Quiz Questions

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For access to formal online learning modules for healthcare providers, please click here to view how to access D2L. Below are sample questions for:

MEDICATIONS

Medications: Basal Insulin Adjustment in Type 2

QUESTION: Arthur

ARTHUR: What do you suggest for an insulin dose tonight? 

  • 38 years old, DM x 5 years, 68 kg, lean and active (may be LADA)
  • Metformin 1000 mg b.i.d.
  • Secretagogue: Gliclazide (Diamicron®) 160 mg b.i.d. 
  • DPP-4i: Sitagliptin (Januvia®) 100 mg daily 
  • A1c 7.6%; prior starting insulin his FBS were 10-11 mmol/L
  • Started detemir (Levemir®) a few weeks back. Currently 7 units at night.
  Breakfast Lunch Supper Bed
Tues 9.9   7.1 8.1
Wed 10.7     6.8
Thur 10.3     7.9
Frid 11.2       

Medications: BBIT Adjustments for Patterns

  • ICR = Insulin to Carbohydrate Ratio
  • ISF = Insulin Sensitivity Factor or Correction Factor
  • TDD =Total daily dose of insulin
    (may or may not include corrections; generally should if readings frequently over target).
QUESTION: Phee

Phee (they/their) is on basal, bolus insulin therapy (BBIT) with an evening basal dose and rapid insulin at meals.  Target A1c is 7%. 

high supper 2

1.What is their pattern?

  • A. Lows, more than 2-3 per week or severe/unaware
  • B. High pattern in 1 or 2 places
  • C. High everywhere
  • D. Erratic (half & half)

2.What insulin would you adjust first?

  • A. Breakfast meal bolus
  • B. Lunch meal bolus
  • C. Supper meal bolus
  • D. HS basal

Resource: Insulin Adjustments, section and TABLE (here) on Adjusting for Hyperglycemia

Medications: BBIT Adjustments for No Pattern (Erratic)

  • ICR = Insulin to Carbohydrate Ratio
  • ISF = Insulin Sensitivity Factor or Correction Factor
  • TDD =Total daily dose of insulin
    (may or may not include corrections; generally should if readings frequently over target)
QUESTION: Sullivan
 

 

Sullivan Glucose
  • ICR 1:18
  • ISF 3
  • Degludec 18 u at HS
  • TDD= 35 u

What do you suggest to address the problem? Pick one.

  • A. Increase basal insulin (degludec)
  • B. Change ICR to give more bolus 
  • C. Change ICR to give less bolus
  • D. Change ISF

 Resources: