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Production Assistant, Diabetes In Control

Sometimes it Takes a Human

63-year-old male, moderate cognitive impairment and lives alone. Patient lost a significant amount of weight, frequent symptomatic hypoglycemia, including light-headedness and dizziness, requiring lowering and stopping some of his glucose lowering medications. GLP-1 was stopped and his glucose levels were in normal range. We were very clear that he should not resume his GLP-1 until we saw him again.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #34: Beta-Cell biology of insulin secretion Part 4 of 5

Gs-protein-coupled receptor: In pancreatic beta cells, various hormones, neurotransmitters, nucleotides, and fatty acids including GLP-1, glucose-dependent insulinotropic polypeptide (GIP), vasoactive intestinal polypeptide (VIP), pituitary adenylate cyclase-activating polypeptide (PACAP), adrenaline, ATP/ADP, lysophosphatidylcholine (LPC), and oleoylethanolamide (OEA) activate their specific receptors. These receptors when coupled with Gs-protein activate adenylate cyclase and increase cAMP production. These cAMP-increasing ligands potentiate both the 1st phase and 2nd phase of GIIS.

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Question 843

Test Your Knowledge

In the fasting state, hyperglycemia is directly related to: 1. Increased hepatic glucose production 2. Defective insulin stimulation of target tissue glucose disposal 3. Decreased adipocyte lipolysis 4. Loss of pancreatic α-cell functionality Did you get it right? Follow the link to find out!

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Cancer Prevention

Do you promote the use of metformin to help prevent cancer as well as to control blood sugars? Follow the link to share your opinion and see what your colleagues think!

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What’s Important to Your Patient?

Male, 26 years of age, type 2 diabetes, obesity, hyperlipidemia, hypertension. Strong family history of type 2 diabetes with complications. Has been a patient since diagnosed 2 years ago. Has met with dietitian. Hasn’t made dietary changes, increased activity, or taken meds prescribed to lower his glucose. A1C 9.2% and rising every 3 months. He would also miss many of his appointments. Stated, “Nothing is going to bother me. Maybe it did my family, but that was a different time and it’s not going to happen to me. I’m going to go on enjoying my life.”

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