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Endo Diabetes Practice Questions (Exam 1)

Terms in this set (11)

AW is a 37 yo female with newly diagnosed diabetes. A1c = 7.2%. SCr 0.7 mg/dL. EGFR within normal limits. What medication would be appropriate for her?
A. Sitagliptin
B. Metformin
C. Canagliflozin
D. Rosiglitazone
B. Metformin

1st line therapy + she has good renal function
Five years later AW is still on the medication you selected in question 1. She now needs additional therapy. She is scared of injections and terrified of hypoglycemia. So you recommend from the following options:
A. Alogliptin
B. Glyburide
C. Exenatide
D. Insulin
A. Alogliptin
-a dpp 4 inhibitor + no risk of hypoglycemia

-Glyburide has a risk of hypoglycemia
-Exenatide is injection
-insulin is an injection + risk of hypoglycemia
UG is a 59 yo male who is on metformin 2000mg XR once daily by mouth and dulaglutide. His BP is 130/82. SCr ~1. His provider thinks UG needs another agent added to therapy. Out of the following, you recommend:
A. Sitagliptin
B. Exenatide
C. Dapagliflozin
D. Glipizide ER
C. Dapagliflozin

Not sitagliptin cuz already on GLP1 agonist + can't use a DPP IV inhibitor
No exenatide - it's a GLP1 agonist - already on dulaglutide
No Glipizide ER - no cost concerns + take into account guidelines
What is UG is 69 years old instead of 59. Still on 2000mg XR once daily po and dulaglutide. What if his BP was 110/72 mmHg. SCr ~1. What are your throughts on using your above answer?
He has low blood pressure and is elderly. He should not use Dapagliflozin as this medication can cause hypotension. Monitor blood pressure if he has to use this medication. You could use glipizide , but try the immediate release, not extended release.
MM is a 56 yo female with eGFR ~36 ml/min and CHF. She wants to take an oral medication and is already on 1000mg metformin XR po daily. Which one do you recommend of the choices listed?
A. Canagliflozin
B. Pioglitazone
C. Semaglutide
D. Liraglutide
C. Semaglutide

no Cana cuz she has bad renal function
No pio cuz she has heart failure
Liraglutide is not oral

do not increase Metformin dose because of her kidney function
YE is a 44 yo female on metformin 1000mg po twice daily. Her A1c is 8%. Her BMI is 33. Next best choice for therapy would be out of options given:
A. Glipizide
B. Liraglutide
C. Insulin
D. Linagliptin
B. Liraglutide (a GLP1 agonist + best weight loss)

Glipizide is a sulfonylurea
Linagliptin is a DPP4 inhibitor
OP is a 49 yo male newly diagnosed with diabetes. A1c is 12.4%, SCr 0.6. He only wants to be on one medication. The most appropriate medication would be:
A. Sitagliptin
B. Metformin
C. Dapagliflozin
D. Insulin
D. Insulin

No metformin because only a small A1C decrease before having to add another medication
Patient's A1C is very high
A provider decides to put a patient on a GLP-1 agonist. The patient wants a once a week medication. Which one of the following would be appropriate?
A. Exenatide/byetta
B. Exenatide/bydrueon
C. Liraglutide
D. More than one of the above
B. Exenatide/bydrueon

A is BID
C is daily
GH is a 55 yo male newly diagnosed diabetic. A1c is 7.3%. EGFR is 36 ml/min. The doctor wants to start metformin as it is the gold standard and first line treatment. Do you agree with the doctor to start metformin in this patient?
A. Yes
B. No, respectfully disagree
No, respectfully disagree

Egfr is too low for metformin - do not start new patients on metformin with eGFR 30-44
LL is a patient with a high copay for brand name medications. He is already on metformin 850mg TID. What would be the best add on treatment given his situation?
A. SGLT-2
B. DPP4 inhibitor
C. Sulfonylurea
D. GLP-1 agonist
C. Sulfonylurea
DP is an 88 yo female on metformin. Her provider wants to start a sulfonylurea. You recommend:
A. Glyburide
B. Glipizide IR
C. Glipizide ER
D. Glimepride
B. Glipizide IR

Glipizde is best for elderly because it has a short half-life (low risk of hypoglycemia). Don't want the ER cuz of long half-life
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