Question of the Week Rationale – Jan 19th

Question of the Week & Rationale 

Our “Question of the Week” is created weekly by Coach Beverly to cover a variety of Diabetes related topics. The questions are designed to keep you current and prepare you for the CDE® Exam.

To sign up to receive the question of the week, download our free CDE® Coach App or join our Facebook Page

This week’s Rationale: Question of the Week – January 16th – test your knowledge before seeing answer below! 

What a perfect way to information share and bring new concepts to light. We appreciate our community of diabetes educators and the opportunity to keep learning together! 

 


Question:

Semaglutide (Ozempic) is a newly approved GLP-1 Receptor Agonist with a few unique features. Which of the following statements is true about Semaglutide (Ozempic)?

  1. It is available as an oral medication or injectable
  2. It reduces A1c less than other GLP-1 RAs
  3. It is associated with greater weight loss than other GLP-1 RAs
  4. It can be administered via pump

 

 

 

 

 

 

 

 

Correct Answer: c. It is associated with greater weight loss than other GLP-1 RAs

Rationale: Semaglutide (Ozempic,) as an adjunct to diet and exercise for the treatment of type 2 diabetes in adults.

Currently only available as an injection, this once weekly (GLP-1) receptor agonist will be available in 0.5-mg and 1.0-mg doses, via a dedicated prefilled pen device. 

Semaglutide might be more effective than some of its competitors. In the five SUSTAIN efficacy trials, semaglutide reduced hemoglobin A1c by 1.5 to 1.8 percentage points. And, Semaglutide was associated with a 4.5- to 6.4-kg weight loss, more than the other available GLP-1 RAs.

For more info:

Download our updated FREE Injectables PocketCard

Or join our Medication Update webinar! 

 

Meds Update 2018– Earn 1.5 CE – $29

Live webinar session February 19th, 2018 at 11:30 a.m. – 1:15 p.m. PST

Feeling overwhelmed by all the new recently approved diabetes medications? Two bio-similiar insulins are now available and another GLP-1 RA was just approved. Plus, 2 new combo oral meds are now available.

 

If you want cutting edge information on the latest pharmacology and hospital glucose management, we highly recommend this Meds Update.

 

NEW QUESTION OF THE WEEK!  

These questions are created weekly by Coach Beverly to cover a variety of Diabetes related topics. They are designed to keep you current and prepare you for the CDE® Exam. 

Click here to take the question of the week >>  Jan 16th, 2018

Want more questions like this? Really test your knowledge and prepare with our NEW 1 – Year Subscription to our entire Online University course catalog.

Download our CDE® Coach App to receive our Question of the Week on your mobile device.  It’s fun!

 


 

Question of the Week & Rationale 

Our “Question of the Week” is created weekly by Coach Beverly to cover a variety of Diabetes related topics. The questions are designed to keep you current and prepare you for the CDE® Exam.

To sign up to receive the question of the week, download our free CDE® Coach App or join our Facebook Page

This week’s Rationale: Question of the Week – January 9th – test your knowledge before seeing answer below! 

What a perfect way to information share and bring new concepts to light. We appreciate our community of diabetes educators and the opportunity to keep learning together! 


Question: The 2018 ADA Standards of Care include updates to the Cardiovascular Disease and risk management section. Which of the following accurately reflects updates to this section?

a. All hypertensive patients with diabetes should monitor home blood pressure.

b. The new B/P goal is 130/80 to match the American Heart Association’s goal.

c. All patients with type 1 diabetes should be started on an ACE Inhibitor.

d. Beta blockers should be avoided for all patients on insulin therapy.

 

 

 

 

 

 

 

 

 

Correct Answer:  a. All hypertensive patients with diabetes should monitor home blood pressure.

Rationale: 

CV Disease Risk Management – ADA 2018 Update

After the American Heart Association set a new B/P target of 130/80, the diabetes world held their breath to see if the American Diabetes Association (ADA) would follow suit and lower it’s BP target. 

The ADA maintains the B/P target of 140/90, based on a comprehensive review of studies measuring the cost/benefit of blood pressure control in people with diabetes. They specifically summarized the ACCORD BP trial findings (see below paragraph*).

Current ADA Recommendations are as follows:

Hypertension, defined as a sustained blood pressure more than or equal to 140/90 is a major risk factor for both CV and microvascular complications. Numerous studies demonstrate that antihypertensive therapy reduces CV events, heart failure, and microvascular complications.

Screening and Diagnosis Recommendations

  • Blood pressure should be measured at every routine clinical visit. Patients found to have elevated blood pressure (more than or equal to 140/90) should have blood pressure confirmed using multiple readings, including measurements on a separate day, to diagnose hypertension. 
  • All hypertensive patients with diabetes should monitor their blood pressure at home.

As far as answers c and d, they are wrong for the following reasons:

  1.  The ADA no longer recommends automatically starting people with Type 1 Diabetes on an ACE Inhibitor if there is no hypertension or proteinuria.
  2. For patients with diabetes post MI, beta blockers are the B/P medication of choice.  Pts with diabetes on insulin can still experience diaphoresis when hypoglycemic (breakthrough symptom). However, they should be encouraged to check BG on a regular basis and notify provider if BG is running lower than targets.

For more info, see our CV Risk Management Blog Post

 

NEW QUESTION OF THE WEEK!  

These questions are created weekly by Coach Beverly to cover a variety of Diabetes related topics. They are designed to keep you current and prepare you for the CDE® Exam. 

Click here to take the question of the week >>  Jan 9th, 2018

Want more questions like this? Really test your knowledge and prepare with our NEW 1 – Year Subscription to our entire Online University course catalog.

Download our CDE® Coach App to receive our Question of the Week on your mobile device.  It’s fun!

 


 

Question of the Week & Rationale 

Our “Question of the Week” is created weekly by Coach Beverly to cover a variety of Diabetes related topics. The questions are designed to keep you current and prepare you for the CDE® Exam.

To sign up to receive the question of the week, download our free CDE® Coach App or join our Facebook Page

This week’s Rationale: Question of the Week – January 3rd – test your knowledge before seeing answer below! 

What a perfect way to information share and bring new concepts to light. We appreciate our community of diabetes educators and the opportunity to keep learning together! 

 


Question:

The 2018 ADA Standards of Care includes updates to the Pharmacologic Algorithm to manage hyperglycemia for individuals with type 2 diabetes. Which of the following accurately reflects updates to the algorithm?

a. Start insulin therapy if A1c is 9% or greater (26% guessed)

b. Try Lifestyle Management for 3 months before starting metformin (10% guessed)

c. When adding a second agent, consider a medication proven to reduce cardiovascular mortality (61% guessed)

d. Avoid use of all injectables and oral meds that contribute to hypoglycemia (15% guessed)

 

Correct Answer:  c. When adding a second agent, consider a medication proven to reduce cardiovascular mortality

Rationale: 

Stepwise Approach to Pharmacologic Management of Type 2 Diabetes – 2018

Step 1

According to the ADA 2018 Standards, section 8, Metformin therapy should be started along with lifestyle Management at diagnosis of type 2 Diabetes (unless contraindicated).

Metformin is effective, safe, inexpensive and may reduce risk of CV events and death.

Step 2

If A1c target is not achieved after 3 months, consider metformin and any one of the six preferred treatment options based on drug specific effects and patient factors.

If A1c target is still not achieved after 3 months on metformin, and the patient has CV Disease, consider adding a second agent with evidence of cardiovascular risk reduction (based on drug specific effects and patient factors).

These include:

  • SGLT-2 Inhibitors – empalgliflozin (Jardiance) and canagliflozin (Invokana)
  • GLP-1 Receptor Agonist – liraglutide (Victoza)

Step 3

If A1c target is still not achieved after 3 months, combine metformin plus two other agents for a three-drug combination.

Step 4  

If A1c target is still not achieved after 3 months, add combination injectable therapy to the three-drug combination.

For all steps, consider including medications with evidence of CV risk reduction, based on drug specific effects and patient factors.

Medication Therapy Based on A1c

  • If A1c is less than 9%, consider monotherapy
  • If A1c is greater than or equal to 9% consider dual therapy
  • If A1c is greater or equal to 10%, or if BG 300 or more, or pt is markedly symptomatic, consider insulin and injectable therapy.

Want to learn more about this topic?

 


 

NEW QUESTION OF THE WEEK!  

These questions are created weekly by Coach Beverly to cover a variety of Diabetes related topics. They are designed to keep you current and prepare you for the CDE® Exam. 

Click here to take the question of the week >>  Jan 3rd, 2018

Want more questions like this? Really test your knowledge and prepare with our NEW 1 – Year Subscription to our entire Online University course catalog.

Download our CDE® Coach App to receive our Question of the Week on your mobile device.  It’s fun!

 


 

Question of the Week & Rationale 

Our “Question of the Week” is created weekly by Coach Beverly to cover a variety of Diabetes related topics. The questions are designed to keep you current and prepare you for the CDE® Exam.

To sign up to receive the question of the week, download our free CDE® Coach App or join our Facebook Page

This week’s Rationale: Question of the Week – December 12th – test your knowledge before seeing answer below! 

What a perfect way to information share and bring new concepts to light. We appreciate our community of diabetes educators and the opportunity to keep learning together! 


Question:

A patient has prediabetes and asks you if he can prevent getting diabetes if he loses weight and gets active. What is the most accurate response?

a. By losing visceral fat and walking, you can prevent diabetes.

b. By taking care of your health today, you won’t get diabetes tomorrow.

c. People who get 30 mins of exercise a day and lose 7% of weight, have a decreased risk of getting diabetes.

d. People who get 30 mins of exercise a day and lose 7% of weight eliminate risk of getting diabetes

Correct Answer:  People who get 30 mins of exercise a day and lose 7% of weight, have a decreased risk of getting diabetes.

Rationale: Wow, 92% of you got this one right. Great job!

The Diabetes Prevention Program demonstrated that people with prediabetes who got active and lost 7% of their body weight, decrease risk of getting diabetes over 3 years, by 58%.  And if they were 60 and older, they decreased risk by 70%.

 For more information on starting  a Diabetes Prevention Program in your community, please visit our Prevention Resource Page.

 

NEW QUESTION OF THE WEEK!  

These questions are created weekly by Coach Beverly to cover a variety of Diabetes related topics. They are designed to keep you current and prepare you for the CDE® Exam. 

Click here to take the question of the week >>  

Want more questions like this? Really test your knowledge and prepare with our NEW 1 – Year Subscription to our entire Online University course catalog.

Download our CDE® Coach App to receive our Question of the Week on your mobile device.  It’s fun!

 


 

Question of the Week & Rationale 

Our “Question of the Week” is created weekly by Coach Beverly to cover a variety of Diabetes related topics. The questions are designed to keep you current and prepare you for the CDE® Exam.

To sign up to receive the question of the week, download our free CDE® Coach App or join our Facebook Page

This week’s Rationale: Question of the Week – December 5th – test your knowledge before seeing answer below! 

What a perfect way to information share and bring new concepts to light. We appreciate our community of diabetes educators and the opportunity to keep learning together! 

 

 


Question:

What best describes the elements of the CDC Diabetes Prevention Program?

a. Includes 16 weekly sessions followed by at least 6 monthly meetings.

b. Sessions must be taught by at least one licensed health care professional (RN, RD, PharmD etc.)

c. Pediatrics and adults with prediabetes can participate in the program.

d. A physician’s referral is required to participate in the Prevention Program.

Correct Answer:  Includes 16 weekly sessions followed by at least 6 monthly meetings.

Rationale: The CDC Approved Diabetes Prevention Program includes weekly meetings for the first 16 weeks within the first 6-month window and 6 monthly meetings in the last half of the year.

The sessions can be led by non-licensed life coaches such as community health workers, volunteers or educators who have completed a certified training for the Prevention Program.  Trained licensed personnel can also deliver the program.

Only overweight adults over the age of 18 can be admitted to the program and no physician’s referral is required.  This program is designed to be accessible for everyone.

For more information, please visit our Diabetes Prevention Program Resource Page.


 

NEW QUESTION OF THE WEEK!  

These questions are created weekly by Coach Beverly to cover a variety of Diabetes related topics. They are designed to keep you current and prepare you for the CDE® Exam. 

Click here to take the question of the week >> December 5th, 2017

Want more questions like this? Really test your knowledge and prepare with our NEW 1 – Year Subscription to our entire Online University course catalog.

Download our CDE® Coach App to receive our Question of the Week on your mobile device.  It’s fun!