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1. Which of the following statements is CORRECT regarding insulin pump infusion sites?

A. Infusion sites selected for insulin delivery are limited to the abdomen B. Infusion sites should be rotated to prevent lipohypertrophy C. Soft cannulas are only available in 90° insertion angles D. Shorter cannula lengths are recommended for those with elevated body mass index (BMI) of 30 or more

2. Which one of the following advantages, versus multiple daily insulin injections (MDIs), does insulin pump therapy demonstrate?

A. Lower rates of hypoglycemia in those with type 2 diabetes mellitus (T2D) B. Insulin pump therapy is more cost-effective than MDIs for those with T2D C. Greater glycated hemoglobin (A1C) reductions for those with type 1 diabetes mellitus (T1D) D. Lower rates of diabetic ketoacidosis (DKA) for patients with either T1D or T2D

3. Which of the following patients would be an ideal candidate for insulin-pump therapy?

A. A woman 34 years of age with T1D who monitors blood glucose (BG) 6 times daily and has an A1C of 7.9% with MDI B. A man 62 years of age with T2D and an A1C of 9% that is nonadherent to Novolin 70/30 twice daily C. An adolescent boy, 16 year of age with T1D who is concerned that an insulin pump will be unattractive to his girlfriend during sexual activity D. A woman 21 years of age with T1D who wants an insulin pump to “take over her diabetes management”

4. Sally is a woman, 31 years of age, with T1D who comes to your pharmacy to pick up insulin for use in her insulin pump. During your conversation with Sally, she complains that her infusion sites are frequently coming detached because of sweating during exercise. Which of the following counseling tips would you provide?

A. Avoid activities that cause excessive sweating so your infusion site doesn't become dislodged B. It is okay if your infusion site becomes detached as long as it is not for more than 4 hours C. Contact your physician because insulin pump therapy may not be appropriate for you D. Consider using a skin prep, such as IV Prep or Skin Tac, to improve adhesion of the infusion site to skin

5. The MiniMed 530G with SmartGuard was the first U.S. Food and Drug Administration (FDA)- approved insulin pump utilizing which closed-loop insulin delivery mechanism?

A. Control-to-target – insulin delivery is adjusted to maintain glucose within a target level B. Control-to-range – insulin delivery is adjusted if glucose levels are outside of a prespecified range C. Threshold suspend – insulin delivery is suspended when glucose values fall below a certain threshold D. Bihormonal control system – contains both insulin and glucagon to regulate glucose levels

6. Which of the following statements is FALSE regarding continuous glucose monitoring (CGM) devices?

A. CGM devices measure glucose levels in the interstitial fluid B. All CGM systems no longer require finger-stick glucose tests C. CGM sensors should be replaced every 3 to 10 days D. CGM device/insulin pump combination requires separate sites for glucose readings and insulin infusion

7. Use of CGM has all of the following advantages over conventional self-monitoring of blood glucose (SMBG), EXCEPT:

A. Visualization of glucose trends using on-screen graphs and trend arrows B. Improved glycemic control as demonstrated by reductions in A1C levels C. Increased detection of hypoglycemic episodes D. Provides more accurate glucose readings when glucose is rapidly falling

8. Which of the following systems is the first “hybrid closed-loop” system approved by the FDA?

A. Medtronic 670G system B. Tandem T:slim X 2 pump C. Omnipod Dash D. Medtronic 630G system

9. Which of the following statements is TRUE regarding closed-loop insulin delivery systems?

A. Control-to-target (CTT) systems maintain BG within a pre-specified range B. Early studies of these systems have not demonstrated improved glycemic control compared with insulin pumps and CGM C. The FDA is prioritizing a review of research protocols that involve these systems to expedite development D. Control-to-range (CTR) systems do not require user input

10. Frank is a man 48 years of age with T1D who uses an insulin pump but recently started with a CGM device. He comes into your pharmacy saying he is worried that the glucose readings on his CGM apparatus differ from the finger-stick readings obtained at the same time. Which of the following counseling points is most appropriate?

A. As you now use a CGM device, you no longer have to do finger-stick glucose tests B. The differences in the readings is possibly due to a lag time between interstitial fluid and BG C. You should only use the glucose reading from the CGM device to make insulin dose adjustments D. Do not enter the finger-stick readings into the CGM device's receiver