to consider which of the following factor(s):
A. The patient's prior home regimen and level of glucose control (if applicable)
B. Nutritional and clinical status
C. Concomitant medications
D. All of the above
5. Many factors play into the regimen, including home medications, nutritional status, drugs, etc. Adjustments to insulin regimens in response to clinical considerations are:
A. Not typically required for hospitalized patients
B. Occasionally required for hospitalized patients
C. Frequently required for hospitalized patients
D. Not standard of care for hospitalized patients
6. Which one of the following is a risk factor for hypoglycemia:
A. Awake and conversant
B. Nothing-by-mouth status
C. Frequent glucose monitoring
D. Consistent nutritional intake
7. The goal glucose in critically ill hospitalized patients on insulin therapy, defined by the AACE and the ADA consensus statement on inpatient glycemic control published in 2009, should be:
A. Less than 150 mg/dL
B. As close to 90 to 130 mg/dL as possible prior to meals
C. Between 140 mg/dL and 180 mg/dL
D. Achieved using a sliding-scale SC insulin regimen
8. The first step to transitioning from an intravenous to an SC insulin regimen is:
A. Estimate the total daily dose of SC insulin to use
B. Determine the type of insulin to use
C. Order sliding-scale insulin only
D. Stop insulin infusion and follow glucose levels without basal insulin
9. Patients newly diagnosed with diabetes should be discharged:
A. Always on basal, nutritional, and supplemental insulin
B. On a simple regimen and provided close follow-up with a dedicated provider who will closely look after their progress
C. Always on oral therapy
D. With no outpatient follow-up
10. Which of the following is a potential barrier to normoglycemia in hospitalized patients:
A. Use of insulin as primary management
B. Formulary restrictions from the steering committee
C. Metric assessments of protocols
D. Fear of hypoglycemia
Evaluation Questions
11. To what extent did the program meet objective #1?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
12. To what extent did the program meet objective #2?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
13. To what extent did the program meet objective #3?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
14. To what extent did the program meet objective #4?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
15. To what extent did the program meet objective #5?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
16. To what extent did the program meet objective #6?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
17. Rate the effectiveness of how well the program related to your educational needs:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
18. Rate how well the active learning strategies (questions, cases, discussions) were appropriate and effective learning tools:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
19. Rate the quality of the faculty:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
20. Rate the effectiveness and the overall usefulness of the material presented:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
21. Rate the appropriateness of the examination for this activity:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
22. Rate the effectiveness of how well the activity related to your practice needs:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
23. Rate the effectiveness of how well the activity will help you improve patient care:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
24. Will the information presented cause you to change your practice?
A. Yes
B. No
25. Are you committed to making these changes?
A. Yes
B. No
26. As a result of this activity, did you learn something new?
A. Yes
B. No
27. What is your practice setting or area of practice?
A. Community Pharmacy/Independent
B. Community Pharmacy/Chain
C. Hospital/Health Systems
D. Administrative/Pharmacy Director
E. Critical Care Pharmacy
F. Long-term Care
G. Managed Care/PBM
H. Oncology
I. Specialty Pharmacy
J. Industry/Manufacturing
28. How many years have you been in practice?
A. <5
B. 5 – 10
C. 11 – 20
D. >20
E. >20
