INSTRUCTIONS Adult diabetes mellitus: Thinking beyond type 2
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- You will receive your CE certificate of earned contact hours and an answer key to review your results.There is no minimum passing grade.
- Registration deadline is May 31, 2018
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Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.0 contact hours for this continuing nursing education activity.
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Your certificate is valid in all states. This activity has been assigned 0.5 pharmacology credits.
Adult diabetes mellitus: Thinking beyond type 2
General Purpose: To provide information about two atypical types of adult diabetes: KPD and LADA. Learning Objectives: After completing this continuing-education activity, you should be able to: 1. Explain the scope of the problem and the NP's role in diagnosing and treating adult diabetes mellitus. 2. Describe the clinical presentation, diagnostic classification, and glucose-lowering regimen for KPD and LADA.
- According to the CDC, what percentage of individuals in the United States age 20 and older has diabetes mellitus?
- DesRoches and colleagues demonstrated that NPs were more likely than physician colleagues to care for populations that
- were older.
- were underserved.
- had more comorbidities.
- Mundinger and colleagues first demonstrated that, compared to primary care by their physician colleagues, primary care by NPs was
- less expensive.
- more accessible.
- The author suggests that one result of the ACA has been the identification of
- previously undiagnosed diabetes.
- new diabetes treatments.
- new classifications of diabetes.
- Literature from Sweden has reported that approximately 25% of T1DM cases are
- secondary to exocrine pancreatic disease.
- drug induced.
- diagnosed as adults.
- The author points out that arriving at the best diabetes diagnostic classification will promote
- better scientific research.
- the most appropriate glucose-lowering regimen.
- lower overall costs.
- In the absence of unequivocal hyperglycemia, which of the following should prompt repeat testing to diagnose diabetes?
- fasting plasma glucose of 120 mg/dL
- A1C of 6.5%
- random plasma glucose of 180 mg/dL
- Which classification of diabetes is characterized by insulin resistance and progressive beta cell dysfunction?
- Obesity is most closely associated with
- autoimmune diabetes.
- A common problem in T1DM is
- weight gain.
- advanced age at onset.
- Age of onset, body habitus, and presence/absence of ketones are
- diagnostic criteria for diabetes.
- modifiable risk factors for diabetes.
- clues to diabetes classification.
- Choukem and colleagues' study of patients with KPD showed that after normoglycemia was achieved,
- impaired insulin secretion persisted.
- beta cell function normalized.
- glucagon suppression normalized.
- Which of the following is a diagnostic criterion for ketosis-prone atypical diabetes?
- glucose toxicity
- positive diabetes-related autoantibodies
- elevated C-peptide
- The most appropriate long-term pharmaceutical treatment for KPD would likely consist of
- exogenous insulin administration.
- metformin alone.
- metformin plus sulfonylureas.
- One of the three criteria for LADA as suggested by the Immunology of Diabetes Society is
- age of at least 50.
- positive for at least 1 antibody.
- initial requirement of insulin for glucose control.
- Which of the following is a sign of significant beta cell destruction?
- Clues to diagnosing LADA might include
- positive response to T2DM therapies.
- history of celiac disease.
- Typically, patients with LADA will eventually require treatment with
- basal and prandial insulin.
- metformin with prandial insulin.
- metformin plus sulfonylureas.