Understanding the Mechanisms to Maintain Glucose

Transcription

1 n posttest n Understanding the Mechanisms to Maintain Glucose Homeostasis: A Review for Managed Care Instructions After reading Understanding the Mechanisms to Maintain Glucose Homeostasis: A Review for Managed Care, complete the program evaluation and select the single best answer to each of the posttest questions. A statement of continuing education credit will be provided to those pharmacists who successfully complete and return the answer form and program evaluation and receive a passing grade of 70% or higher on the posttest. Pharmacist Credit Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 2.5 contact hours (0.25 CEUs) under the ACPE universal activity number of H01-P. This activity is available for CE credit through January 12, Obtaining Credit: Participants must read each article in this supplement, complete the evaluation form, and achieve a passing score of 70% or higher on the posttest. Detailed instructions on obtaining CE credit are included on page S30. Type of activity: Knowledge. Posttest Questions 1. In 2007, the total costs of diabetes mellitus (DM) in the United States were estimated at: a. $58 billion b. $116 billion c. $156 billion d. $174 billion 2. Approximately 85% of endogenous glucose production is derived from the: a. Kidneys b. Muscle c. Liver d. Pancreas 3. The majority of glucose uptake ( 80%) in peripheral tissue occurs in the: a. Kidneys b. Muscle c. Liver d. Pancreas VOL. 18, NO. 1 n The American Journal of Managed Care n S27

2 Posttest 4. of the 12 known GLUT molecules, which is considered the major transporter for adipose, muscle, and cardiac tissue? a. GLUT1 b. GLUT2 c. glut3 d. glut4 5. Numerous factors contribute to development of type 2 DM (T2DM), but the 2 central defects are: a. increased hepatic glucose production and adipocyte dysfunction b. Insulin deficiency and insulin resistance c. increased hepatic glucose production and insulin resistance d. Adipocyte dysfunction and insulin deficiency 6. Which of the following is considered most useful in determining the degree of renal insufficiency and the stage of chronic kidney disease? a. Serum creatinine (SrCr) b. Blood urea nitrogen (BUN) c. urine total protein d. glomerular filtration rate (GFR) 7. With respect to renal involvement in glucose homeostasis, the primary mechanisms include all of the following EXCEPT: a. release of glucose into the circulation via gluconeogenesis b. uptake of glucose from the circulation to satisfy the kidneys energy needs c. reabsorption of glucose at the level of the proximal tubule d. Suppression of excessive hepatic glucose production 8. With respect to the kidneys, what is the tubular maximum for glucose (TmG)? a. <70 mg/min/1.73 m 2 in healthy adults and b. 70 to 110 mg/min/1.73 m 2 in healthy adults and c. 260 to 350 mg/min/1.73 m 2 in healthy adults and d. >350 mg/min/1.73 m 2 in healthy adults and 9. Which of the following act by directly binding to the GLP-1 receptor on pancreatic β-cells or by preventing the inactivation of GLP-1, thereby augmenting glucose-mediated insulin secretion? b. incretin-based therapies c. Biguanides d. Amylin agonists 10. Glucose-galactose malabsorption (GGM) is characterized by intestinal symptoms that manifest within the first few days of life and result from: a. Failure to excrete excess glucose from the kidneys b. failure to absorb glucose and fat from the intestinal tract c. failure to absorb glucose and galactose from the intestinal tract d. failure to absorb galactose and fat from the intestinal tract 11. The earliest evidence of clinically apparent nephropathy is: a. Abnormal levels of albumin in the urine b. increased levels of SrCr c. declining GFR d. increased BUN 12. Diabetes has become the most common single cause of end-stage renal disease in the United States and Europe as a result of several factors, EXCEPT: a. Increasing prevalence of T2dm b. A longer life span among patients with diabetes c. Better formal recognition of renal insufficiency d. decreased spending on end-stage renal disease 13. The most recent glycemic goal recommended by the American Diabetes Association is a glycated hemoglobin (A1C) level of less than: a. 9% b. 8% c. 7% d. 6% S28 n n JANuary 2012

3 Posttest 14. Which of the following agents is indicated for treatment of T2DM and for the treatment of hyperlipidemia? a. Bromocriptine b. colesevelam c. dapagliflozin d. exenatide 15. Which of the following inhibit glucagon production in a glucose-dependent fashion and predominantly decrease postprandial glucose excursions? b. incretin-based agents c. Biguanides d. Amylin agonists (amylinomimetics) 16. Which of the following is not associated with weight loss? a. Metformin b. glyburide c. exenatide d. Pramlintide 17. All of the following are rarely associated with hypoglycemia when given as monotherapy except: a. Sitagliptin b. metformin c. exenatide d. chlorpropamide 18. Which of the following agents or classes of agents is most effective in lowering glycemia and reducing any level of elevated A1C to, or close to, the therapeutic goal? b. Thiazolidinediones c. insulin d. Biguanides 19. exenatide is a hormone with similarity to: a. GIP b. glp-1 c. Amylin d. Both B and C 20. In a study examining the healthcare costs among patients with T2DM, the addition of a new oral antidiabetic drug resulted in: a. 9% higher medication costs b. 14% lower impatient costs c. higher total risk-adjusted healthcare costs d. A and B e. B and C VOL. 18, NO. 1 n The American Journal of Managed Care n S29

4 CPE Instructions Pharmacy Credits Instructions Scoring Options 1. This lession is FREE online; receive instant grading and download your certificate at www. PharmacyTimes.com. 2. Mail and/or fax will be processed for a nominal fee of $10 (see below for address and fax number). Testing and Grading Procedures for Pharmacists 1. Each participant achieving a passing grade of 70% or higher on any examination will receive a statement of credit giving the number of CE credits earned. This form should be safeguarded and may be used as documentation of credits earned. 2. Participants receiving a failing grade on any exam wil be notified and permitted to take 1 reexamination at no extra cost. 3. All answers should be recorded on the answer form. For each question, decide which choice is the best answer, and circle the letter of the response representing your choice. 4. Go to to submit your responses at no fee; or mail completed exam form for a nominal fee of $10 to: Pharmacy Times Office of Continuing Professional Education 666 Plainsboro Road, Suite 356 Plainsboro, NJ or fax the form to: Please all inquiries to ceinfo@pharmacytimes.com or call us at Evaluation form follows. ACE005 S30 n n JANuary 2012

5 CPE Answer Form and Evaluation Please print clearly. CE Answer Form: January 2012 Understanding the Mechanisms to Maintain Glucose Homeostasis: A Review for Managed Care activity H01-P (test valid through January 12, No credit will be given after this date.) 1. a b c d 5. a b c d 9. a b c d 13. a b c d 17. a b c d 2. a b c d 6. a b c d 10. a b c d 14. a b c d 18. a b c d 3. a b c d 7. a b c d 11. a b c d 15. a b c d 19. a b c d 4. a b c d 8. a b c d 12. a b c d 16. a b c d 20. a b c d e Presently Enrolled in CE Program Nonsubscriber Participant Pharmacist Name: Address: City: Zip: Daytime Phone: Specialty: Pharmacist Pharmacy Technician Other (Specify) NABP e-profile Number: Date of Birth (MM/DD Format): CE Evaluation Form: January 2012 Understanding the Mechanisms to Maintain Glucose Homeostasis: A Review for Managed Care Please rate the effectiveness of this activity. Your input and comments are encouraged and appreciated. Poor Poor Poor Average Poor Excellent 1. Overall, how would you rate this activity? Overall, how would you rate the work of the instructor(s)? How would you rate the quality of the instructional materials? Were the learning objectives of this activity met? Not at all Partially Completely (Objective 1) (Objective 2) (Objective 3) Was the activity useful and relevant to your practice? Do you believe the subject matter was presented objectively? Yes No If no, please explain: 7. Do you intend to make any changes to your practice based on learnings from this program? a. Yes b. No If yes, which of the following changes do you intend to implement? (Please select all that apply) a. Provide more in-depth counseling to patients b. Proactively talk to patients with this disease/problem/issue c. Educate staff to better help patients d. Seek more resources to provide to patients e. Implement disease management program f. Improve monitoring for adherence/ persistence g. Other h. None 8. Do you anticipate any barriers in trying to implement changes in your practice? a. Yes b. No c. Don t know If yes, what barriers do you anticipate? (Please select all that apply) a. Lack of time b. Lack of resources c. Lack of pharmacy technician help d. Corporate focus is elsewhere e. Legal issues f. Insurance issues/restrictions g. Patients don t want this service or have no time h. Other i. None 9. Based on the learning from this activity, overall how confident are you in your ability to counsel/educate/manage the disease/condition/ problem (1 being NOT confident and 5 being very confident)? a. 1 (Not confident) b. 2 c. 3 (Somewhat confident) d. 4 e. 5 (Very confident) 10. What other topics related to this topic would you like to explore in future CE activities? Please mail this form to: Pharmacy Times Office of Continuing Professional Education, 666 Plainsboro Road, Suite 356, Plainsboro, NJ VOL. 18, No. 1 n The American Journal of Managed Care n S31