Diabetes: prevention of type 2 diabetes: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · Diabetes: prevention of type 2 diabetes

Sample item

A 45-year-old overweight man has impaired glucose tolerance and an HbA1c of 6.0 percent. Based on the Diabetes Prevention Program trial, which strategy gives the greatest reduction in progression to diabetes?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Intensive lifestyle modification with diet, regular exercise and weight loss

In the Diabetes Prevention Program, intensive lifestyle change aiming at about 7 percent weight loss and 150 minutes of exercise a week cut progression by about 58 percent. Metformin reduced it by about 31 percent, so it is less effective than lifestyle change. Indian studies have shown a similar benefit.

Option by option

  • A. Metformin alone

    Metformin helped, but its roughly 31 percent reduction was smaller than that of lifestyle change.

  • B. Annual screening only, with no intervention

    Screening alone does nothing to reduce the risk of progression.

  • C. Intensive lifestyle modification with diet, regular exercise and weight loss (correct)

    Correct. Lifestyle modification gave the largest reduction in the trial, about 58 percent.

  • D. A sulfonylurea

    Sulfonylureas are used to treat established diabetes and are not a standard prevention strategy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this PSM question

What is the answer to this PSM question?

The best answer is C, Intensive lifestyle modification with diet, regular exercise and weight loss. In the Diabetes Prevention Program, intensive lifestyle change aiming at about 7 percent weight loss and 150 minutes of exercise a week cut progression by about 58 percent.

Why is "Metformin alone" not the answer?

Metformin helped, but its roughly 31 percent reduction was smaller than that of lifestyle change.

Why is "Annual screening only, with no intervention" not the answer?

Screening alone does nothing to reduce the risk of progression.

Why is "A sulfonylurea" not the answer?

Sulfonylureas are used to treat established diabetes and are not a standard prevention strategy.

What concept does this question test?

It tests Diabetes: prevention of type 2 diabetes in PSM. Metformin reduced it by about 31 percent, so it is less effective than lifestyle change. Indian studies have shown a similar benefit.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Diabetes: prevention of type 2 diabetes?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.