For Question of the week, test takers usually choose the correct answer 70-80% of the time. However, for this Tuesday’s question of the week, only about 23% of respondents chose the correct answer.

So, we thought this would be a perfect opportunity for another answer rationale. We’ll explore this question and the best answer in more detail and throw in some test-taking tips along the way.

Question of the week on October 8:

The American Diabetes Association recommends which of the following interventions to decrease risk of cardiovascular disease?

Answer Options:

1. Maintain B/P less than 130/80 for people with type 1 and type 2 diabetes
2. Start statin on 42-year-old with diabetes and no history of cardiovascular disease
3. If an ACE-Inhibitor fails to achieve B/P targets, add a Angiotensin Receptor Blocker (ARB)
4. Aspirin therapy is recommended for individuals over age of 40 with type 2 diabetes

As shown above, the most common choice was option 1, the second most common answer was option 3, then option 2, and finally option 4.

For this question, a key consideration is what “The American Diabetes Association recommends.” This focus helps test takers hone in on ADA Standards.

Option 1 is juicy but incorrect. The ADA standard for individuals without cardiovascular disease risk or history is to maintain a B/P of less than 140/90. The blood pressure target in Option 1 of 130/80, is the B/P target for individuals with cardiovascular disease or a 10 year CVD risk of 15% or greater. The general goal for people with diabetes is to keep B/P less than 140/80. However, for those with a higher risk of CV events, the target is 130/80. Blood pressure targets are based on the individual assessment of risk.

Option 3 is incorrect because ACE-Inhibitor and Angiotensin Receptor Blockers should not be paired together. Option 3 says “add a Angiotensin Receptor Blocker” not switch to. Giving an ACE and and ARB together is not recommended due to potential renal issues.

Option 4 is incorrect because aspirin therapy is recommended for individuals over the age of 50 with CV risk factors.

Option 2 is the best answer. The standard for people with diabetes who are over the age of 40 is to start a statin to reduce the risk of cardiovascular disease. No CVD history is required to initiate statin therapy in this standard for people over the age of 40 with either type 1 or type 2.

For more info, here is a link to ADA’s Standard Ten. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2019

Our DiabetesEd Online University also offers courses on Standards of Care and Cardiovascular Disease. Check it out here!

We hope you appreciate this week’s rationale and keep studying hard! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

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