1
Q
According to ADA 2026 standards, what is the definition of person-centered care?
A
Care that considers an individual’s comorbidities and prognoses, is respectful of and responsive to individual preferences, needs, and values, and ensures that the individual’s values guide all clinical decisions.
2
Q
What is the ADA 2026 definition of Social Determinants of Health (SDOH)?
A
The economic, environmental, political, and social conditions in which people live.
3
Q
In the context of diabetes management, what is ‘therapeutic inertia’?
A
The failure to initiate or intensify therapy in a timely manner for an individual who has not achieved recommended individualized metabolic goals.
4
Q
A systematic review and meta-analysis of team-based care for adults with diabetes showed what percentage change in A1C?
A
A change of -0.5% (95% CI -0.7 to -0.3).
5
Q
The CINEMA Program demonstrated that team-based care for adults with type 2 diabetes or prediabetes resulted in what absolute reduction in 10-year ASCVD risk?
A
An absolute reduction of -2.4%.
6
Q
Switching to a high-deductible health plan has been shown to increase the risk of what acute diabetes complications?
A
Severe hypoglycemia and hyperglycemic crises.
7
Q
According to ADA 2026 recommendations, health systems should stratify clinical quality data to address gaps in care by what factors?
A
Insurance status, race, ethnicity, preferred language, disability, and social determinants of health.
8
Q
What validated two-item screening tool can be used to assess for food insecurity?
A
1) ‘Within the past 12 months, we worried whether our food would run out before we got money to buy more,’ and 2) ‘Within the past 12 months the food we bought just didn’t last, and we didn’t have money to get more.’
9
Q
What are the four criteria by which diabetes can be diagnosed in nonpregnant individuals?
A
A1C >6.5%,
Fasting Plasma Glucose (FPG) >126 mg/dL,
2-h plasma glucose >200 mg/dL during an OGTT,
or a random plasma glucose >200 mg/dL with classic symptoms of hyperglycemia.
10
Q
In the absence of unequivocal hyperglycemia, how is a diagnosis of diabetes confirmed?
A
It requires two abnormal results from different tests at the same time, or the same test at two different time points.
11
Q
What are the criteria for defining prediabetes based on A1C, FPG, and 2-h PG during an OGTT?
A
A1C 5.7–6.4%, FPG 100–125 mg/dL (IFG), or 2-h PG 140–199 mg/dL (IGT).
12
Q
What condition might be suspected in an adult with slowly progressive autoimmune diabetes, often termed LADA?
A
Type 1 diabetes, as all forms of autoimmune β-cell destruction are included under this rubric regardless of age of onset.
13
Q
Screening for presymptomatic type 1 diabetes involves testing for autoantibodies against which four antigens?
A
Insulin (IA), glutamic acid decarboxylase (GAD), islet antigen 2 (IA-2), and zinc transporter 8 (ZnT8).
14
Q
Immune checkpoint inhibitor (ICI)-induced autoimmune diabetes occurs in what percentage of treated individuals?
A
It occurs in 0.6–1.4% of treated individuals.
15
Q
ICI-induced diabetes is more frequent with agents that block which specific cellular pathway?
A
The programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PDL-1) pathway.
16
Q
For the general population without specific risk factors, at what age should screening for prediabetes and type 2 diabetes begin?
A
Screening should begin at age 35 years.
17
Q
What is the recommended screening interval for prediabetes and type 2 diabetes in people with normal initial results?
A
Repeat screening is recommended at a minimum of 3-year intervals.
18
Q
Hyperglycemia has been reported to occur in what percentage of people receiving systemic anticancer treatment?
A
Hyperglycemia occurs in 15–50% of people receiving systemic anticancer treatment.
19
Q
Pivotal trials of PI3Kα inhibitors (e.g., alpelisib) showed that grade 3 or 4 hyperglycemia emerged in up to what percentage of participants?
A
Up to 36% of participants.
20
Q
What was the median time to onset for alpelisib-induced hyperglycemia in a phase 3 randomized controlled trial?
A
The median time to onset was 13 days.
21
Q
A large meta-analysis reported that the incidence of all-grade hyperglycemia with everolimus (an mTOR inhibitor) was as high as _____.
A
0.27
22
Q
What is the ADA recommendation for influenza vaccination in people with diabetes who are 2-49 years old and not pregnant?
A
They are cautioned against the live attenuated influenza vaccine and recommended to receive the inactive or recombinant influenza vaccination.
23
Q
A patient with diabetes has a T-score of -1.8. Why might they still be at high risk for fracture?
A
Fracture risk in diabetes is influenced by factors beyond bone mineral density (BMD), such as poor bone quality, and is not fully captured by the T-score alone.
24
Q
What duration of type 2 diabetes is associated with a significantly higher fracture risk?
A
A duration of greater than 10 years.
25
In what populations with type 2 diabetes should a DXA scan be considered for monitoring bone mineral density?
In adults aged $\geq$65 years, or in younger individuals ($\geq$50 years) with bone or diabetes-related risk factors like insulin use or diabetes duration >10 years.
26
What is a major risk associated with denosumab use in patients with advanced CKD (eGFR <30 mL/min/1.73 m2)?
A markedly increased risk of hypocalcemia.
27
A post hoc analysis of the FREEDOM trial showed a higher risk of what type of fracture in people with diabetes treated with denosumab?
A higher risk of nonvertebral fractures.
28
In people with diabetes, which is a low-bone-turnover condition, what class of therapy should be considered for very-high-risk individuals for fracture?
Osteoanabolic therapy (teriparatide, abaloparatide, romosozumab).
29
Diabetes is associated with an increased risk of which six types of cancer?
Cancers of the liver, pancreas, endometrium, colon and rectum, breast, and bladder.
30
New onset of atypical diabetes in a middle-aged or older person may precede the diagnosis of what specific cancer?
Pancreatic adenocarcinoma.
31
What is the estimated increased risk of any disability for people with diabetes compared to those without?
There is a 50–80% increased risk of disability.
32
What is the most prevalent type of disability among people with diabetes, affecting 47-84% of this population?
Lower-body functional limitation.
33
What is the effect of successful eradication of Hepatitis C Virus (HCV) on A1C levels in individuals with diabetes?
A meta-analysis found a mean reduction in A1C levels of 0.45%.
34
What is the first-line therapy for erectile dysfunction in men with diabetes?
Phosphodiesterase type 5 inhibitors (PDE5Is).
35
In men with diabetes and symptoms of hypogonadism, when should a total testosterone level be measured?
A morning total testosterone level should be measured.
36
What is the recommendation for screening adults with type 2 diabetes or prediabetes for MASH-related cirrhosis?
Screen with a calculated fibrosis-4 index (FIB-4), even if they have normal liver enzymes.
37
For adults with T2DM or prediabetes, a FIB-4 score of _____ or higher should prompt additional risk stratification with transient elastography or an ELF test.
$\geq$ 1.3
38
Which two classes of glucose-lowering therapies have evidence for histological benefit in MASH?
Pioglitazone and GLP-1 Receptor Agonists (GLP-1 RAs).
39
What is the preferred agent for treating hyperglycemia in adults with type 2 diabetes and decompensated cirrhosis?
Insulin therapy.
40
Is statin therapy safe in adults with type 2 diabetes and compensated cirrhosis from MASLD?
Yes, statin therapy is safe and should be initiated or continued for cardiovascular risk reduction as clinically indicated.
41
What is a potential adverse effect of pioglitazone on weight?
Pioglitazone causes dose-dependent weight gain.
42
According to an NHANES analysis, how does the prevalence of hearing impairment in individuals with diabetes compare to those without?
Hearing impairment was about twice as prevalent in individuals with diabetes.
43
What are the four critical time points when Diabetes Self-Management Education and Support (DSMES) should be provided?
At diagnosis, annually (or when not meeting goals), when complicating factors develop, and when transitions in life and care occur.
44
What is the recommended daily sodium limit for people with diabetes?
Less than 2,300 mg/day.
45
What is the recommended minimum intake of fiber for people with diabetes?
At least 14 g of fiber per 1,000 kcal.
46
Individuals with diabetes on SGLT2 inhibitors at risk for DKA should be educated on risk mitigation and discouraged from what type of eating pattern?
A ketogenic eating pattern.
47
According to the 2026 standards, is supplementation with micronutrients like chromium or herbs like cinnamon recommended for glycemic benefits in people with diabetes?
No, supplementation with these is not recommended for glycemic benefits.
48
Counseling against _____ supplementation is recommended, as there is evidence of harm for certain individuals and no benefit.
β-carotene
49
Periodic testing of vitamin B12 levels should be considered in people taking metformin, particularly in those with what two conditions?
Anemia or peripheral neuropathy.
50
For people with diabetes who consume alcohol, what are the recommended daily limits for men and women?
$\leq$2 drinks a day for men or $\leq$1 drink a day for women.
51
What is the minimum percentage of weight loss from baseline that seems necessary to achieve metabolic improvements in adults with diabetes?
A minimum weight loss of 5% or more.
52
What is the weight loss goal in prediabetes to delay progression to type 2 diabetes?
At least 5–7% from baseline body weight.
53
In the International Diabetes Federation risk assessment for religious fasting, what is the risk score for a patient with Type 1 diabetes?
A risk score of 1.
54
In the IDF religious fasting risk score, what score is assigned for a patient with impaired hypoglycemia awareness?
A score of 6.5, categorizing them as high risk.
55
A fasting risk score of >6.0 indicates what level of risk for a person with diabetes considering religious fasting?
High risk, where fasting is probably unsafe.
56
During religious fasting like Ramadan, how should the dose of basal insulin (excluding ultra-long-acting analogs) be adjusted if the patient is not well managed?
The dose should be reduced by 25–35%.
57
For a patient on twice-daily mixed insulin who is fasting for Ramadan, how should the dose for the meal followed by fasting be adjusted?
The dose should be reduced by 35–50%.
58
According to a meta-analysis, structured exercise interventions of at least 8 weeks have been shown to lower A1C by what percentage in people with T2DM?
By 0.66%, even without a significant change in BMI.
59
Vigorous-intensity aerobic or resistance exercise may be contraindicated in patients with what specific ocular complication of diabetes?
Proliferative diabetic retinopathy or severe nonproliferative diabetic retinopathy.
60
What is the recommended pharmacotherapy for smoking cessation that was found to be most efficacious for people with diabetes in the EAGLES trial?
Varenicline.
61
Recreational cannabis use in any form should be advised against for people with type 1 diabetes due to the risk of what condition?
Diabetic ketoacidosis (DKA), specifically hyperglycemic ketosis.
62
What are the diagnostic criteria for hyperglycemic ketosis cannabis hyperemesis syndrome in a person with type 1 diabetes?
Blood glucose $\geq$250 mg/dL, anion gap >10, serum β-hydroxybutyrate >0.6 mmol/L, pH $\geq$7.4, and bicarbonate $\geq$15 mmol/L.
63
At what minimum frequency should psychosocial screening be implemented for people with diabetes?
At least annually, or when there is a change in health status, treatment, or life circumstances.
64
How does diabetes distress differ from depression and anxiety?
It refers specifically to the emotional burdens and worries associated with living with and managing diabetes, and has unique relationships with glycemia and other outcomes.
65
What is the prevalence of diabetes distress in individuals with type 2 diabetes?
The prevalence exceeds 60%.
66
What is the prevalence of diabetes distress in individuals with type 1 diabetes?
The prevalence surpasses 70%.
67
A systematic review and meta-analysis found the pooled prevalence of anxiety disorders among individuals with diabetes to be what percentage?
0.28
68
A meta-analysis of pharmacologic treatment for depression in adults with diabetes showed a greater reduction in depressive symptoms but no significant improvement in what key glycemic marker?
A1C.
69
What is the median prevalence of insulin restriction for weight control among people with type 1 diabetes?
0.15
70
What two disordered eating behaviors are commonly reported in people with type 2 diabetes?
Binge eating and night eating syndrome.
71
What class of medication was associated with a statistically significant reduction in dementia in a systematic review and meta-analysis?
GLP-1 Receptor Agonists (GLP-1 RAs).
72
Episodes of _____ are independently associated with cognitive decline and are a risk factor for accelerated decline.
severe hypoglycemia
73
What percentage of people with type 2 diabetes are estimated to have obstructive sleep apnea (OSA)?
0.55
74
A systematic review and meta-analysis found that continuous positive airway pressure (CPAP) significantly reduced A1C by what percentage?
0.24%.
75
Two phase 3 RCTs in adults with OSA and obesity showed that what dual incretin agonist significantly reduced sleep apnea severity compared with placebo?
A dual GIP and GLP-1 RA (tirzepatide).
76
In the absence of classic hyperglycemic symptoms, FPG or A1C is typically preferred for routine screening due to _____
ease of administration
77
For some conditions, like cystic fibrosis–related diabetes, the _____ is preferentially recommended for screening due to its higher sensitivity.
2-h PG (OGTT)
78
What is the recommended treatment for individuals with diabetes with impaired hypoglycemia awareness who want to engage in religious fasting?
They are considered high risk (score 6.5) and fasting is probably unsafe; they should be advised against fasting.
79
A patient with T2DM on metformin and a DPP-4 inhibitor wants to fast for Ramadan. How should their medication doses be adjusted?
No dose change is needed for metformin or DPP-4 inhibitors; the timing should be adjusted to coincide with meals.
80
What is the primary rationale for referring people with diabetes to a registered dietitian nutritionist (RDN)?
To provide individualized medical nutrition therapy (MNT).
81
Research confirms that a variety of eating patterns are acceptable for diabetes management, including Mediterranean, DASH, low-fat, and _____ patterns.
carbohydrate-restricted, vegetarian, and vegan
82
What are the common core characteristics among healthful eating patterns recommended for people with diabetes?
Inclusion of nonstarchy vegetables, whole fruits, lean proteins, and minimizing red meat, sugar-sweetened beverages, and processed foods.
83
For men with diabetes and symptomatic hypogonadism, testosterone replacement may improve sexual function, well-being, muscle mass, and _____.
bone density
84
In women with type 1 diabetes, what physical challenges related to sexual health were reported in a qualitative study?
Pain, vaginal dryness, and impaired sensitivity.
85
Which glucose-lowering medication classes lack evidence of benefit in MASH from randomized controlled trials with histological endpoints?
Sulfonylureas, glinides, dipeptidyl peptidase 4 inhibitors, and acarbose.
86
What are the two most prevalent racial/ethnic minoritized groups for diabetes among adults in the U.S. according to the source?
Non-Hispanic Black individuals (17.4%) and non-Hispanic Asian individuals (16.7%).
87
What is a major barrier to high-quality diabetes care described as a delivery system that is often fragmented and lacks clinical information capabilities?
A delivery system that is poorly designed for the coordinated and longitudinal delivery of chronic care.
88
For individuals with diabetes and diabetes-related complications, what specialists should be considered for referral as part of the interprofessional team?
Behavioral health professional, cardiologist, endocrinologist, eye specialist, nephrologist, and podiatrist, among others.
89
For older adults with diabetes, the care team should consider the person's nutritional status, including their ability to afford, acquire, prepare, and _____ nutritious food.
consume (oral health)
90
For pregnant individuals with diabetes, particularly those with type 1 or requiring intensive insulin, what specialist should be part of the care team?
A maternal-fetal medicine specialist or an obstetrician experienced in the care of pregnant individuals with diabetes.
91
What is the ADA's recommendation on the use of telehealth to improve access to care?
Care systems should facilitate both in-person and virtual team-based care.
92
The Joint Commission requires accredited organizations to take specific steps to reduce health care disparities, including designating an individual to lead these efforts and stratifying what type of data?
Quality and safety data using sociodemographic characteristics.
93
What is the ADA 2026 stance on referring people with diabetes to lay health coaches, navigators, or community health workers?
It is recommended to provide additional self-management support from these individuals when available (Grade A evidence).
94
A patient with diabetes reports housing insecurity. Besides stable housing, what specific needs related to diabetes management should be considered?
Secure places to keep medications and supplies, as well as refrigerator access to safely store insulin.
95
What viral family has been associated with type 1 diabetes?
Enteroviruses (e.g., Coxsackievirus B).
96
What type of vaccination is recommended for all adults with diabetes, with an extra dose for pregnant individuals and a booster every 10 years?
Tetanus, diphtheria, pertussis (Tdap).
97
The two-dose Shingrix vaccine is recommended for people with diabetes aged _____.
$\geq$50 years
98
What physical disability is diabetic peripheral neuropathy (DPN) strongly associated with, leading to impaired postural balance and gait kinematics?
Functional disability.
99
How does autonomic neuropathy increase the risk of exercise-induced injury?
Through decreased cardiac responsiveness, postural hypotension, impaired thermoregulation, and greater susceptibility to hypoglycemia.
100
What is the recommended approach for individuals with diabetic autonomic neuropathy before they begin physical activity more intense than usual?
They should undergo cardiac investigation.
101
Use of partial or total _____ is a potential short-term strategy for weight loss, as demonstrated in trials like Look AHEAD and DiRECT.
meal replacements
102
Time-restricted eating has been shown to be safe for adults with type 1 or type 2 diabetes, but those taking _____ should be medically monitored during the fasting period.
insulin and/or secretagogues
103
What is the ADA's advice for people who use e-cigarettes for smoking cessation?
They should be advised to avoid using both combustible and electronic cigarettes, and if using only e-cigarettes, they should be advised to discontinue those too.
104
In individuals with type 1 diabetes, lower executive functioning is linked with more self-management difficulties and elevated _____.
A1C
105
What is the ADA recommendation regarding routine physical activity for people with CKD?
There is no evidence that vigorous-intensity exercise accelerates CKD progression, and no specific exercise restrictions are generally needed.
106
What is the leading cause of morbidity and mortality in people with diabetes?
Atherosclerotic cardiovascular disease (ASCVD).
107
The recommendations for cardiovascular risk factor modification for people with type 1 diabetes are extrapolated from data obtained in which patient population?
Data from people with type 2 diabetes, as no randomized trials have been specifically designed for type 1 diabetes.
108
In people with type 2 diabetes and established heart failure (preserved or reduced ejection fraction), what class of medication is recommended to reduce the risk of worsening heart failure and cardiovascular death?
An SGLT2 inhibitor (including SGLT1/2 inhibitor) with proven benefit in this population.
109
For an individual with diabetes and symptomatic stage C heart failure, what four classes of medications are recommended as guideline-directed medical therapy?
ACE inhibitors or ARBs, MRAs, β-blockers, and SGLT2 inhibitors.
110
In an individual with diabetes and symptomatic stage C heart failure with ejection fraction >40%, what specific type of MRA is recommended to reduce worsening heart failure events?
A nonsteroidal MRA with proven benefit.
111
A serious but infrequent risk associated with SGLT inhibition, particularly in the presence of risk factors like systemic illness or reduced insulin doses, is _____.
diabetic ketoacidosis (including euglycemic ketoacidosis)
112
To minimize the risk of ketoacidosis when using SGLT inhibitors, clinicians should assess susceptibility, provide education, and prescribe home monitoring supplies for what substance?
β-hydroxybutyrate.
113
According to the DCCT, intensive glycemic management in people with type 1 diabetes (mean A1C ~7%) was associated with what magnitude of reduction in microvascular complications?
50–76% reductions in the rates of development and progression.
114
What term describes the enduring microvascular benefits of early intensive glycemic control seen in the DCCT/EDIC and UKPDS follow-up studies, even after glycemic separation between groups disappeared?
Metabolic memory or a legacy effect.
115
The landmark ACCORD trial was stopped early due to a higher mortality rate in the intensive glycemic treatment arm, which was predominantly achieved through greater use of which medications?
Insulin and other medications with a high risk for hypoglycemia.
116
The long-term follow-up of the DCCT cohort (EDIC study) showed that participants in the intensive treatment arm had a significant 57% reduction in what composite cardiovascular outcome?
Nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death.
117
Cardiovascular benefits of SGLT2 inhibitors or GLP-1 RAs are not contingent upon what glycemic metric?
A1C lowering.
118
Level 1 hypoglycemia is defined as a measurable glucose concentration <___ mg/dL and ≥___ mg/dL.
<70 mg/dL (<3.9 mmol/L) and ≥54 mg/dL (≥3.0 mmol/L).
119
What is the glucose threshold for Level 2 hypoglycemia, at which neuroglycopenic symptoms typically begin to occur?
A blood glucose concentration <54 mg/dL (<3.0 mmol/L).
120
How is Level 3 hypoglycemia defined?
A severe event characterized by altered mental and/or physical functioning that requires assistance from another person for recovery, irrespective of the glucose level.
121
What is the strongest risk factor for the recurrence of hypoglycemia in individuals treated with insulin or sulfonylureas?
A prior history of hypoglycemic events, especially level 2 or 3 events.
122
What condition is defined as not experiencing the typical counterregulatory hormone release or associated symptoms at low glucose levels, which dramatically increases the risk for level 3 hypoglycemia?
Impaired hypoglycemia awareness (hypoglycemia unawareness).
123
For older adults with complex health using CGM, what is the recommended percent time in range (70–180 mg/dL)?
Greater than 50% (or 12 hours per day).
124
For older adults with complex health using CGM, time spent in hypoglycemia (<70 mg/dL) should not be more than what percentage or duration per day?
Not more than 1%, or 15 minutes per day.
125
During an intercurrent illness, which two classes of diabetes medications should be considered for holding if oral intake cannot be maintained or there is concern for acute kidney injury?
Metformin and SGLT2 inhibitors.
126
Coadministration of sulfonylureas with which class of antimicrobials can dramatically increase their effective dose and lead to hypoglycemia?
Commonly used antimicrobials like fluoroquinolones, clarithromycin, sulfamethoxazole-trimethoprim, metronidazole, and fluconazole.
127
In clinical trials of SGLT2 inhibitors in adults with type 1 diabetes, a fasting β-hydroxybutyrate of _____ or higher increased the risk of DKA in the next month by 3.2-fold.
0.8 mmol/L
128
In pregnant individuals, diabetic ketoacidosis may present with a glucose level <200 mg/dL, a condition known as what?
Euglycemic DKA.
129
For individuals with overweight or obesity and type 2 diabetes, what is the minimum percentage of weight loss that improves glycemia and other intermediate cardiovascular risk factors?
5–7% of baseline weight.
130
Sustained loss of what percentage of body weight in individuals with T2DM usually confers greater benefits, including disease-modifying effects and possible remission?
>10% of body weight.
131
To achieve significant weight loss with lifestyle programs, a daily energy deficit of ____ kcal/day is recommended.
500–750 kcal/day
132
Effective long-term weight maintenance programs encourage what volume of regular physical activity per week?
200–300 minutes per week.
133
Structured, very-low-calorie meal plans (800–1,000 kcal/day) should generally be prescribed for a short term, up to how many months?
Up to 3 months.
134
In people with type 2 diabetes and overweight or obesity, what two classes of medications are preferred for pharmacotherapy due to their greater weight loss efficacy?
A glucagon-like peptide 1 (GLP-1) receptor agonist or a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist.
135
What is the recommended action regarding sulfonylureas and insulin when adding a GLP-1 RA or dual GIP/GLP-1 RA to a patient's regimen?
Sulfonylureas should be discontinued or the dose reduced, and insulin dosing should be adjusted to avoid hypoglycemia.
136
In the SURMOUNT-2 trial, tirzepatide at 10 mg and 15 mg doses resulted in how much more body weight loss compared to placebo in patients with T2DM?
9.6% and 11.6% more than placebo, respectively.
137
Metabolic surgery should be considered as a weight and glycemic management approach in people with T2DM and a BMI of _____.
≥30.0 kg/m2
138
For Asian American individuals with type 2 diabetes, the BMI threshold for considering metabolic surgery is what?
≥27.5 kg/m2.
139
What is the median disease-free period from diabetes recurrence following Roux-en-Y gastric bypass (RYGB) for individuals who initially achieve remission?
8.3 years.
140
What are three presurgical predictors associated with higher rates of diabetes remission after metabolic surgery?
Younger age, shorter duration of diabetes (e.g., <8 years), and lesser severity of diabetes (not using insulin).
141
What condition, typically presenting >1 year after metabolic surgery, is characterized by a sharp drop in plasma glucose 1-3 hours after a high-carbohydrate meal?
Post–metabolic surgery hypoglycemia.
142
The initial management of post-metabolic surgery hypoglycemia includes education to reduce the intake of what type of nutrients?
Rapidly digested carbohydrates.
143
What technology is recommended to improve safety in individuals with post-metabolic surgery hypoglycemia, especially those with impaired awareness?
Continuous glucose monitoring (CGM).
144
For most adults with type 1 diabetes, why are insulin analogs preferred over injectable human insulins?
To minimize hypoglycemia risk.
145
Which insulin delivery systems are preferred for individuals with type 1 diabetes who can use them safely, as they consistently improve time in range, lower A1C, and reduce hypoglycemia?
Automated insulin delivery (AID) systems.
146
What is the indication for donislecel-jujn, the first FDA-approved allogeneic islet cell therapy?
Treatment of adults with type 1 diabetes unable to reach A1C goals due to repeated episodes of severe hypoglycemia despite intensive management.
147
Under what three conditions should pancreas transplantation be reserved for people with type 1 diabetes?
When undergoing simultaneous kidney transplantation, following kidney transplantation, or for those with recurrent ketoacidosis or severe hypoglycemia despite optimized management.
148
In adults with type 2 diabetes and established or high risk of ASCVD, the treatment plan should include which two classes of medications for comprehensive risk reduction, irrespective of A1C?
A glucagon-like peptide 1 receptor agonist (GLP-1 RA) and/or a sodium–glucose cotransporter 2 (SGLT2) inhibitor.
149
Concurrent use of a GLP-1 RA or a dual GIP and GLP-1 RA with which other class of incretin-based therapy is not recommended?
Dipeptidyl peptidase 4 (DPP-4) inhibitors.
150
For adults with T2DM, combining insulin with which class of medication is recommended for greater glycemic effectiveness, weight benefits, and reduced hypoglycemia risk?
A GLP-1 RA or a dual GIP and GLP-1 RA.
151
In adults with type 2 diabetes and advanced CKD (eGFR <30 mL/min/1.73 m2), which class of medication is preferred for glycemic management and cardiovascular event reduction?
A GLP-1 RA.
152
What is the recommendation for initiating SGLT2 inhibitor therapy with regard to kidney function?
SGLT2 inhibitors can be initiated if the eGFR is above 20 mL/min/1.73 m2.
153
Initial combination therapy should be considered in people with T2DM presenting with A1C levels _____% above their individualized goal.
1.5–2.0%
154
What is the ADA's recommendation regarding the use of compounded GLP-1 and dual GIP/GLP-1 RA products that are not FDA-approved?
Their use is not recommended due to uncertainty about content and concerns about safety, quality, and effectiveness.
155
Use of GLP-1 RAs or dual GIP/GLP-1 RAs may affect the absorption of oral contraception due to their impact on what physiological process?
Gastric emptying time.
156
What contraceptive advice should be given to individuals taking oral contraceptives who are starting or increasing the dose of tirzepatide?
They should use a second form of contraception until the maintenance dose of tirzepatide is achieved and used for at least 4 weeks.
157
In individuals with a history of pancreatitis, use of which classes of diabetes medications should be avoided?
Incretin medications (i.e., GLP-1 RAs, a dual GIP and GLP-1 RA, and DPP-4 inhibitors).
158
What is the preferred and most accurate method for diagnosing posttransplantation diabetes mellitus (PTDM)?
An oral glucose tolerance test (OGTT).
159
In the early postoperative period after transplantation, what is the preferred drug for glycemic management?
Insulin.
160
Individuals with maturity-onset diabetes of the young (MODY) due to HNF1A and HNF4A mutations can initially be treated with what class of medication?
Low-dose sulfonylurea therapy.
161
SGLT inhibitor-associated DKA occurs in approximately what percentage of people with type 1 diabetes?
Approximately 4%.
162
What is the typical presentation of blood glucose in a significant proportion of patients who develop DKA while on SGLT2 inhibitors?
Euglycemic or with glucose levels <250 mg/dL, which can delay diagnosis.
163
A CGM assessment of Time in Range (TIR) is considered useful for clinical management when the CGM is worn for at least ____% of a 10- to 14-day period.
0.7
164
A goal of >70% TIR aligns with an A1C of approximately what value?
∼7% (∼53 mmol/mol).
165
According to the DCCT, further lowering of A1C from 7% to 6% is associated with added reduction in risk of _____ complications, but the absolute risk reductions become much smaller.
microvascular
166
Severe hypoglycemia (Level 3) is strongly associated with what two adverse outcomes?
Cardiovascular events and mortality.
167
What is the recommended screening frequency for impaired hypoglycemia awareness in at-risk individuals?
At least annually and when clinically appropriate.
168
Experiencing one or more episodes of level 2 or 3 hypoglycemia should prompt what action regarding the patient's treatment plan?
Reevaluation of the treatment plan, including deintensifying or switching diabetes medications if appropriate.
169
A high coefficient of variation (>___%) on CGM has been related to an increased occurrence of hypoglycemia.
>36%
170
How does food insecurity affect the risk of hypoglycemia?
It is a major risk factor associated with increased risk of hypoglycemia-related emergency department visits and hospitalizations.
171
In the Obesity chapter, what is the primary recommended action when a person declines or questions anthropometric measurements like weight and height?
The health care professional should be mindful of possible prior stigmatizing experiences, query for concerns, and explain the value of monitoring for treatment decisions.
172
In the Look AHEAD trial, ILI participants who lost ≥10% of their weight at 1 year had what reduction in risk of mortality compared to the control group?
A 21% reduced risk of mortality.
173
According to the POUNDS Lost trial, isocalorically replacing ultra-processed foods with less processed foods resulted in a significant improvement in what body composition metric?
Trunk fat loss.
174
The observed weight loss with obesity pharmacotherapy is typically _____ in people with diabetes compared to those of similar baseline weight without diabetes.
lower
175
In the STAMPEDE trial, after 5 years, what percentage of participants with T2DM treated with RYGB achieved an A1C of ≤6.0%?
0.29
176
The perioperative mortality rate for metabolic surgery is typically 0.1–0.5%, which is similar to what common abdominal procedures?
Cholecystectomy and hysterectomy.
177
In people who have undergone metabolic surgery, there is an increased risk for substance use, new-onset depression/anxiety, and what other serious behavioral health condition?
Suicidal ideation.
178
According to the DCCT, intensive insulin therapy (mean A1C 7.3%) was associated with a higher rate of what adverse event compared to conventional treatment (mean A1C 9.1%)?
Severe hypoglycemia.
179
According to Table 9.2, which GLP-1 RA has demonstrated a benefit for the progression of CKD?
Subcutaneous semaglutide.
180
According to Table 9.2, which DPP-4 inhibitor carries a potential risk for heart failure?
Saxagliptin.
181
What is the recommended first-line agent for people with T2DM and CKD, based on the FLOW trial results?
Semaglutide.
182
In individuals with type 2 diabetes and obesity, which two glucose-lowering agents have the highest efficacy for both glucose lowering and weight loss?
Tirzepatide and semaglutide.
183
Use of CGM is recommended at diabetes onset and thereafter for adults on insulin therapy and on noninsulin therapies that can cause what specific adverse effect?
Hypoglycemia.
184
What is the mechanism by which post-metabolic surgery hypoglycemia occurs?
Altered gastric emptying leads to rapid glucose absorption, excessive GLP-1 secretion, overstimulation of insulin release, and a subsequent sharp drop in plasma glucose.
185
What is the key difference in timing between dumping syndrome and post-metabolic surgery hypoglycemia?
Dumping syndrome usually occurs shortly after a meal and soon after surgery, while post-metabolic surgery hypoglycemia typically presents >1 year after surgery.
186
Term: ASCVD (Atherosclerotic Cardiovascular Disease)
Definition: A history of acute coronary syndrome, myocardial infarction, stable/unstable angina, coronary/arterial revascularization, stroke, or peripheral artery disease.
187
What is the recommended frequency for screening for overweight and obesity using BMI?
Annually.
188
During active weight management treatment, how often should obesity-related anthropometric measurements be monitored?
At least every 3 months.
189
The risk of DKA in people with type 1 diabetes using SGLT2 inhibitors can be ____ times higher than in nonusers.
5–17
190
Which two classes of oral glucose-lowering medications are associated with weight gain?
Insulin secretagogues (sulfonylureas, meglitinides) and thiazolidinediones.
191
In the STEP 2 trial, semaglutide 2.4 mg resulted in a body weight loss of _____% more than placebo after 68 weeks in people with T2DM.
0.062
192
What percentage of individuals experience T2DM relapse at 5 years after surgery with RYGB versus VSG?
Estimated relapse rates are 33.1% for RYGB and 41.6% for VSG.
193
For individuals with type 1 diabetes and recurrent severe hypoglycemia despite optimized management, what two types of transplantation may be considered?
Pancreas transplant alone or human islet transplantation.
194
When should insulin therapy be considered at initiation for a person with type 2 diabetes?
When hyperglycemia is severe, especially with catabolic features (weight loss, ketosis), blood glucose ≥300 mg/dL, or A1C >10%.
195
According to a meta-analysis of four large trials, intensive glycemic management in T2DM led to a significant reduction in what specific macrovascular event?
Myocardial infarctions.
196
Which of the following is NOT a major risk factor for hypoglycemia: food insecurity, kidney failure, neuropathy, or impaired hypoglycemia awareness?
Neuropathy is listed as an 'other risk factor', not a 'major risk factor'.
197
In older adults, poor cognitive function is a risk factor for what acute diabetes complication?
Severe hypoglycemia.
198
When initiating or escalating doses of a GLP-1 RA in a patient with kidney impairment, what should be monitored if they report severe adverse GI reactions?
Kidney function.
199
At 5 years post-surgery, what was the average total body weight loss for patients who underwent RYGB versus VSG in the PCORnet analysis?
24.1% for RYGB and 16.1% for VSG.
200
Which medication for post-metabolic surgery hypoglycemia works by slowing carbohydrate absorption?
Acarbose.
201
What is the primary treatment for cystic fibrosis-related diabetes?
Insulin therapy.
202
In the T1D Exchange study, what was a key finding regarding severe hypoglycemia despite the use of modern diabetes technology?
Severe hypoglycemia and impaired awareness of hypoglycemia persist in people with type 1 diabetes despite use of diabetes technology.
203
What is a core preventative strategy to minimize the risk of ketoacidosis with SGLT inhibitors, which should be repeated throughout treatment?
Reassessment of susceptibility, re-education, and ensuring continued access to ketone monitoring supplies.
204
Postprandial glucose measurements should be made how long after the beginning of a meal to capture peak levels in people with diabetes?
1–2 hours after the beginning of the meal.
205
What is a major limiting factor in the glycemic management of both type 1 and type 2 diabetes?
Hypoglycemia.
206
When a low sensor glucose reading occurs in a low-risk individual without symptoms, what should be investigated?
Causes of artifactual hypoglycemia, such as compression of a CGM sensor during sleep.
207
A temporary relaxation of glycemic goals for several weeks can improve what two aspects of hypoglycemia in many people with diabetes?
Counterregulation and hypoglycemia awareness.
208
Which two surgical procedures account for the overwhelming majority of metabolic surgeries performed in the U.S.?
Vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB).
209
For whom is the adjunctive non-insulin medication pramlintide approved?
Adults with type 1 diabetes and adults with type 2 diabetes who use mealtime insulin.
210
What did the REMOVAL trial conclude about the effect of metformin on cardiovascular events in patients with type 1 diabetes?
It did not find a significant benefit on cardiovascular events.
211
In the context of diabetes, what does the term 'therapeutic inertia' mean?
The failure to initiate or intensify therapy in a timely manner when treatment goals are not met.
212
What is the role of nutritional supplements in weight loss, according to the ADA standards?
They are not recommended as they have not been shown to be effective for weight loss.
213
What are the three core components of intensive behavioral interventions for weight loss?
Nutrition changes, physical activity, and behavioral strategies.
214
Which GLP-1 RA is available in both subcutaneous and oral formulations?
Semaglutide.
215
How do SGLT2 inhibitors and GLP-1 RAs compare to insulin in terms of hypoglycemia risk when used for intensification in T2DM?
They have a lower risk of hypoglycemia compared with insulin.
216
What specific laboratory monitoring is recommended for patients taking metformin long-term?
Monitoring for vitamin B12 deficiency and providing repletion as appropriate.
217
What is the recommended approach to care when individualizing blood pressure goals for a person with diabetes?
A shared decision-making process between the person with diabetes and their clinician.
218
For a patient with diabetes, established heart failure, and an eGFR of 25 ml/min/1.73m2, which medication class is preferred for glycemic control and cardiorenal protection: SGLT2 inhibitor or GLP-1 RA?
A GLP-1 RA is preferred, as SGLT2 inhibitors are generally initiated only if eGFR is >20 but GLP-1 RAs have proven benefit at lower eGFRs.
219
What is the primary reason that a nonsteroidal MRA should not be used with a traditional MRA (e.g., spironolactone)?
The source does not specify the reason, only that they should not be used together, likely due to increased risk of hyperkalemia and other side effects.
220
A 10-14 day CGM assessment with wear time of ___% or higher can be used to assess glycemic status and is useful in clinical management.
0.7
221
What is the recommended weight loss goal in people with prediabetes to reduce progression to diabetes?
5–7% weight loss.
222
What is a potential complication of GLP-1 RA use in lung transplant recipients that warrants caution?
Gastroparesis and gastroesophageal reflux, which may induce allograft lung damage.
223
What type of insulin is used in the first FDA-approved inhaled insulin product?
Inhaled human insulin.
224
According to Figure 9.1, which insulin plan for T1DM is associated with the highest cost and greatest flexibility?
Automated insulin delivery (AID) with an ultra-rapid-acting analog (URAA).
225
Metformin is contraindicated in patients with an eGFR below what threshold?
eGFR <30 mL/min/1.73 m2.
226
In the ADVANCE-ON study, what was the long-term effect of intensive glucose control on cardiovascular events at 10 years of follow-up?
There was no significant effect on cardiovascular events.
227
In the ACCORDION follow-on study, what happened to the excess total mortality seen during the intensive treatment phase of ACCORD?
The excess mortality was reduced by returning to conventional management, resulting in no difference in total mortality after 9 years of follow-up.
228
The cardiovascular benefits of which specific GLP-1 RAs have been demonstrated in cardiovascular outcomes trials?
Dulaglutide, liraglutide, and semaglutide (both SQ and oral).
229
The cardiovascular benefits of which specific SGLT2 inhibitors have been demonstrated for reducing MACE in cardiovascular outcomes trials?
Canagliflozin and empagliflozin.
230
In a patient with T2DM and metabolic dysfunction–associated steatohepatitis (MASH), which class of medication should be considered for its demonstrated benefits?
A GLP-1 RA.
231
What is the primary action to take if a patient on insulin therapy experiences an episode of Level 2 hypoglycemia?
Reevaluate the treatment plan, which may include deintensifying or switching medications.
232
What is the definition of Acute Kidney Injury (AKI)?
AKI is a rapid decline in kidney function, typically within hours to days, characterized by an increase in serum creatinine and/or a decrease in urine output.
233
Adults with diabetes have a risk ratio of _____ for hospitalizations for AKI requiring dialysis compared to adults without diabetes.
5.0 (95% CI 4.8–5.1)
234
For a patient on an ACE inhibitor or ARB, what is the maximum acceptable increase in serum creatinine (in the absence of volume depletion) before discontinuation should be considered?
An increase of less than 30% does not warrant discontinuation.
235
What is the recommended target for reducing urinary albumin in people with CKD and albuminuria $\ge$300 mg/g to slow CKD progression?
The aim is to reduce urinary albumin by $\ge$30%.
236
For individuals with an eGFR <60 mL/min/1.73 m$^2$ receiving ACE inhibitors, ARBs, or MRAs, what electrolyte should be periodically measured?
Serum potassium should be measured periodically to assess for hyperkalemia.
237
According to clinical trials, what effect has a reduction in albuminuria to levels <300 mg/g or by >30% from baseline had in people with type 2 diabetes on ACE inhibitor or ARB therapy?
It has been associated with improved kidney and cardiovascular outcomes.
238
What are the only two proven primary prevention interventions for CKD in people with diabetes?
Blood glucose management (A1C goal of 7%) and blood pressure management (<130/80 mmHg).
239
What is the on-treatment blood pressure goal for people with CKD if it can be safely attained?
The goal is <130/80 mmHg.
240
For nonpregnant people with diabetes and hypertension, an ACE inhibitor or ARB is strongly recommended for those with severely increased albuminuria, defined as a UACR of _____.
$\ge$300 mg/g creatinine
241
For primary prevention of CKD, are ACE inhibitors or ARBs recommended in people with diabetes who have normal blood pressure, normal UACR, and normal eGFR?
No, they are not recommended for primary prevention in this population.
242
What was the finding of clinical trials studying the combination of ACE inhibitors and ARBs for CKD or CVD?
The combination showed no benefits and had higher rates of adverse events like hyperkalemia and AKI.
243
What is the recommended eGFR threshold for initiating an SGLT2 inhibitor in people with type 2 diabetes and CKD?
SGLT2 inhibitors should be initiated in individuals with an eGFR $\ge$20 mL/min/1.73 m$^2$.
244
Until what point can SGLT2 inhibitors be safely continued in patients with type 2 diabetes and CKD?
They can be safely continued until the patient requires dialysis or experiences kidney failure.
245
In the FLOW study, semaglutide showed a 24% lower hazard ratio for the primary composite kidney outcome, which included the onset of >50% decline in eGFR, onset of persistent eGFR <15, initiation of dialysis/transplant, and what other two events?
Kidney death and cardiovascular death.
246
A nonsteroidal MRA is recommended to reduce CKD progression and cardiovascular events in people with CKD and albuminuria if the eGFR is at what level?
The eGFR must be $\ge$25 mL/min/1.73 m$^2$.
247
When initiating a nonsteroidal MRA like finerenone, when should potassium levels be monitored?
Potassium levels should be monitored 1 month after initiation.
248
According to the CONFIDENCE trial, what was the reduction in UACR at 180 days with the simultaneous initiation of finerenone and empagliflozin?
The combination therapy led to a 52% reduction in UACR.
249
Can individuals with an eGFR <20 mL/min/1.73 m$^2$ who are not on dialysis be safely continued on SGLT2 inhibitors?
Yes, they can be safely continued on SGLT2 inhibitors to reduce the risk of CKD progression and for cardiovascular benefits.
250
What ocular complication of diabetes is the most frequent cause of new cases of blindness among adults aged 20–74 years in high-income countries?
Diabetic retinopathy.
251
What has been observed regarding retinopathy when glucose-lowering therapies, such as GLP-1 RAs, cause rapid reductions in A1C?
Rapid reductions in A1C have been shown to be associated with a risk of initial worsening of retinopathy.
252
When should an initial dilated and comprehensive eye examination be performed for an adult with type 1 diabetes?
It should be performed 5 years after the onset of diabetes.
253
When should an initial dilated and comprehensive eye examination be performed for a person with type 2 diabetes?
It should be performed at the time of the diabetes diagnosis.
254
If a patient with diabetes has no evidence of retinopathy on one or more annual eye exams and glycemic indicators are within goal, screening every _____ may be considered.
1–2 years
255
Individuals with preexisting type 1 or type 2 diabetes who become pregnant should receive an eye exam before pregnancy, in the first trimester, and then monitored how often?
They may need to be monitored every trimester and for 1 year postpartum as indicated by the degree of retinopathy.
256
What therapy is indicated to reduce the risk of vision loss in individuals with high-risk proliferative diabetic retinopathy (PDR)?
Panretinal laser photocoagulation therapy.
257
What is the first-line treatment for most eyes with diabetic macular edema (DME) that involves the foveal center and impairs visual acuity?
Intravitreous injections of anti–vascular endothelial growth factor (anti-VEGF).
258
In a comparative effectiveness study, which anti-VEGF agent provided superior vision outcomes for DME in eyes with moderate visual impairment (vision of 20/50 or worse)?
Aflibercept was shown to be superior to bevacizumab in this subgroup.
259
What adjunctive medication, when added to therapy for dyslipidemia, may slow the progression of retinopathy, particularly in its early stages?
Fenofibrate.
260
A comprehensive diabetic foot examination should include inspection of the skin, assessment of foot deformities, and what two other types of assessment?
Neurological assessment (e.g., 10-g monofilament) and vascular assessment (e.g., pulses).
261
For individuals with evidence of sensory loss or prior ulceration or amputation, how often should their feet be inspected by a healthcare professional?
Their feet should be inspected at every visit.
262
What is the recommended screening frequency for peripheral artery disease (PAD) in all people with diabetes >50 years of age, according to SVS and APMA guidelines?
They should undergo screening via noninvasive arterial studies, and if normal, these should be repeated every 5 years.
263
For a chronic diabetic foot ulcer that fails to show a reduction of _____% or more after 4 weeks of appropriate wound management, consideration should be given to the use of advanced wound therapy.
0.5
264
According to the International Working Group on Diabetic Foot (IWGDF) risk stratification, what is the risk category and recommended examination frequency for a patient with loss of protective sensation (LOPS) but no PAD or foot deformity?
Category 1 (Low risk), with an examination frequency of every 6–12 months.
265
According to the IWGDF risk stratification, a patient with a history of a foot ulcer is classified into which risk category?
Category 3 (High risk), requiring examination every 1–3 months.
266
For children and adolescents with type 1 diabetes, when should nephropathy screening begin?
Screening should begin at puberty or age $\ge$11 years (whichever is earlier), once the youth has had diabetes for 5 years.
267
For children and adolescents with type 2 diabetes, when should nephropathy screening with a UACR be performed?
Screening should be performed at the time of diagnosis and annually thereafter.
268
In children and adolescents, an elevated UACR (>30 mg/g creatinine) should be confirmed on how many samples over what period?
It should be confirmed on two of three samples over a 6-month period.
269
What is the recommended first-line treatment for confirmed hypertension in children and adolescents with diabetes?
In addition to lifestyle modification, ACE inhibitors or ARBs should be started.
270
What is the blood pressure treatment goal for an adolescent aged $\ge$13 years with diabetes and hypertension?
The goal is a blood pressure of <130/80 mmHg.
271
For youth with type 1 diabetes aged $\ge$11 years, when should the initial dilated and comprehensive eye examination for retinopathy be recommended?
It is recommended once the youth has had type 1 diabetes for 3–5 years.
272
How often should repeat dilated eye exams or retinal photography be performed for children and adolescents with type 1 diabetes after the initial examination?
It is recommended every 2 years.
273
When should retinopathy screening be performed in children and adolescents with type 2 diabetes?
Screening should be performed at or soon after diagnosis and annually thereafter.
274
When should an annual comprehensive foot exam for neuropathy begin for children with type 1 diabetes?
It should begin at the start of puberty or at age $\ge$11 years (whichever is earlier), once the youth has had diabetes for 5 years.
275
When should children and adolescents with type 2 diabetes be screened for neuropathy by foot examination?
They should be screened at diagnosis and annually thereafter.
276
Long-term follow-up data from the _____ study reported that most individuals with type 2 diabetes diagnosed as children or adolescents had microvascular complications by young adulthood.
TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth)
277
What is the recommended A1C goal for most children and adolescents with diabetes?
An A1C of <7% (<53 mmol/mol) is appropriate for most.
278
For selected children and adolescents with diabetes, what more stringent A1C goal may be suggested if it can be achieved safely?
A more stringent goal, such as <6.5% (<48 mmol/mol), may be suggested.
279
A less stringent A1C goal, such as <7.5%, may be appropriate for children and adolescents with diabetes who cannot articulate symptoms of hypoglycemia or have what other specific challenges?
Other challenges include hypoglycemia unawareness, inability to access advanced technology or check blood glucose regularly, or have nonglycemic factors that increase A1C.
280
In children with type 2 diabetes and overweight or obesity, what is the minimum target for decrease in excess weight through comprehensive lifestyle programs?
The goal is to achieve at least a 7–10% decrease in excess weight.
281
The presence of islet autoantibodies in pediatric individuals with clinical features of type 2 diabetes has been associated with what outcome?
It has been associated with faster progression to insulin deficiency.
282
In the T1DEXIP study, nocturnal hypoglycemia was more frequent in youth with type 1 diabetes under what conditions of physical activity?
It was more frequent when activity levels were higher and of longer duration.
283
In youth with type 1 diabetes, intense physical activity should be postponed with marked hyperglycemia (glucose $\ge$350 mg/dL), moderate to large urine ketones, and/or a $\beta$-hydroxybutyrate level of _____.
>1.5 mmol/L
284
What is the recommended minimum daily amount of moderate-to-vigorous aerobic activity for all children and adolescents, including those with diabetes?
They should participate in 60 minutes of activity daily.
285
The concept that a period of near-normal glycemia produces long-term beneficial effects on microvascular complications, even if subsequent glycemic control worsens, is termed _____.
Metabolic memory
286
What medication classes, in addition to SGLT2 inhibitors and nsMRAs, are listed as interventions that lower albuminuria in Table 11.3?
ACE inhibitors, ARBs, and GLP-1 RAs.
287
In individuals with diabetes and/or CKD receiving an ACE inhibitor or ARB, SGLT2 inhibitor initiation was associated with a lower risk of what electrolyte abnormality?
Hyperkalemia.
288
The CREDENCE trial evaluated canagliflozin in adults with type 2 diabetes, a UACR of $\ge$300–5,000 mg/g, and an eGFR range of _____.
30–90 mL/min/1.73 m$^2$
289
The DAPA-CKD trial enrolled participants with a mean eGFR of 43.1 mL/min/1.73 m$^2$ and an eGFR range of _____.
25–75 mL/min/1.73 m$^2$
290
What is the primary mechanism through which SGLT2 inhibitors are thought to slow GFR loss and reduce albuminuria?
They reduce intraglomerular pressure through mechanisms that appear independent of glycemia.
291
Lixisenatide and exenatide are GLP-1 RAs that require dose adjustment or have limited data in individuals with an eGFR below what threshold?
An eGFR <30 mL/min/1.73 m$^2$.
292
True or false: The presence of retinopathy is a contraindication to aspirin therapy for cardioprotection.
False, aspirin does not increase the risk of retinal hemorrhage and is not contraindicated.
293
What is the Ipswich touch test used for?
It is a neurological assessment method used to screen for loss of protective sensation (LOPS) in the feet.
294
A toe systolic blood pressure of <_____ mmHg is suggestive of PAD and an inability to heal foot ulcerations.
<30 mmHg
295
A warm, swollen, red foot in a person with neuropathy, with or without trauma and without an open ulcer, should raise suspicion for what condition?
Charcot neuroarthropathy.
296
The five basic principles of diabetic foot ulcer treatment include offloading, debridement, revascularization, infection management, and ____.
Use of wound-appropriate topical dressings
297
While evidence is mixed for hyperbaric oxygen therapy, several high-quality RCTs support the efficacy of what other oxygen-based therapy for healing chronic DFUs?
Topical oxygen therapy.
298
During what developmental stage should reproductive health and preconception counseling be incorporated into routine diabetes clinic visits for all pediatric individuals of childbearing potential?
During adolescence, generally during the stage of pubertal growth and development.
299
What is the recommendation regarding the transfer of care from pediatric to adult specialists for young people with diabetes?
There is no age-specific cutoff; it should be a shared decision-making process involving the specialist, adolescent, and caregivers.
300
In what circumstances are GLP-1 RAs recommended for patients with type 2 diabetes and CKD?
They are recommended to reduce kidney disease progression and cardiovascular risk in this population.
301
The ADA recommends monitoring for what electrolyte abnormality when diuretics are used, especially after initiation or dose changes?
Hypokalemia.
302
The _____ study was a large prospective study that compared liraglutide, sitagliptin, glimepiride, and insulin glargine for kidney-protective effects and found no differences.
GRADE (Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study)
303
For individuals with type 1 diabetes, how long is the lag time for the effects of intensive glucose control to manifest as improved eGFR outcomes?
The lag time is over 10 years.
304
In patients with advanced CKD, what two alternative glycemic markers can be helpful when A1C levels become less reliable?
Glycated albumin and fructosamine.
305
The landmark _____ study showed that panretinal photocoagulation reduced the risk of severe vision loss from PDR.
DRS (Diabetic Retinopathy Study)
306
Which two newer anti-VEGF agents can achieve visual acuity gains similar to aflibercept 2 mg but with adjustable dosing up to every 16 weeks for DME?
Faricimab and aflibercept 8 mg.
307
For eyes with center-involved DME but good vision (20/25 or better), what management approach provides similar 2-year vision outcomes compared to immediate anti-VEGF therapy?
Close monitoring with initiation of anti-VEGF therapy if vision worsens.
308
The _____ staging system is used to stage PAD severity, predict amputation risk, and predict DFU healing.
WIfI (Wound, Ischemia, and foot Infection)
309
In children and adolescents with diabetes, what is the definition of elevated blood pressure for those aged $\ge$13 years?
A blood pressure of 120–129/<80 mmHg.
310
In children and adolescents with diabetes, what is the definition of confirmed hypertension for those aged $\ge$13 years?
A blood pressure consistently $\ge$130/80 mmHg.
311
For children with type 2 diabetes, when should evaluation for MASLD (by measuring AST and ALT) be performed?
It should be performed at diagnosis and annually thereafter.
312
What is the 'honeymoon phase' or 'partial remission' in type 1 diabetes?
It is a transient period of increased endogenous insulin secretion shortly after diagnosis when insulin therapy resolves glucotoxicity, allowing for improved secretion from residual β-cells.
313
What percentage of children and adolescents with type 2 diabetes are estimated to present with DKA at onset?
Approximately 11%.
314
Besides anti-VEGF therapy, what are two other reasonable treatment options for eyes with persistent DME?
Macular laser photocoagulation or intravitreal therapy with corticosteroids.
315
Which two thiazolidinediones might be associated with the development or worsening of DME, although evidence is conflicting?
Pioglitazone and rosiglitazone.
316
The triad of peripheral sensory neuropathy, _____, and foot deformity was present in over 63% of participants with diabetic foot ulcers in a multicenter trial.
minor trauma
317
When should children and adolescents with type 1 diabetes and their families be educated on adjusting insulin for high-fat and high-protein meals?
This education should be provided as meal composition affects postprandial glucose excursions.
318
The use of _____ should be offered for diabetes management at diagnosis or as soon as possible in children and adolescents with diabetes capable of using the device safely.
Continuous glucose monitoring (CGM)
319
Automated insulin delivery (AID) systems should be offered for diabetes management to which pediatric population?
Children and adolescents with type 1 diabetes who are capable of using the device safely.
320
For how many days must CGM be used to provide a reliable assessment of glycemia in children and adolescents?
While 14 days is standard, recent data indicate that 10 or more days is reliable, and $\ge$7 days may be sufficient for those meeting TIR goals.
321
What percentage of pregnancies in women with preexisting diabetes were estimated to have worsening of nonproliferative diabetic retinopathy?
The pooled progression rate was 31.0% (95% CI 23.2–39.2) per 100 pregnancies.
322
What is the FDA pregnancy category for current anti-VEGF medications?
Category C, meaning animal studies have shown evidence of embryo-fetal toxicity, but there are no controlled data in human pregnancy.
323
At any eGFR, the degree of _____ is associated with risk of CVD, CKD progression, and mortality.
albuminuria
324
In a patient initiated on SGLT2 inhibitors or GLP-1 RAs, what hemodynamic change often causes an initial rise in serum creatinine that does not warrant discontinuation of the medication?
Hemodynamic changes in the tubuloglomerular feedback mechanism.
325
The EMPA-KIDNEY trial showed efficacy of empagliflozin in participants with an eGFR as low as _____.
20 mL/min/1.73 m$^2$
326
Which class of anti-hypertensive medications can cause hypokalemia and require serum potassium monitoring?
Diuretics.
327
For PDR management, a potential drawback of anti-VEGF therapy compared to panretinal laser is the need for a greater number of visits and treatments, and risk of worse outcomes if there are _____.
nonintentional lapses in treatment
328
What three artificial intelligence (AI) platforms are FDA-approved for diabetic retinopathy screening?
AEYE-DS (AEYE Health), EyeArt AI (Eyenuk), and LumineticsCore (Digital Diagnostics).
329
The IWGDF guidelines recommend an interprofessional approach for individuals with foot ulcers and high-risk feet, such as those on dialysis, with Charcot foot, or with a history of _____ or amputation.
prior ulcers
330
A systematic review showed no significant reduction in first-time ulcer incidence after 18 months of using specialized therapeutic footwear compared to _____.
standard insoles and extradepth shoes
331
What is the recommended screening frequency for retinopathy in children with type 2 diabetes?
At diagnosis and annually thereafter.
332
What is the recommended screening frequency for nephropathy in children with type 1 diabetes after initiation?
Annually.
333
What is the term for a neurovascular complication of diabetes characterized by microaneurysms, retinal hemorrhages, and potential neovascularization?
Diabetic retinopathy.
334
In the setting of lower levels of albuminuria (30–299 mg/g), ACE inhibitor or ARB therapy has been shown to reduce progression to more advanced albuminuria and cardiovascular events, but has not reduced progression to _____.
kidney failure
335
While glucose-lowering effects are blunted, kidney and cardiovascular benefits of SGLT2 inhibitors were still seen at eGFR levels as low as 20 mL/min/1.73 m$^2$ even with no significant change in _____.
glucose
336
Two studies (Ku et al. and Hattori et al.) provided retrospective support for continuing or restarting ACE inhibitors/ARBs in patients with CKD, showing better long-term kidney outcomes and lower _____.
mortality
337
What is the primary treatment for Charcot neuroarthropathy in its acute phase?
Total non-weight-bearing and urgent referral to a foot care specialist.
338
For children with type 1 diabetes and triglycerides >400 mg/dL (fasting), what is the recommended treatment to reduce pancreatitis risk?
Optimize glycemia and begin fibrate therapy.
339
In children and adolescents, when is ambulatory blood pressure monitoring (ABPM) strongly considered?
It is considered when high blood pressure is found on three separate measurements.
340
What are the five components of a comprehensive neurological foot exam in children and adolescents with diabetes?
Inspection, assessment of foot pulses, pinprick, 10-g monofilament sensation, vibration sensation (128-Hz tuning fork), and ankle reflex tests.
341
According to ADA 2026 standards, when should preconception counseling be initiated for all people with diabetes and childbearing potential?
Starting at puberty and continuing throughout their reproductive years.
342
What is the ideal A1C target that should be achieved before conception for an individual with diabetes?
Less than 6.5% (<48 mmol/mol), if it can be achieved safely without excessive hypoglycemia.
343
For individuals with a history of gestational diabetes mellitus (GDM), what is recommended before a subsequent pregnancy?
They should undergo preconception screening for diabetes and receive preconception care.
344
What is the recommended daily dose of folic acid for individuals with diabetes planning a pregnancy?
At least 400-800 μg of folic acid.
345
For individuals with preexisting diabetes planning pregnancy, what eye examination is recommended before conception?
A dilated eye examination to screen for and assess diabetic retinopathy.
346
How often should pregnant individuals with preexisting diabetes be monitored for diabetic retinopathy?
Ideally before pregnancy, in the first trimester, then every trimester, and for 1 year postpartum as indicated by the degree of retinopathy.
347
Which two classes of antihypertensive medications should be discontinued prior to conception in individuals with diabetes?
ACE inhibitors and angiotensin receptor blockers (ARBs).
348
Due to its long half-life, semaglutide should be discontinued at least _____ before a planned pregnancy.
2 months
349
What are the ADA-recommended fasting plasma glucose goals for pregnant individuals with diabetes?
Less than 95 mg/dL (<5.3 mmol/L).
350
What is the ADA-recommended 1-hour postprandial glucose goal for pregnant individuals with diabetes?
Less than 140 mg/dL (<7.8 mmol/L).
351
What is the ADA-recommended 2-hour postprandial glucose goal for pregnant individuals with diabetes?
Less than 120 mg/dL (<6.7 mmol/L).
352
Why is A1C slightly lower during pregnancy, and what is the ideal A1C goal?
It is lower due to increased red blood cell turnover; the ideal goal is <6% (<42 mmol/mol) if achievable without significant hypoglycemia.
353
For pregnant individuals with type 1 diabetes using CGM, what is the target for Time in Range (TIR) between 63-140 mg/dL?
Greater than 70%.
354
What is the target for Time Below Range (TBR) <63 mg/dL for pregnant individuals with type 1 diabetes using CGM?
Less than 4%.
355
What is the target for Time Above Range (TAR) >140 mg/dL for pregnant individuals with type 1 diabetes using CGM?
Less than 25%.
356
What is the preferred pharmacologic agent for managing type 1, type 2, and gestational diabetes during pregnancy?
Insulin.
357
Why are metformin and glyburide not recommended as first-line agents for diabetes management in pregnancy?
Both agents cross the placenta to the fetus, and long-term safety data for offspring is of concern.
358
If metformin is used for polycystic ovary syndrome to induce ovulation, when should it be discontinued during pregnancy?
It should be discontinued by the end of the first trimester.
359
During which part of pregnancy do insulin requirements typically increase due to progressive insulin resistance?
The second and third trimesters, starting around 16 weeks.
360
What might a rapid and significant reduction in insulin requirements during the third trimester indicate?
It may indicate the development of placental insufficiency, although data are conflicting.
361
What is the only basal insulin with randomized controlled trial (RCT) data supporting its use in pregnancy, though it is no longer on the market?
Insulin detemir.
362
Which two rapid-acting insulin analogs are widely considered safe and effective for use during pregnancy?
Insulin aspart and insulin lispro.
363
In pregnant individuals with type 1 or type 2 diabetes, when should low-dose aspirin be initiated to lower the risk of preeclampsia?
Starting at 12–16 weeks of gestation.
364
What is the recommended dose of low-dose aspirin for preeclampsia prevention in high-risk pregnant individuals?
100–150 mg/day.
365
According to the CHAP trial, what is the recommended blood pressure threshold for initiating or titrating therapy in pregnant individuals with chronic hypertension?
A threshold of <140/90 mmHg.
366
When should individuals with a history of GDM be screened for persistent diabetes or prediabetes postpartum?
At 4–12 weeks postpartum.
367
What is the preferred test for postpartum screening in individuals with a history of GDM?
A 75-g oral glucose tolerance test (OGTT).
368
How often should individuals with a history of GDM have lifelong screening for the development of type 2 diabetes or prediabetes?
Every 1–3 years.
369
For individuals with a history of GDM who are found to have prediabetes, what interventions are recommended to prevent progression to type 2 diabetes?
Intensive lifestyle interventions and/or metformin.
370
In the immediate postpartum period, how do insulin requirements for individuals with preexisting diabetes typically change?
Insulin requirements decrease dramatically (roughly 34% lower than prepregnancy requirements) due to a sharp drop in insulin resistance.
371
An A1C test should be performed on all hospitalized individuals with diabetes or hyperglycemia if a result is not available from the prior _____.
3 months
372
For the majority of critically ill individuals (ICU), insulin therapy should be initiated for persistent hyperglycemia starting at what threshold?
A threshold of $\ge$180 mg/dL ($\ge$10.0 mmol/L).
373
What is the recommended glycemic goal for most critically ill (ICU) individuals once insulin therapy is initiated?
140–180 mg/dL (7.8–10.0 mmol/L).
374
For most noncritically ill hospitalized individuals, what is the recommended glycemic goal?
100–180 mg/dL (5.6–10.0 mmol/L), if it can be achieved without significant hypoglycemia.
375
What is the definition of level 2 hypoglycemia in a hospitalized patient?
A glucose concentration <54 mg/dL (<3.0 mmol/L).
376
For hospitalized individuals with diabetes who are eating, how often should point-of-care (POC) blood glucose monitoring be performed?
Before meals.
377
For hospitalized individuals with diabetes who are not eating, how often should glucose monitoring be advised?
Every 4–6 hours.
378
To be considered valid for comparison, a CGM reading must be within _____ of a POC measurement when blood glucose is $\ge$70 mg/dL.
$\pm$20%
379
What is the recommended method for achieving glycemic goals in critically ill individuals?
Continuous intravenous insulin infusion.
380
What is the preferred insulin treatment for noncritically ill hospitalized individuals with poor or no oral intake?
A basal insulin or a basal plus correction insulin regimen.
381
For most noncritically ill hospitalized individuals with adequate nutritional intake, what is the preferred insulin treatment regimen?
An insulin regimen with basal, prandial, and correction components.
382
Why is the sole use of a correction or supplemental insulin regimen (sliding scale) discouraged in the inpatient setting?
It is a reactive approach that is inferior to proactive basal-bolus regimens in achieving glycemic control and is associated with worse outcomes.
383
When transitioning a patient from an intravenous insulin infusion to subcutaneous insulin, how long before stopping the infusion should the first dose of subcutaneous basal insulin be given?
2 hours before discontinuing the intravenous infusion.
384
For a hospitalized individual with type 1 diabetes, is it safe to hold their basal insulin if they are taking nothing by mouth (NPO)?
No, basal insulin must not be held for individuals with type 1 diabetes to prevent diabetic ketoacidosis (DKA).
385
In which hospitalized patient population may SGLT2 inhibitors be initiated or continued if there are no contraindications?
In individuals hospitalized with heart failure.
386
SGLT2 inhibitors should be held for at least _____ days before a scheduled surgery.
3 days (4 days for ertugliflozin).
387
What medication class, with or without basal insulin, may be a reasonable option for hospitalized individuals with mild to moderate hyperglycemia?
Dipeptidyl peptidase 4 inhibitors (DPP-4i).
388
When a hospitalized patient has a documented blood glucose value of <70 mg/dL, what action should be taken regarding their treatment plan?
The treatment plan should be reviewed and changed as necessary to prevent recurrent hypoglycemia.
389
A fasting blood glucose of <_____ mg/dL in a hospitalized patient is a predictor of hypoglycemia within the next 24 hours.
100
390
For hospitalized individuals receiving continuous enteral nutrition, what is a typical starting dose calculation for the nutritional insulin component?
1 unit of regular or rapid-acting insulin for every 10–15 g of carbohydrate in the formulation.
391
For individuals treated with once-daily prednisone, which type of insulin is often administered concomitantly to match the steroid-induced hyperglycemic response?
NPH insulin.
392
To improve postoperative outcomes after elective surgery, what is the recommended preoperative A1C goal?
An A1C goal of <8% (<64 mmol/mol).
393
What is the recommended blood glucose range to maintain before, during, and after surgery?
Between 100 and 180 mg/dL (5.6 and 10.0 mmol/L).
394
Due to concerns about delayed gastric emptying and aspiration risk, what is the general recommendation for holding once-weekly GLP-1 RAs before elective surgery under general anesthesia?
Expert guidance varies, but a personalized approach is recommended, considering holding the drug for at least 7 days for those at higher risk.
395
What are the three core components of managing diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS)?
Administering intravenous fluids, insulin, and electrolytes.
396
What is the plasma glucose level defining euglycemic DKA?
Plasma glucose <200 mg/dL (<11.1 mmol/L) in the presence of ketosis and metabolic acidosis.
397
What is the diagnostic criterion for ketosis in DKA based on serum $\beta$-hydroxybutyrate concentration?
A concentration $\ge$3.0 mmol/L.
398
What is the diagnostic criterion for metabolic acidosis in DKA based on serum bicarbonate?
A bicarbonate concentration <18 mmol/L.
399
What is the diagnostic criterion for hyperosmolarity in HHS based on calculated effective serum osmolality?
Greater than 300 mOsm/kg.
400
In individuals with mild and uncomplicated DKA, what is an alternative to continuous intravenous insulin infusion for treatment?
Subcutaneous rapid-acting insulin given every 1–2 hours.
401
For a patient hospitalized with hyperglycemia, when should an outpatient follow-up visit be scheduled after discharge?
Within 1 month of discharge, or earlier (1-2 weeks) if glycemic medications were changed or management is not optimal.
402
The ADA advocacy statement on 'Diabetes and Employment' states that employment decisions should never be based on _____.
Generalizations or stereotypes regarding the effects of diabetes.
403
The ADA advocacy statement on 'Diabetes Management in Detention Facilities' emphasizes the need for what foundational element to ensure proper care?
Written policies and procedures for diabetes management and staff training.
404
The _____ statement from the ADA addresses the care of children with diabetes under age 5 in settings like childcare centers and preschools.
Care of Young Children With Diabetes in the Childcare and Community Setting
405
What is the recommended A1C goal that may be relaxed to <7% in pregnancy if necessary to prevent hypoglycemia?
The ideal goal of <6% (<42 mmol/mol).
406
Why should commonly used estimated A1C and glucose management indicator (GMI) calculations not be used in pregnancy?
Due to physiological changes like increased red blood cell turnover, these calculations are not accurate estimates of A1C in pregnancy.
407
The risk of congenital anomalies is directly proportional to elevations in A1C during which period of pregnancy?
The first 10 weeks of pregnancy.
408
What class of reversible contraception is highlighted for discussion in preconception counseling for individuals with diabetes?
Long-acting, reversible contraception (LARC).
409
What is the recommended minimum daily intake of carbohydrates for all pregnant people?
A minimum of 175 grams of carbohydrate.
410
A key component of a safe transition from hospital to outpatient care is _____, which involves cross-checking home and hospital medications.
Medication reconciliation
411
In the critical care setting, how often is POC blood glucose monitoring typically required for patients on intravenous insulin therapy?
Every 30 minutes to every 2 hours.
412
The landmark NICE-SUGAR trial found that intensive glycemic control (80-110 mg/dL) in critically ill patients led to higher rates of _____ and increased mortality compared to moderate control.
Hypoglycemia
413
For individuals hospitalized for DKA or HHS, what is a crucial component of the discharge planning process to prevent recurrence?
Education on the recognition, prevention, and management of DKA and/or HHS.
414
What is the term for a meal plan in the hospital that facilitates matching the prandial insulin dose to the amount of carbohydrate provided?
Controlled carbohydrate meal plans.
415
What is the definition of level 3 hypoglycemia?
A clinical event characterized by altered mental and/or physical functioning that requires assistance from another person for recovery.
416
The recommended dietary reference intake for all pregnant people includes a minimum of _____ g of protein.
71
417
What is the term for the concept of coordinating glucose checks, meal delivery, and nutritional insulin coverage in the hospital setting?
A 'meal triad'.
418
What is the primary risk associated with the use of sulfonylureas, such as glyburide, in pregnancy?
Increased neonatal hypoglycemia.
419
What is the most important diabetes-specific component of preconception care?
The attainment of glycemic goals prior to conception.
420
In individuals with overweight or obesity and a history of GDM, weight loss of $\ge$_____% prior to a subsequent pregnancy was associated with a lower risk of GDM recurrence.
5
421
During pregnancy, treatment with atenolol is not recommended, but other _____ may be used if necessary for hypertension.
β-blockers
422
The risk of an unplanned pregnancy outweighs the risk of any currently available _____ option.
Contraception
423
In women with GDM, what intervention has been shown to reduce their subsequent risk of developing type 2 diabetes?
Breastfeeding.
424
What is a major barrier to effective preconception care in individuals with diabetes?
Many pregnancies are unplanned.
425
An admission A1C value of $\ge$_____ suggests that the onset of diabetes preceded hospitalization.
6.5% ($\ge$48 mmol/mol)
426
What is the definition of hyperglycemia in hospitalized individuals?
Any blood glucose level >140 mg/dL (>7.8 mmol/L).
427
To prevent rebound hyperglycemia, subcutaneous basal insulin should be given _____ before an intravenous insulin infusion is discontinued.
2 hours
428
To treat hypoglycemia in a conscious hospitalized patient, what is the standard initial intervention?
Administering 15 g of fast-acting carbohydrate.
429
Why is the OGTT preferred over A1C for postpartum screening at 4-12 weeks after a GDM pregnancy?
A1C may be persistently lowered by increased red blood cell turnover related to pregnancy and blood loss at delivery.
430
In the CONCEPTT trial, real-time CGM use in pregnant women with type 1 diabetes was associated with reductions in large-for-gestational-age births and _____.
Severe neonatal hypoglycemia
431
Why might GLP-1 RA drugs be held for acutely ill individuals in the hospital setting?
Data on their inpatient use are limited, and they may be associated with nausea, vomiting, and delayed gastric emptying.
432
What is the term for the condition where a pregnant person with type 1 diabetes develops ketosis at lower blood glucose levels than in the nonpregnant state?
Euglycemic diabetic ketoacidosis (DKA).
433
In normal pregnancy, what is the typical pattern of insulin sensitivity in the early first trimester?
Early pregnancy may be a time of enhanced insulin sensitivity and lower glucose levels.
434
A study of hospitalized individuals found that 84% of those with severe hypoglycemia (<40 mg/dL) had a preceding episode of hypoglycemia <_____ mg/dL during the same admission.
70
435
Which hydrophilic statin may be associated with less fetal harm than lipophilic statins if statin use is deemed necessary during pregnancy?
Pravastatin.
436
If a CGM reading is used for insulin dosing in the hospital, it must be within $\pm$_____ mg/dL of a POC measurement when blood glucose is <70 mg/dL.
20
endo boards
flashcards
Decks in class (40)
# Cards
-
male reproductive- SB notes91
-
ESAP 2022158
-
thyroid cancer- SB notes42
-
pituitary-SB70
-
lipid 2025 guidelines AACE46
-
vasomotor postmen txt uptodate62
-
ATA thyroid cancer guidelines 202594
-
Diagnosis of primary aldosteronism up to date60
-
Utd- Classic CAH 21-hydroxylase def Peds - diagnosis60
-
Treatment of classic CAH due to 21-hydroxylase deficiency in adults up to date60
-
DKS HHS consensus ADA 202473
-
cushings- SB notes71
-
lipids+TAG- SB notes138
-
obesity- SB notes73
-
ESAP 202477
-
2023 meet the professor71
-
2024 meet the professor91
-
2025 meet the professor76
-
thyroid -SB94
-
MEN-SB62
-
calcium-SB78
-
male hypogonadism-SB57
-
hyperaldosteronism- SB50
-
bariatric-SB55
-
adrenal insufficiency-SB60
-
hypoglycemia-SB55
-
osteoporosis107
-
transgender-SB81
-
hypoaldo RTA 4 - UTD55
-
EBR 20236
-
female reproductive endo guidelines78
-
acromegaly-utd/pit soc/2025 consensus177
-
ADA- DM guidelines436
-
endo - DM in elderly, hyper/hypo - glycemia, dm in preg284
-
UTD-thyroid storm/ hyperthyroidism206
-
UTD-Toxic MNG management56
-
ATA hyperthyoidism guidelines49
-
utd- AVP def118
-
GH def- UTD, guideline update150
-
UTD- osteomalacia80
