We want to fix our mistake and clarify this important information. For last month’s practice question, a participant reached out to us and kindly shared that one of the medications listed was actually recently approved by the FDA for kids ages 10-17. We want to make this right, so you can pass on updated info to people living with diabetes and your colleagues, plus prepare for exam success! Look for 2 correct answers and explanations for this Rationale of the Week.

Question: KS is 14 years old and recently diagnosed with type 2 diabetes. Their A1C is 8.6%, LDL cholesterol is 137 mg/dL and their GFR is greater than 90.

Based on this clinical information and the ADA Standards for Pediatric Care, in addition to lifestyle and behavior changes, what medication(s) would be recommended?

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

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Based on this clinical information and the ADA Standards for Pediatric Care, in addition to lifestyle and behavior changes, what medication(s) would be recommended?

Answer Choices:

1. Dulaglutide (Trulicity) and Metformin
2. Metformin and an ACE Inhibitor
3. Exenatide XR (Bydureon) and a statin
4. Empagliflozin (Jardiance) or Metformin

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Getting to the Best Answer

If you are thinking about taking the certification exam, 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” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.

Answer 1 is CORRECT. 23.08% chose this answer. “Dulaglutide (Trulicity) and Metformin.” Both metformin and Dulaglutide (Trulicity) are FDA approved for children starting at age of ten. Dulaglutide was recently FDA approved for pediatrics up at doses up to 1.5 mg per week. We have updated our eMed PocketCards to include this GLP-1 RA as approved for kids ages 10-17.

Answer 2 is incorrect. 16.62% of you chose this answer. “Metformin and an ACE Inhibitor.” Although this answer if tempting, because metformin is FDA approved for children starting at age of ten, there is no mention of hypertension that would justify starting an ACE Inhibitor. See Med PocketCards. For this reason, this is not the best answer.

Answer 3 is CORRECT. About 39.36% of respondents chose this. “Exenatide XR (Bydureon) and a statin.” YES, this is the BEST answer. GREAT JOB. Two of the GLP-1 RA’s are approved for kids including exenatide XR and liraglutide. See Med PocketCards. In addition, statins are indicated for children age 10 or greater if they have diabetes and an LDL cholesterol of 130 mg/dL or greater.

Finally, Answer 4 is incorrect. 20.93% chose this answer. “Empagliflozin (Jardiance) or Metformin.” Although this answer if tempting, because metformin is FDA approved for children starting at age of ten, none of the SGLT-2’s are approved for pediatrics, including empagliflozin. See Med PocketCards. For this reason, this is not the best answer.

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! For more information, see ADA Standard 14 on Children and Adolescents or join our webinar (see below).

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Want to learn more about this question? Enroll in our

Level 2 | From Tots to Teens | Diabetes Standards | 1.5 CEs

This course includes updated goals & guidelines for children living with type 1 or type 2 diabetes. This course discusses the special issues diabetes educators need to be aware of when working with children with diabetes & their families. We discuss the clinical presentation of diabetes, goals of care, & normal growth & development through the early years through adolescence. Strategies to prevent acute & long-term complications are included with an emphasis on positive coping for families & children with diabetes.

Objectives:

1. Discuss the goals of care for Type 1 and Type 2 Kids with Diabetes.
2. State Strategies to prevent acute and chronic complications.
3. Discuss the importance of positive psychosocial adjustment & resources.

Intended Audience: A great course for healthcare professionals seeking information about providing care for children with diabetes and their families.

Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University.

All hours earned count toward your CDCES Accreditation Information

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The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.