8. The MOST IMPORTANT goal of treatment in DM2 is: include rationale

a.   Restoration of normal plasma glucose levels

b.   Correction of plasma glucose to lower than average levels

c.   Weight loss

d.   Blood pressure lowering

9. D.B.’s glycosolated hemoglobin (HgbA1c) level indicates which of the following: include rationale

a.   D.B.’s blood glucose has been well-controlled for the past 6-12 weeks.

b.   D.B.’s blood glucose was well-controlled until about 3 weeks ago.

c.   D.B’s blood glucose has not been well-controlled for at least the past 6-12 weeks.

d.   D.B.’s blood glucose was not well-controlled until about 3 weeks ago.

10. Which of the following is NOT an appropriate treatment option for DM2? include rationale

a.   Meal planning

b.   Exercise and weight loss

c.   Oral hypoglycemics and/or insulin injections

d.   Pancreas transplant

11. Nonenzymatic glycosolation, which is caused by the attachment of glucose to proteins,

lipids, and nucleic acids, ultimately leads to all the following chronic DM complications,

EXCEPT: include rationale

a.   Thickened basement membranes of blood vessels and nerves

b.   Cellular proliferation of glomeruli and blood vessels

c.   Atherosclerosis

d.   Swelling of the lens of the eye and visual impairment

12. The increased insulin resistance, vascular proliferation, and vessel permeability associated

with inappropriate activation of the protein kinase C (PKC) enzyme is known to contribute to

which complication of chronic DM? include rationale

a.   Retinopathy

b.   Nephropathy

c.   Neuropathy

d.   All the above

13. Which two organs are most often affected by diabetic microvascular disease and resultant

tissue ischemia? include rationale

a.   Skin and kidneys

b.   Brain and eyes

c.   Kidneys and eyes

d.   Skin and heart

14. The first sign of renal dysfunction in diabetic nephropathy is: include rationale

a.   Decreased urinary output

b.   Decreased glomerular filtration rate (GFR)

c.   Increased plasma creatinine

d.   Microalbuminuria