1. The GLP-1 receptor agonists exert their physiologic action by all of the following EXCEPT:
A. Increased glucose-dependent insulin secretion from the pancreas
B. Decreased inappropriate glucagon secretion during hyperglycemia
C. Increased urinary glucose output
D. Slowed gastric emptying
E. Unsure
2. Which of the following is an advantage of the GLP-1 receptor agonists?
A. They only increase weight by 2-3 pounds on average
B. They are inexpensive compared to most other second-line therapies
C. They improve the lipid profile by increasing HDL and decreasing LDL
D. They have a low risk of hypoglycemia
E. Unsure
3. Which of the following GLP-1 receptor agonists primarily targets post-prandial glucose levels?
A. Exenatide XR
B. Exenatide
C. Liraglutide
D. Dulaglutide
E. Unsure
4. Which of the following statements is true about the availability and administration of different GLP-1 receptor agonist products?
A. Exenatide should be administered once daily at least 1 hour before breakfast.
B. Liraglutide is available in a pre-filled, multi-use pen device; the patient must dial the pen to the desired dose.
C. Lixisenatide should be administered once weekly at least 1 hour before breakfast on the same day each week.
D. Dulaglutide is available in a pre-filled, multi-use pen device; the patient must dial the pen to the desired dose.
E. Unsure
5. Which of the following statements most accurately describes the potential role of the newly approved oral GLP-1 receptor agonist semaglutide for the treatment of type 2 diabetes?
A. It may be a good alternative for a patient who experienced nausea with two other GLP-1 receptor agonists
B. It may be a good alternative for a patient who has trouble using an injectable pen device due to poor dexterity
C. It may be a good alternative in patients with adherence issues who wish to take all of their medications at once in the morning
D. It may be a good alternative in patients with ASCVD because it lowers the risk of major CV events
E. Unsure
6. Which of the following statements most accurately describes a disadvantage of the injectable GLP-1 receptor agonists?
A. They cannot be used with basal insulin because the risk of hypoglycemia is too high with that combination
B. They have a high risk of hypoglycemia which should be avoided in patients with type 2 diabetes
C. They must be given via subcutaneous injection which could be difficult for patients who are resistant to injections
D. They have a high risk of causing hypothyroidism which is a common comorbidity of type 2 diabetes
E. Unsure
7. Which of the following GLP-1 receptor agonists is administered once weekly?
A. Dulaglutide
B. Liraglutide
C. Lixisenatide
D. Oral semaglutide
E. Unsure
8. Which of the following statements is TRUE when comparing GLP-1 receptor agonists to other medication classes used to treat type 2 diabetes?
A. GLP-1 receptor agonists are less effective at lowering A1C compared to basal insulin
B. GLP-1 receptor agonists are equally effective at lowering weight compared to DPP-4 inhibitors
C. GLP-1 receptor agonists are less effective at lowering A1C compared to sulfonylureas
D. GLP-1 receptor agonists are more effective at lowering A1C compared to DPP-4 inhibitors
E. Unsure
9. Which of the following statements is TRUE regarding differences between injectable GLP-1 receptor agonists within the class?
A. Exenatide XR is more effective at lowering A1C compared to semaglutide
B. Exenatide XR has the highest rate of GI adverse effects in the class
C. Semaglutide is more effective at lowering A1C compared to dulaglutide
D. Semaglutide has the lowest rate of GI adverse effects in the class
E. Unsure
10. Which of the following statements is TRUE regarding new agents or new indications for medications for the treatment of type 2 diabetes?
A. The fixed-ratio combination lixisenatide + insulin glargine recently gained an expanded indication for use in children and adolescents aged 10-17
B. Exenatide recently gained an expanded indication for use in children and adolescents aged 10-17
C. Oral semaglutide was recently approved for use in adults with type 2 diabetes who have failed injectable GLP-1 receptor agonist therapy
D. The fixed-ratio combination liraglutide + insulin degludec recently gained an expanded indication for use in adults with type 2 diabetes as adjunct to diet and exercise
E. Unsure
Evaluation Questions
11. Review new and emerging GLP-1 RAs for cardiovascular and renal benefits for patients with type 2 diabetes
A. Always
B. Most of the Time
C. Sometimes
D. Never
12. Develop individual treatment plans based on 2020 ADA Standards of Medical Care in Diabetes when considering GLP-1 RAs
A. Always
B. Most of the Time
C. Sometimes
D. Never
13. Educate patients and family about tolerability and self-injection techniques
A. Always
B. Most of the Time
C. Sometimes
D. Never