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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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Lower Diagnosis Standard

Should we lower the A1c to 5.7 for the diagnosis for diabetes and remove prediabetes as a diagnosis, so that we can treat pharmaceutically? Follow the link to share your opinion.

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Adding Prandial Insulin

Your patient has been systematically titrating his basal insulin dose for the last 6 months. His daily dose is NPH .90 U/kg/day. Despite his good efforts, you decide it would be prudent to add a prandial insulin dose to his treatment regimen. Which of the following scenarios might lead you to this conclusion?

A. A1C=7.4%, FPG less than 130 mg/dl, PPG greater than 180 mg/dl
B. A1C=7.0%, FPG less than 130 mg/dl, PPG less than 180 mg/dl
C. A1C=7.0%, FPG less than 120mg/dl, PPG less than 160mg/dl
D. A1C=6.8%, FPG less than 120 mg/dl, PPG less than 160 mg/dl

Follow the link for the answer.

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