Monday , October 23 2017

Question 843

In the fasting state, hyperglycemia is directly related to:


Answer: 1.: Increased hepatic glucose production

Educational Critique: Hyperglycemia is caused by a number of factors. Increased hepatic glucose production is the primary mechanism in the fasting state. In type 2 diabetes, while the islet ß-cells are still able to produce insulin, they are producing relatively insufficient amounts for the degree of insulin insensitivity. In the postprandial state, insufficient suppression of hepatic glucose production as well as decreased insulin stimulated glucose uptake at the target tissues (primarily skeletal muscle) lead to increased plasma glucose. In type 2 diabetes, pancreatic a-cell functionality also changes to a hypersecretory state of glucagon release, leading to further hepatic glucose production. Adipocyte lipolysis generates free fatty acids, which contribute to gluconeogenesis.