1. For questions 1 and 2, please consider the following scenario:
SS is a patient with type 2 diabetes. SS’s provider would like to initiate him on a GLP-1 receptor agonist to both help lower his hemoglobin A1c (A1C) and assist him with weight loss. SS is currently managed on metformin 1000 mg twice daily, sitagliptin 100 mg once daily, and pioglitazone 45 mg once daily. SS’s point-of-care A1C today is 7.7%.

If SS is started on a GLP-1 receptor agonist, which of his background glucose-lowering medications should be discontinued?

2. SS's physician would like a recommendation for a once-weekly injectable GLP-1 receptor agonist with the highest potential for weight loss. Which injectable once-weekly GLP-1 receptor agonist does the American Diabetes Association (ADA) rank as the agent with the best efficacy for weight loss?

3. A patient with type 2 diabetes is currently well managed on exenatide XR 2 mg once weekly without report of gastrointestinal adverse events. Due to a change in the patient's insurance, he will be switching to dulaglutide 1.5 mg once weekly. Which of the following would be the most appropriate advice to the patient about when to take his first injection of dulaglutide?

4. Which of the following GLP-1 receptor agonists has been associated with the development of subcutaneous nodules at the injection site?

5. Your family medicine physician colleague is questioning the cardiovascular (CV) benefits of GLP-1 receptor agonists in terms of dose. He asks if CV benefit is greater at the highest recommended dose or if there is benefit at the lower doses as well. Which statement below is the most appropriate reply?

Evaluation Questions

6. How confident are in your treatment choice for SS?

7. How confident are in your treatment choice for your diabetes patient who is switching to dulaglutide?

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