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In the fasting state, hepatic VLDL assembly and secretion predominate. Utilization of nascent apo B100 for the assembly and secretion of VLDL is, to a large extent, limited by substrate availability, namely TG, as apo B100 is constitutively synthesized. In the presence of adequate TG, apo B100 is progressively lipidated through the actions of hepatic MTP, and the newly assembled VLDL particle is transported to the Golgi apparatus, where it may undergo further lipidation before secretion into plasma.

Study focused on type 2 diabetes patients who initiate metformin.

Pyruvate dehydrogenase and lipogenesis: The generation of pyruvate via glycolysis and L-PK brings the chapter full circle. Tracer experiments in humans estimate PDH flux to be very small in the postabsorptive liver. However, in the fed state activation of hepatic lipogenesis requires activation of PDH flux to generate acetyl-CoA from carbohydrate. PDH consists of three subunits (E1 – E3) that catalyze the sequential decarboxylation, acetyl-CoA formation and reduction of NAD+ to NADH, respectively.

The liver regulates nutrient supply to the entire body. Antoine Lavoisier first scientifically disputed the concept of vitalism by proving that the combustion of material in the blood formed the basis of life and mechanical work by muscle. He suggested that these nutrients were not only absorbed by digestion but that liver played an important anabolic role in maintaining life.

In this exclusive interview transcript, Dr. Stanley Schwartz discusses SGLT-2s and evidence-based medicine: the risk of DKA in Type 2 diabetes is just five in 10,000, compared to a benefit of 38% reduction in cardiovascular mortality.

A team of researchers at the University of Wisconsin School of Medicine and Public Health has identified the genetic cause for a rare syndrome in children with poorly controlled type 1 diabetes.

Will the current information for SGLT-2 inhibitors prevent you from recommending it for diabetes treatment? Follow the link to take the poll!

Have you ever had an error in the use of insulin with your patients? Follow the link to respond!

You have decided that one of your a 72-year-old patients should add a basal insulin dose to her antihyperglycemic regimen. During your discussion with her, she voices concern that between her “arthritic hands and poor vision” she won’t be able to accomplish this. You make the recommendation that using an insulin pen will make injection easier for her. Which of the following statement regarding insulin pens is true? Follow the link to take the quiz!

For those who cannot afford to pay for the new insulins ($250), do you recommend going back to NPH ($25/vial) and Regular insulins ($25/vial)? Follow the link to respond!