For last week’s practice question, we quizzed participants on if AACE recommends medications to treat prediabetes. 90% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it by clicking here.
A 36-year-old has an A1C of 6.2%, BMI of 36, hypertension, and a strong family history of type 2 diabetes. Despite sustained nutrition and physical activity interventions, they can’t seem to lower their A1C. They ask whether medication could help reduce their risk of developing type 2 diabetes.
Which approach is MOST consistent with American Association of Clinical Endocrinology (AACE) recommendations?
- A. Avoid pharmacologic treatment until the A1C or FPG reaches the diagnostic threshold for diabetes.
- B. Consider pharmacotherapy, including metformin or GLP-1–based therapy to reduce metabolic risk.
- C. Initiate a sulfonylurea to improve beta-cell function and prevent progression to type 2 diabetes.
- D. Initiate basal insulin to preserve pancreatic beta-cell function and lower A1C.
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 A is incorrect. 5.10% chose this answer: “Avoid pharmacologic treatment until the A1C or FPG reaches the diagnostic threshold for diabetes.”
This may have been true in the past, but both the ADA and AACE now recommend considering pharmacologic treatment in the prediabetes phase to delay or prevent a future diabetes diagnosis.
Answer B is correct. 89.80% of you chose this answer, “Consider pharmacotherapy, including metformin or GLP-1–based therapy to reduce metabolic risk.” Great job! This is the correct answer.
Prediabetes provides an opportunity for active intervention rather than watchful waiting. AACE recommends addressing excess adiposity and associated metabolic complications as part of diabetes prevention. For an individual with obesity and prediabetes, evidence-based obesity pharmacotherapy may be considered alongside nutrition, physical activity, behavioral support, and management of cardiovascular risk factors. Current AACE guidance takes a patient-centered, complication-focused approach to obesity/adiposity-based chronic disease rather than relying on BMI or glucose alone.
Answer C is incorrect. 3.06% of respondents chose this: “Initiate a sulfonylurea to improve beta-cell function and prevent progression to type 2 diabetes.”
Is not the best answer since sulfonylureas aren’t recommended as diabetes-prevention therapy and carry risks including hypoglycemia and weight gain.
Finally, Answer D is incorrect. 2.04% chose this answer, “Initiate basal insulin to preserve pancreatic beta-cell function and lower A1C.”
Not the best answer since insulin is not routinely used to delay progression from prediabetes to type 2 diabetes.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Test You Knowledge Tuesday and participate in this fun learning activity!
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