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CSOWM 3 exam with complete solutions 2024_2025.
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CSOWM 3 exam with complete solutions2024/2025
Physical Activity for Children/Adolescents with DM (1 & 2) & Pre-DM
- ANSWER✓✓-At least 60 min/day of moderate to vigorous aerobic
activity
vigorous muscle strengthening and bone strengthening activity at least 3 days
per week
Physical Activity for Adults with DM - ANSWER✓✓-150 min of
moderate to vigorous aerobic activity weekly (over at least 3 days)
no more than 2 consecutive days w/o activity
75 min of vigorous aerobic activity weekly (if appropriate)
2-3 weekly sessions of resistance exercise on non consecutive days
all adults should decrease sedentary time (interrupt every 30 min for BG benefit)
flexibility & balance training recommended 2-3 times weekly for older adults with
DM
Potential contraindications for diabetes and exercise - ANSWER✓✓-
Retinopathy (risk of vitreous hemorrhage or retinal detachment)
Peripheral neuropathy (exam feet, wear protection)
Autonomic neuropathy (thorough cardiac eval)
,Diabetic kidney disease (acutely increase urinate albumin excretion) , however no
specific exercise restrictions needed.
DM and Psychosocial Care - ANSWER✓✓-Should be integrated with a
pt-centered approach and provided to all people diagnosed
may include attitudes, expectations with meds and outcomes, affect or mood,
QOL, resources like financial, social, and emotional, and psychiatric history
Critical times to evaluate DSMES - ANSWER✓✓-1. At diagnosis
2. Annually
3. When complications arise
4. When transitions in care occur
Behavior Management for Diabetics - ANSWER✓✓-DSMES
MNT
Physical Activity
Smoking cessation
Psychosocial care
Pharmacotherapy for type 2 DM - ANSWER✓✓-Metformin initially
(low cost)
Early insulin if evidence of catabolism, hyperglycemia, and A1c > 10%
SGLT-2 inhibitors or GLP-1 agonist in patients with CVD, kidney dx, or heart
failure
DPP-4 inhibitors - ANSWER✓✓-weight neutral type II DM medication
ends in -gliptin
(Januvia)
Better GI tolerability over Metformin
Type II DM Meds that cause weight gain - ANSWER✓✓-
Thiazolidinediones (low cost)
Sulfonylureas (Glyburide, Glipizide, Glimepiride) (low cost)
Insulin
GLP-1 Agonists - ANSWER✓✓-Liraglutide (Victoza, Saxenda)
, Semaglutide (Ozempic, Wegovy)
Exenatide
Dulaglutide (Trulicity)
Injections that affect POMC neurons and cause satiety
SGLT2 inhibitors - ANSWER✓✓-Canagliflozin (Invokana)
Dapagliflozin (Farxiga)
Empagliflozin (Jardiance)
prevents reabsorptions of glucose as well as water in the renal tubules
Assessment of Obesity Management in Type II DM - ANSWER✓✓-
Annual BMI calculations (more frequently if necessary)
Inpatient eval may be necessary if deterioration of medical status is associated
with significant weight gain or loss (medication use, food intake, glycemic status)
For pt's with high weight-related stress, special accommodations should be made
to ensure privacy
Obesity Management in Type II DM (short-term) - ANSWER✓✓-Diet,
PA, and BT designed to achieve and maintain >/= 5% weight loss (3-
5% is minimum for any benefit)
>/= 16 sessions in 6 months
Achieve a 500-750 kcal deficit (individualized meal planning)
Individual or group settings
Very low-calorie diets (</= 800 kcal) prescribed only to carefully selected patients
Obesity Management in Type II DM (long-term) - ANSWER✓✓-For >/=
1 year weight maintenance:
- minimum monthly contact
- 200-300 min/wk of physical activity
-self-monitoring
Look AHEAD Trial - ANSWER✓✓-Assessed long-term health
consequences of intentional wt loss. Showed feasibility of achieving
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