An elderly woman with poorly controlled blood glucose levels
on Thursday, July 21, 2022
An elderly woman with type 2 diabetes has poorly controlled blood glucose levels despite treatment with metformin. The physician decides to try pioglitazone.
Which best describes the mode of action of pioglitazone?
a) reduces insulin resistance and improves insulin sensitivity
b) suppresses basal hepatic glucose production
c) reduces fasting plasma glucose
d) activates the AMP-activated protein kinase
e) stimulates first-phase insulin secretion in the pancreatic beta cells
Correct Answer: A
Explanation:
An elevated rate of basal hepatic glucose output is the primary determinant of elevated fasting blood glucose levels in patients with type 2 diabetes. The primary effect of metformin is the suppression of basal hepatic glucose production, thereby reducing fasting plasma glucose . Metformin does not stimulate insulin secretion; in contrast, metformin reduces fasting plasma insulin and improves whole-body insulin-stimulated glucose metabolism (insulin sensitivity). While it is possible that the beneficial effect of metformin on insulin sensitivity is mediated directly, a more likely explanation is that it is secondary to a reduction in hyperglycemia, triglycerides, and free fatty acids. Recent in vitro and in vivo evidence has shown that metformin activates the AMP-activated protein kinase
Question Number 0102 Question : A 13 year old obese boy presents with a three month history of progressive hip pain. There is no hist...
Using Nägele's rule, the estimated delivery date for a patient with menarche age 12, regular menses, and an LMP of March 25 is: A. ...
Question Number 1189 Question : what suspensory ligaments connect the outer edge of the lens of the eye with the ciliary processes? a) zo...
