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Production Assistant, Diabetes In Control

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #91: Lipid and Lipoprotein Metabolism, Hypolipidemic Agents, and Therapeutic Goals Part 3

In the fasting state, hepatic VLDL assembly and secretion predominate. Utilization of nascent apo B100 for the assembly and secretion of VLDL is, to a large extent, limited by substrate availability, namely TG, as apo B100 is constitutively synthesized. In the presence of adequate TG, apo B100 is progressively lipidated through the actions of hepatic MTP, and the newly assembled VLDL particle is transported to the Golgi apparatus, where it may undergo further lipidation before secretion into plasma.

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Treatment Changes

Test Your Knowledge

A 42-year-old patient was diagnosed with type 2 diabetes approximately one year ago and is currently taking metformin, a DPP-4 inhibitor, and a basal insulin dose (current daily dose .9 U/kg/day). Despite good compliance with her diet, exercise, and medication regimen, she reports postprandial glucose measurements of usually about 190 mg/dL. Her current A1C is 7.6%. Which of the following changes in her management do you consider most important? A. Add a sulfonylurea to her regimen B. Increase her basal insulin dose C. Add a pre-meal rapid-acting insulin D. Discontinue her basal insulin dose and add a prandial insulin dose Follow the link to see the answer.

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