Management of Complex Diabetes Cases

1. To initiate medication therapy to manage hyperglycemia in patients with diabetes, start metformin if the patient’s HgbA1c is greater than the target A1c, but less than 9%.

a) True
b) False

2. Primary prevention aspirin therapy for patient with increased risk of ASCVD is to provide 75-162 mg aspirin daily, if they are not at increased risk of bleeding.

a) True
b) False

3. According to the ADA, 2019 Diabetes Standards of Medical Care, the recommendation for the treatment of confirmed hypertension in people with diabetes with an initial BP of less than to 160/100mmHg and no Albuminuria is to start one of the following medications: ACEi, ARB, CCB or Diuretic.

a) True
b) False

4. According to the DDTP Type 2 Diabetes –Lipid & Aspirin recommendations, the following statin medications/doses are considered moderate intensity: Atorvastatin 10-20mg, Rosuvastatin 5-10mg, Simvastatin 20-40mg, Pravastatin 40mg, Lovastatin 40-60mg, or Fluvastatin 60mg

a) True
b) False

5. Which of the following did the presenter call “Back to the Basics” when meeting with a patient in a clinical setting?

a) Assess and treat the “whole” person-spiritual, cultural, emotional, social, as well as physical
b) Prioritize care according to what is important to the patient
c) Assess and address health disparities
d) If possible, involve the family in the care
e) Establish a healthy, trusting rapport with the patient
f) Involve the patient in establishing the plan of care
g) Assess readiness to learn and readiness to provide self-care
h) Practice active-listening
i) Individualize care and set realistic goals-know when to be more stringent or less stringent with treatment goals
j) All of the above.

6. In addition to a medical history and physical, it may also be necessary to obtain patient information about which of the following in order to establish treatment goals and a plan of care:

a) Medication compliance
b) Food availability, eating patterns, nutritional status
c) Relationship with significant other and other support systems
d) Employment/financial situation
e) Substance abuse
f) Needle phobias
g) Preconceived ideas of diabetes and treatment for hyperglycemia
h) Access to care
i) Spiritual and cultural beliefs
j) Transportation
k) History of depression, anxiety, etc.
l) All of the above.