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Production Assistant, Diabetes In Control

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #130: Pathogenesis of Type 2 Diabetes Mellitus Part 1

Normal glucose homeostasis: Any discussion of the pathogenesis of type 2 diabetes mellitus (T2DM) must start with a review of mechanisms involved in the maintenance of normal glucose homeostasis in the basal o postabsorptive state (10–12-h overnight fast) and following ingestion of a typical mixed meal. In the postabsorptive state the great majority of total body glucose disposal takes place in insulin independent tissues.

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Clinical Case Vignette: Macronutrients

Mr. Carlson is a man, 52-years of age. He is Caucasian and works as a grocery store manager. His labs show that they were significant for elevated random plasma glucose 166 mg/dL, A1C 7.6% and elevated lipids (TG=175 mg/dL, LDL 148 mg/dL, HDL 38 mg/dL, total cholesterol 221 mg/dL). His physical exam is notable for central abdominal obesity (waist circumference 42”), BP 147/91, HR 72, RR 18, BMI 36 kg/m2, but otherwise normal. He is started on metformin and a dietitian is recommended. The dietitian discusses with him the benefits of medical nutrition therapy on weight, glycemic control, blood pressure, lipid profile, and overall wellbeing. Which following statement regarding macronutrients is true? A. The ratio of carbohydrates, protein and fat is the same for all patients. B. Total calories consumed per day is the key strategy for achieving glycemic control. C. Reduced intake of trans fat lowers the HDL and raises the LDL. D. Saturated fat should be less than 7% of total calories. Follow the link for the answer.

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GLP-1, SGLT-2 Combo

Have you recommended to any patients the drug treatment of using a GLP-1 receptor agonist and a SGLT-2 inhibitor combination? Follow the link to share your opinion.

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