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MAKING BEST PRACTICE, EVERYDAY PRACTICE

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Breaking through convention to simplicity in type 2 diabetes care – Case study 1

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Breaking through convention to simplicity in type 2 diabetes care – Case study 1 Breaking through convention to simplicity in type 2 diabetes care – Case study 1

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Question 1 of 15
1. Question
This questionnaire saves your responses automatically every 20 seconds if you are interrupted while answering.
1. What further investigations may be useful to determine the extent of his diabetes related complications?
A. Fundus photography
B. Electrocardiogram
C. Fibrosis-4 score
D. All the above
Question 2 of 15
2. Question
2. What would the target HbA1c be for this patient?
A. <8.5%
B. <7.5%
C. <6.5%
D. Individualised goal based on available resources and patient factors
Question 3 of 15
3. Question
3. Which add-on therapy in this patient is unlikely to cause further weight gain?
A. Thiazolidinedione
B. GLP-1 agonist
C. Sulphonylurea
D. Insulin
Question 4 of 15
4. Question
4. The actions of GLP-1 agonist therapy falls rapidly once glucose levels fall into the normal range and is therefore not associated with hypoglycaemia.
A. True
B. False
Question 5 of 15
5. Question
5. Which glucose-lowering agent has the greatest HbA1c reduction?
A. Insulin
B. Sulphonylurea
C. GLP-1 agonist
D. Metformin
Question 6 of 15
6. Question
6. iGlarLixi is considered as add-on therapy. Which medication in the patient’s current treatment regimen needs to be discontinued?
A. Metformin
B. Dapagliflozin
C. Sitagliptin
D. None. All current medications are compatible
Question 7 of 15
7. Question
7. Which other aspects of his holistic diabetes management needs to be addressed?
A. Lipid control
B. Weight management
C. Smoking cessation
D. All the above
Question 8 of 15
8. Question
8. Which dose of iGlarLixi do you start this patient on?
A. 50/100 introduced with 10 dose steps
B. 50/100 at 20 dose steps
C. 33/100 at 10 dose steps
D. 33/100 at 20 dose steps
Question 9 of 15
9. Question
9. iGlarLixi may be given at any time of the day.
A. True
B. False
Question 10 of 15
10. Question
10. The patient complains of some nausea, what do you suggest?
A. Prescribe anti-emetic such as domperidone or odansetron
B. Reduce iGlarLixi dose
C. Advise on dietary modifications
D. Increase dosing interval
Question 11 of 15
11. Question
11. What would be the next step to achieve the desired HbA1c?
A. Add a sulphonylurea
B. Add rapid-acting, prandial insulin to largest meal
C. Increase iGlarLixi dose to 30 dose steps
D. Encourage patient to continuously do self-monitoring of glucose and titration of iGlarLixi
Question 12 of 15
12. Question
12. What is the maximum dose of iGlarLixi 50/100 which the patient can titrate up to?
A. 40 dose steps
B. 60 dose steps
C. 80 dose steps
D. No maximum dose but the daily dose needs to be split as to not to exceed 60 dose steps pe dose
Question 13 of 15
13. Question
13. What would be the recommended LDL target in this patient?
A. <3.0mmol/l
B. <2.5mmoil/l
C. <1.8mmol/l
D. <1.4mmol/l
Question 14 of 15
14. Question
14. According to the latest KDIGO classification, how would you classify his CKD?
A. G1, A1 (low risk)
B. G1, A2 (moderately increased risk)
C. G2, A2 (moderately increased risk)
D. G3a, A2 (high risk)
Question 15 of 15
15. Question
15. Which of the following drug interventions are at present NOT indicated?
A. Aspirin
B. Increasing Atorvastatin dose
C. Increasing iGlarLixi dose
D. All the above

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