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1. When can/should insulin be used in the treatment of patients with type 2 diabetes?

A. Can be used at any point during the type 2 diabetes care continuum B. Can be used early in type 2 diabetes C. Should be used when oral agents are no longer effective and A1C is not controlled D. Is the drug of choice for symptomatic type 2 patients with high A1C levels (>9%) E. All of the above

2. The American Association of Clinical Endocrinologists (AACE) recommends starting insulin therapy in which situation?

A. After dual or triple therapy fails and A1C levels are >9%, regardless of symptoms B. If patients present with symptoms and A1C levels are 9%, regardless of whether oral agents have been tried C. Only after all oral therapies have been tried D. Only after all non-insulin therapies have been tried E. A and B only

3. Which dosage range is correct for the recommended starting basal insulin analog for a male weighing 220 pounds with an A1C of 8.7%?

A. 10-20 units B. 20-40 units C. 22-44 units D. 44-88 units

4. Which is the correct recommended total daily dose of long-acting insulin for a patient with an A1C<8%?

A. 0.1-0.2 U/kg B. 0.15-0.25 U/kg C. 0.2-0.3 U/kg D. 0.3-0.4 U/kg

5. Daytime hypoglycemia is more dangerous than nighttime hypoglycemia, so it is more important to keep daytime insulin doses low.

A. True B. False

6. A patient is currently taking 45 units of basal insulin and 15 units of prandial insulin at each meal and has a documented episode of nocturnal hypoglycemia (<70 mg/dL). Which dose adjustment is most appropriate to recommend?

A. 27 units of basal insulin, 9 units of prandial insulin at each meal B. 35 units of basal insulin, 15 units of prandial insulin at each meal C. 45 units of basal insulin, 10 units of prandial insulin at each meal D. 15 units of basal insulin, 15 units of prandial insulin at each meal

7. Which is true with regard to insulin injection techniques?

A. Patients can use fleshy parts of their bodies like earlobes to inject insulin B. Injecting insulin is as painful as checking fingersticks for blood glucose levels C. Pharmacists should periodically reassess insulin injection techniques, especially if patients are not achieving A1C goals D. All of the above are true

8. Which of the following is NOT true about insulin injections?

A. Injection into the back of the arm is the easiest site for self-administration B. Patients can use one thigh for an insulin injection and the other for a GLP-1 receptor agonist, if they are using both therapies C. The most common site to inject insulin is the stomach D. Scar tissue should be avoided

9. If a patient is on basal insulin and is achieving their fasting blood glucose goal, but not their A1C goal, is overweight, and wants to avoid hypoglycemia, which agent would be recommended?

A. Addition of a prandial insulin B. Switch to a premixed insulin C. Addition of a thiazolidinedione D. Addition of a GLP-1 receptor agonist

10. Which patient would be a candidate for adding an additional agent like a DPP-4 inhibitor or a GLP-1 receptor agonist or intensifying to basal bolus insulin therapy from basal insulin therapy?

A. A patient with a fasting blood glucose >200 mg/dL, with an A1C >7.0% B. A patient with a fasting blood glucose <110 mg/dL, with an A1C >7.5% C. A patient with a postprandial blood glucose <110 mg/dL, with an A1C >7.5% D. A patient with a postprandial blood glucose <110 mg/dL, with an A1C <7.0%