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Production Assistant, Diabetes In Control

High-Temp Cooking

According to a recent study, frequently consuming meat, poultry, or fish cooked at high temperatures increases the risk for hypertension by how much?

A. 11%
B. 17%
C. 23%
D. 25%
E. 38%

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #138: Pathogenesis of Type 2 Diabetes Mellitus Part 9

In summary, postbinding defects in insulin action primarily are responsible for the insulin resistance in T2DM. Diminished insulin binding, when present, is modest and secondary to downregulation of the insulin receptor by chronic hyperinsulinemia. In type 2 diabetic patients with overt fasting hyperglycemia, a number of postbinding defects have been demonstrated, including reduced insulin receptor tyrosine kinase activity, insulin signal transduction abnormalities, decreased glucose transport, diminished glucose phosphorylation, and impaired glycogen synthase activity. The glycolytic/glucose oxidative pathway is largely intact and, when defects are observed, they appear to be acquired secondary to enhanced FFA/lipid oxidation. From the quantitative standpoint, impaired glycogen synthesis represents the major pathway responsible for the insulin resistance in T2DM, and is present long before the onset of overt diabetes, that is, in normal glucose-tolerant, insulin-resistant prediabetic subjects and in individuals with IGT. The impairment in glycogen synthase activation appears to result from a defect in the ability of insulin to phosphorylate IRS-1, causing a reduced association of the p85 subunit of PI-3 kinase with IRS-1 and decreased activation of the enzyme PI-3 kinase.

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Symptom Tracking

A 72-year-old patient arrives in your office complaining of shakiness and sweating before he went to bed the previous night. He doesn’t recall checking his blood glucose level at the time, however he felt better after a glass of milk and a few graham crackers. His current medications are metformin, pioglitazone, and glyburide. Which one of the following medications is the most likely cause of his symptoms?

A. Metformin
B. Pioglitazone
C. Glyburide

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #137: Pathogenesis of Type 2 Diabetes Mellitus Part 8

Glucose transport: Activation of the insulin signal transduction system in insulin target tissues stimulates glucose transport via a mechanism that involves translocation of a large intracellular pool of glucose transporters (associated with low-density microsomes) to the plasma membrane and their subsequent activation after insertion into the cell membrane.

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