Our September 14th Question of the week quizzed test takers on a new med. Less than half, 47% of respondents, chose the correct answer. This was a hard question since this finerenone was only recently FDA approved. We are excited to share info about this med along to you, so you can pass on correct info to people living with diabetes and kidney disease.

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question

Question: JR has a GFR of 43 and lives with type 2 diabetes.  JR excitedly brings you an article that talks about finerenone (Kerendia), a newly approved non-steroidal mineralocorticoid receptor antagonist which is indicated for people with chronic kidney disease (CKD) associated with Type 2 diabetes.

If JR is started on this medication, what instruction would you provide?

Answer Choices:

• Make sure to take this medication on an empty stomach
• Contact the provider if you notice ankle swelling
• Notify your provider if you experience a non-productive cough
• Avoid taking medication with grapefruit or grapefruit juice.

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

Getting to the Best Answer

If you are thinking about taking the certification exam, it is helpful to know about newly approved diabetes medications, although it may take at least a year to appear in exams. However, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” that seem so familiar to you, right under your nose. Your job is to weed through the to choose the BEST answer.

Answer 1 is incorrect. 12.5% chose this answer, “Make sure to take this medication on an empty stomach.” If you don’t know anything about a particular medication and are forced to guess, this answer is pretty unlikely to be the best answer, for one reason. Most meds don’t need to be taken on an empty stomach. Two diabetes related meds, levothyroxine and oral semaglutide DO need to be taken on an empty stomach, but an empty stomach is not required for most other meds. Finerenone can be taken with or without food.

Answer 2 is incorrect. 27.8% of you chose this answer, “Contact the provider if you notice ankle swelling.” This was another juicy answer that we purposefully included. There is a class of diabetes medications, the TZDs (pioglitazone and rosiglitazone) that can cause ankle swelling, so this answer might have seemed familiar to you. Also when trying to find false answers, you may want to consider that it seems unlikely that a medication that slows kidney failure would have edema as a side effect.

Answer 3 is incorrect. 12.2% chose this answer, “Notify your provider if you experience a non-productive cough.” This juicy answer goes with a common blood pressure medication class, ACE Inhibitors, that people with diabetes are often prescribed to manage hypertension. With finerenone, the major consideration is monitoring the potassium in the first month of initiation.

Answer 4 is correct. 47.5% of respondents chose this answer, “Avoid taking medication with grapefruit or grapefruit juice.” GREAT JOB, this is the best answer. Since finerenone is a CYP3A4 substrate, the package insert recommends to avoid taking finerenone with other strong cype3A4 inhibitors. It also advises to avoid taking finerenone with grapefruit or grapefruit juice. Great job!

Want to learn more about finerenone?

Check out our New Updated Med Cheat Sheets 2021 (page 2) and consider attending our Virtual Conference with Dr. Diana Isaacs, who will speak more to this topic. You can also check out our Blog Post on New Meds for Diabetes.

We hope you appreciate this week’s rationale! 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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• Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES – Educator of the Year, 2020
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CEs: Includes over 30 CEs
Program Info: 2021 Diabetes Educator Course Flyer & Schedule (subject to change)
Speakers: View Conference Faculty.
Dates: Your registration fee includes access to FREE podcast and all recorded webinars for one year.

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Virtual DiabetesEd Specialist Conference Deluxe | Oct. 6-8 | 30+ CEs

Deluxe Virtual Program for $459 includes:

• Presentations by our team of experts
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2021 Diabetes Educator Course Flyer & Schedule (subject to change)

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Virtual DiabetesEd Specialist Conference Basic | Oct. 6-8 | 30+ CEs

Basic virtual program for $359 includes:

• Presentations by our team of experts
• Q & A Session with the instructor after each webinar
• State-of-the-art review of current diabetes care and technology.
• Resources for each session
• Access to FREE podcast and recorded webinars within a week of each live session for one full year.

2021 Diabetes Educator Course Flyer & Schedule (subject to change)

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Team of Experts: Our team of expert faculty has been fine-tuning this course for over fifteen years and we know what you need to succeed! In addition to informative lectures, we also use group activities and case studies to highlight the essential knowledge, skills, and strategies needed to succeed in diabetes education today!

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Bonus Courses worth 12+ CEs, FREE

When you register for our Virtual Course, you have immediate access to these Bonus DiabetesEd University Online Courses – for FREE!

• Test Taking Toolkit – Over 200 sample test questions!
• Level 2 – Assessing and Promoting Well-Being: From Population Health to a Person-Centered Approach 1.5 CEs
• Level 2 – Hospital and Hyperglycemia 1.5 CEs
• Level 2 – Hyperglycemic Crisis, DKA and HHS Standards 1.0 CEs
• Level 2 – Meds Management Update for Type 2 – 1.5 CEs
• Level 2 – Setting up a Successful Diabetes Program 1.5 CEs
• Level 2 – Pregnancy and Diabetes 1.5 CEs
• Level 2 – From Tots to Teens – Diabetes Standards 1.5 CEs
• Level 2 – Older Adults and Diabetes 1.5 CEs
• Mindfulness and Compassion in the Diabetes Encounter – 1.0 CE

2021 Diabetes Educator Course Flyer & Schedule (subject to change)

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