1. Please refer to the following CASE scenario when answering Questions 1 and 2:
RJ is a patient with type 2 diabetes (T2D) and obesity who is not yet reaching his individualized A1C goals. He is currently managed on monotherapy with metformin 1000 mg twice daily. Through a process of shared decision making, RJ states that he would prefer to try a once-weekly GLP-1 RA with the greatest potential for weight loss.

Which of the following agents is a once-weekly GLP-1 RA?

2. Which of the following GLP-1 RA products is ranked by the American Diabetes Association (ADA) as having the greatest potential for weight loss?

3. TL is a patient with T2D and established atherosclerotic cardiovascular disease (ASCVD). His primary care provider would like to start him on a GLP-1 RA and has asked if any of the currently available agents carry an indication to reduce the risk for major adverse cardiovascular events (MACE) in adults with T2D and established cardiovascular (CV) disease. Which of the following agents currently carries such an indication?

4. BS is a patient with T2D considering treatment with an injectable GLP-1 RA. While BS is not opposed to injections, he would prefer a single-dose injection device, so he doesn't have to deal with pen needles. Which of the following products is available commercially in a single-dose pen device that does not require use of pen needles?

5. ZK is a patient with T2D. She was recently hospitalized with heart failure (HF). Per recommendations from the ADA, an agent from which of the following medication classes would be preferentially recommended for ZK, independent of her current A1C?

6. A patient with T2D, CKD, and albuminuria (UACR = 320 mg/g) is not meeting his individualized glycemic targets despite treatment with metformin and dapagliflozin. Which of the following would be preferentially recommended by KDIGO as the next add-on glucose-lowering agent in this patient?

7. JW is a patient with T2D. His current A1C is 7.7% despite treatment with metformin ER 1000 mg twice daily. JW does not have a history of ASCVD, HF, or CKD, and is not considered high risk for these comorbidities. In the absence of these compelling indications, all of the following are recommended as key considerations by the ADA when selecting an add-on glucose-lowering agent to lower A1C, EXCEPT:

8. Please refer to the following CASE scenario when answering Questions 8 and 9:
GR is a patient with T2D and established ASCVD. It is determined she could benefit from the addition of a GLP-1 RA or SGLT2 inhibitor to mitigate her CV risk.

A history of which of the following may prompt use of a GLP-1 RA over a SGLT2 inhibitor?

9. Upon review of GR's labs, her most recent eGFR was 48 mL/min/1.73m2 and her most recent UACR was 320 mg/g. In consideration of her T2D, established ASCVD, and CKD, which of the following medications would be preferred per current guideline recommendations?

10. BB is a patient with T2D who has failed to meet his individualized glycemic goals despite triple oral glucose-lowering therapy. His provider has recommended that an injectable glucose-lowering agent be started to help lower his A1C. Which of the following does the ADA recommend as the first injectable agent in most patients with T2D?

Evaluation Questions

11. How confident are in your treatment choices for the patients in this test?

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