Diabetes Assessment 2 : Version 2

Metformin decreases hepatic _____________ production, decreases ________________ absorption of glucose, and improves ______________ sensitivity by increasing peripheral glucose uptake and utilization.

Glucagon, intestinal, insulin

Insulin, pancreatic, insulin

Insulin, intestinal, incretin

Glucose intestinal, insulin

Approximately _______ of sitagliptin is excreted unchanged in the ___________.

43%; urine

79%; urine

43%; feces

79%; feces

What is the half-life of sitagliptin?

6.2 hours

12.4 hours

17.6 hours

3 hours

The dosage of JANUMET XR should be individualized while not exceeding the maximum recommended daily dose of ______________ sitagliptin and _________ metformin.

100 mg; 2000 mg

100 mg; 1000 mg

50 mg; 2000 mg

50 mg; 1000 mg

For patients taking two tablets of the 50 mg sitagliptin/500 mg metformin hydrochloride extended-release tablet or the 50 mg sitagliptin/1000 mg metformin hydrochloride extended-release tablet, the two tablets should be taken together once daily.

True

False

JANUMET XR can safely be used in patients with renal insufficiency.

True

False

Fill in the blanks:

Brand Generic Name Therapeutic Class

Galvus ___________ _______________

________ liraglutide _______________

Linagliptin, DPP4-inhibitor; Byetta, GLP-1 analog

Exenatide, GLP-1 analog; Byetta, GLP-1 analog

Vildagliptin, DPP4- inhibitor; Victoza, GLP-1 analog

Saxagliptin, DPP4- inhibitor; Victoza, DPP4- inhibitor

Sitagliptin and metformin have complementary mechanisms of action and additive/synergistic effects with respect to _______________ the concentrations of active ____________in plasma.

Increasing; GLP-1

Increasing; incretins

Increasing; GIP

Maintaining; GLP-1

Which of the following is approved indication of sitagliptin?

I.Combination with insulin

II.Combination with PPARr agonist

III.Combination with SU

IV.Combination with metformin and SU

I, II and III

I, II and IV

II, III and IV

All of the above

The GLP-1 level is ___ and action is ____ for type 2 diabetes patients; while GIP level is ___ and action is ___ for type 2 diabetes patients

Decreased, intact, intact, decreased

Intact, decreased, intact, decreased

Intact, decreased, decreased, intact

Decreased, intact, decreased, intact

List out the core defects that combination of sitaglipin and metformin addressed in type 2 diabetes patients

I.Improve insulin secretion

II.Improve insulin resistance / increase insulin sensitivity

III.Lower hepatic glucose production

I and II

I and III

II and III

All of the above

The following is true except

Higher HbA1c baseline level correlates With larger HbA1c reduction with the use of sitagliptin

Sitagliptin is superior to glipizide as add-on therapy to metformin with additional advantage of lower risk hypoglycemia and weight reduction

Sitagliptin has higher rates of hypoglycemia requiring non-medicalassistance as add-on when combined with glimepiride with/without metformin

In Muslim patients with T2DM who fasted during Ramadan, treatment with sitagliptin at no dosage adjustment vs SU resulted in significantly lower incidences of symptomatic hypoglycemia

TECOS is the cardiovascular safety trial for ____. The patients enrolled in the TECOS are with ____, A1C in the range of _____. The median duration of follow-up is ___years.

Sitagliptin; Pre-existing CV disease or multiple CV risk factors ; 6.5 – 8%; 3.0

Sitagliptin; pre-existing CV disease; 6.5 – 8%; 3.0

Saxagliptin; preexisting CV disease; 6.5 – 12%; 2.1

Saxagliptin; pre-existing CV disease or multiple CV risk factors; 6.5 – 12%; 2.1

The primary endpoint of TECOS includes ____. The study drug showed ____, and _____ in terms of hospitalization due to heart failureThe primary endpoint of TECOS includes ____. The study drug showed ____, and _____ in terms of hospitalization due to heart failure

CV death non fatal MI and non fatal stroke; non-inferior to standard of care; no difference compared to placebo

CV death non fatal MI non fatal stroke and hospitalization for unstable angina; superior to standard of care; no difference compared to placebo

CV death non fatal MI non fatal stroke and hospitalization for unstable angina; non-inferior to standard of care; increased risk compared to placebo

CV death non fatal MI non fatal stroke and hospitalization for unstable angina; non-inferior to standard of care; no difference compared to placebo

OGTT diagnostic value for Diabetes is ≥ 7.0 mmol/L post 2-hour

True

False

American Diabetes Association (ADA) recommend consider starting with 2-drug combinations in patients with very high HbA1c (≥10%) to achieve control more rapidly

True

False

The glycemic target as recommended in American Association of Clinical Endocrinologists (AACE)/ American College of Endocrinology (ACE) is 6.5% with individualize approach.

True

False

Sitagliptin and metformin have complementary mechanisms of action and additive/synergistic effects with respect to increasing the concentrations of active GLP-1 in plasma.

True

False

Sitagliptin has a dedicated phase III clinical study to evaluate efficacy as monotherapy in Japanese patients.

True

False

One of sitagliptin renal clinical studies is efficacy and safety comparison with gliclazide in patients with type 2 diabetes mellitus and end-stage renal disease on dialysis.

True

False

What is the criteria for diagnosis of diabetes based on

FPG ≥ _____mmol/L

CGTT ≥ _____mmol/L

6,5; 11.1

7.0; 11.1

7.0; 12.0

6.5; 12.0

Sitagliptin showed superiority comparing to glipizide in patients with end-stage renal disease or on dialysis .

True

False

Which of the following statements are correct?

I.Confirmed events of acute pancreatitis were uncommon, but numerically more frequent in the sitagliptin group

II.Confirmed events of acute pancreatitis were uncommon, but numerically less frequent in the sitagliptin group

III.Confirmed events of pancreatic cancer were uncommon, but numerically more frequent in the placebo group

IV.Confirmed events of pancreatic cancer were uncommon, but numerically less frequent in the placebo group

V.Both are not statistically significant

VI.Both are statistically significant

I, III, V

II, IV, V

I, III, VI

II, IV, VI

TECOS has enrolled renal impaired patients with eGFR < 30

True

False

The elderly subanalysis in TECOS study include patients older than 65 years old

True

False

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