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Question #860

Test Your Knowledge

You are seeing a 57-year-old man whose 10-year cardiovascular risk profile suggests that he should receive a low-dose statin. What should you consider regarding statins and the risk for incident diabetes? a. Statins are not associated with any significant difference in the risk for diabetes. b. Statins can increase the risk for incident diabetes by 48%. c. Statins may particularly promote diabetes among older adults. d. A total of 255 patients receiving statins for 4 years would produce 1 additional case of diabetes. Did you get it right? Follow the link to find out!

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Type 2 Treatment Preferences

Which treatment do you feel most comfortable with for type 2 patients? 1. DPP-4 2. GLP-1 3. SGLT-2 4. Sulfonylurea 5. TZD 6. Insulin Follow the link to share your opinion and see what your colleagues think!

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Time Will Tell What Patient Will Do

Male, 21 years of age has class III obesity, binge eating disorder, fatty liver, and asthma, and was recently diagnosed with type 2 diabetes. It is his freshman year at a college away from home. He eats in the cafeteria, and has no refrigerator or stove in his room. He visits today after not taking metformin or GLP-1 agonist since at starting school. He is under a lot of stress and states the food at school is terrible, unhealthy, and not diabetes-friendly at all. Note, he has been taught a lower carb meal plan. He says he is not taking Glucophage or Victoza; each of them at low doses gives him terrible diarrhea. He states he checks his glucose twice a week, with fastings in the 90-100 range. He is up 10 pounds since our last visit in September.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #50: Biosynthesis, secretion, and action of glucagon Part 4 of 4

Glucagon and diabetes: Plasma levels of glucagon have been found to be increased in all experimental and clinical forms of diabetes mellitus. This disturbance undoubtedly contributes to the hyperglycemia of the disease and excessive ketogenesis of diabetic coma. Numerous studies have shown that failure of glucagon suppression contributes to postprandial hyperglycemia in type 1 and type 2 diabetes.

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