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Nurse Practitioner:
doi: 10.1097/01.NPR.0000453112.11510.2d
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Update on the American Diabetes Association Standards of Medical Care

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INSTRUCTIONS Update on the American Diabetes Association Standards of Medical Care

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Update on the American Diabetes Association Standards of Medical Care

General Purpose: The purpose of this learning activity is to provide information about the 2014 ADA Standards of Medical Care. Learning Objectives: After reading this article and taking this test, you should be able to: 1. Discuss the demographics of and recommendations for the diagnosis of diabetes. 2. Select recommended approaches to prevention and control of diabetes.

  1. According to CDC estimates, what percentage of adults and children in the United States have diabetes?
    1. 5.7%
    2. 6.9%
    3. 9.3%
    4. 10.8%
  2. According to medical experts, which treatment approach is gaining importance?
    1. careful management of insulin options
    2. diet and exercise to avoid obesity
    3. primary prevention
    4. individualized care
  3. Secondary prevention is focused on
    1. reducing risk factors associated with diabetes.
    2. interrupting the process of the asymptomatic disease.
    3. preventing the development of diabetes.
    4. treating symptoms in addition to the underlying cause of the disease.
  4. Tertiary prevention refers to
    1. stabilizing or preventing the worsening of a symptomatic disease.
    2. managing the late-onset symptoms in addition to the underlying cause of the disease.
    3. managing the disease in a patient who is in an acute care setting for other reasons.
    4. treating the symptoms of end-stage diabetes mellitus.
  5. Which of the following has been accepted by the ADA to diagnose diabetes?
    1. 4-hour glucose tolerance test
    2. 5-hour OGTT
    3. nonfasting glucose load test
    4. 6.5% or greater glycated hemoglobin (A1C) level threshold
  6. Individuals who have certain types of anemias or hemoglobinopathies should be tested using
    1. 4-hour glucose tolerance test.
    2. 75-g OGTT.
    3. nonfasting plasma glucose.
    4. A1C.
  7. Individuals who have more than two autoantibodies for T1DM have which percentage likelihood of developing the disease in 10 years?
    1. 50%
    2. 60%
    3. 70%
    4. 84%
  8. The two basic categories of tertiary prevention are
    1. prevention of abnormal glucose levels and addressing comorbid conditions.
    2. managing insulin levels and promoting lifestyle changes.
    3. managing comorbid conditions and preventing diabetic neuropathies.
    4. control of blood glucose levels and promotion of healthy lifestyle.
  9. Female patients with T2DM taking insulin or insulin secretagogues should be educated about the
    1. need to abstain from drinking alcohol.
    2. benefits of drinking alcohol in preventing renal complications.
    3. potential for delayed hypoglycemia after drinking alcohol.
    4. need to limit alcohol drinks to two per day.
  10. Current guidelines suggest limiting monotherapy to how long for reaching A1C goals?
    1. 6 weeks
    2. 3 months
    3. 4 to 5 months
    4. 6 months
  11. Education of patients with diabetes should include
    1. advantages of frequent changes to medication regimens.
    2. discussion of the progressive nature of diabetes.
    3. the inevitability of the development of comorbidities.
    4. need to limit traveling and other leisure activities.
  12. The most extensive changes in the 2014 ADAStandards of Medical Careinvolve
    1. medication management.
    2. management of comorbidities.
    3. medical nutritional therapy.
    4. secondary prevention.
  13. Which statement about fat intake for the patient with diabetes is accurate?
    1. Patients with diabetes should avoid all fatty foods.
    2. The ideal amount of suggested daily fat intake has been lowered by 10 g.
    3. The quality of fat intake is more important than the quantity.
    4. Over-the-counter long-chain n-3 fatty acid supplements are effective substitutes for dietary fats.
  14. Current recommendations for insulin during inpatient hospital stays
    1. strongly discourage sliding scale insulin dosing.
    2. strongly discourage physiologic insulin therapy.
    3. advocate calculating basal insulin doses on carbohydrate levels in meals.
    4. encourage insulin dosing based on premeal glucose levels for T1DM.
  15. In patients with T1DM, the intake of dietary sodium is associated with
    1. the development of diabetic retinopathy.
    2. exacerbation of diabetic comorbidities.
    3. all-cause mortality and end-stage kidney disease.
    4. the need for increased dosages of insulin.
  16. Current ADA nutrition guidelines recommend that all adults with diabetes reduce salt intake to less than
    1. 1,000 mg/d.
    2. 1,200 mg/d.
    3. 1,500 mg/d.
    4. 2,300 mg/d.
  17. Which of the following isnota factor associated with increasing cardiovascular autonomic neuropathy?
    1. age
    2. gender
    3. length of time individual has had diabetes
    4. level of hyperglycemia
  18. In a T1DM patient with no previous evidence of retinopathy, the next recommended eye exam should be scheduled for
    1. 1 year.
    2. 2 years.
    3. 3 years.
    4. 5 years.
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