Decreased production of glucose from the liver

This is correct! Metformin activates AMPK-dependent protein kinase (AMPK) due to a reduction in cellular energy stores. AMPK reduces hepatic glucose production (gluconeogenesis) through inhibition of expression of genes that are important in gluconeogenesis. Remember that gluconeogenesis contributes to hyperglycaemia in diabetes.


Further Developments

Five years later, Mr. Green reports progressive exertional dyspnoea over several months, now short of breath after one flight of stairs, with new orthopnoea requiring two pillows and intermittent paroxysmal nocturnal dyspnoea. The medical notes show lack of follow-up over the past 18 months, which Mr. Green explains were due to a job change. He reports that his home blood pressure readings have been on the high side.

On examination his blood pressure is 132/78 mm/Hg and his BMI is now 30 kg/m2; physical examination shows bibasilar rales. Mr. Green is scheduled for an echocardiogram and invasive coronary angiography with a contrast agent to assess for obstructive coronary artery disease.

What is the most appropriate advice for Mr. Green for use of metformin during this time?  

  • Assess the situation to identify any potential risks to yourself or the victim. Secure the victim with the help of a third party. [undo]
  • Αλληλόμορφα [undo]
  • Наполягати на амбулаторному обстеженні та лікуванні. [undo]
  • Whatsapp [undo]
  • Laboratory Safety [undo]
  • Βασίζομαι στα φυσικά χαρακτηριστικά [undo]
  • Option 1 [undo]
  • Intro [undo]
  • Reschedule without offering alternative solutions [undo]
  • Decreased entry of glucose into muscle cells [undo]
  • Increased entry of fatty acids into adipocytes [undo]
  • Increased entry of fatty acids into adipocytes [undo]
  • Χρησιμοποιώ μόνο Μεντελική πιθανότητα [undo]
  • Opțiunea 3 [undo]
  • USING BASIC LABORATORY EQUIPMENT [undo]
  • Adverse effect to formoterol (LABA) [undo]
  • Un microscop care folosește o sursă de electroni pentru a mări obiectele [undo]
  • Game Over [undo]
  • Theophylline [undo]
  • Re-referral [undo]
  • Meet the patient [undo]
  • The Telemedicine Dilemma [undo]
  • Let the woman shout, shake and slap the victim. [undo]
  • Genome Sequencing [undo]
  • Μίτωση [undo]
  • Home Visit [undo]
  • Alotetaan! [undo]
  • Pipettes [undo]
  • Sacubitril-valsartan (ARNI) [undo]
  • new node [undo]
  • Start [undo]
  • Ο ασθενής σας δίνει λεπτομερές ιατρικό ιστορικό [undo]
  • Costi are 25 de ani și stă împreună cu tatăl și mama sa în minunata lor casă. [undo]
  • Option 2 [undo]
  • Bisoprolol [undo]
  • Do telemedicine [undo]
  • Root Node [undo]
  • Second [undo]
  • Root Node [undo]
  • ELECTRON MICROSCOPY [undo]
  • 1cm to 10m [undo]
  • [undo]
  • Testul cu iod [undo]
  • Πρακτική Άσκηση σε Εγκληματολογικό Εργαστήριο [undo]
  • give paracetamol [undo]
  • MICROSCOPIA ELECTRONICĂ [undo]
  • Increased elimination of cholesterol [undo]
  • Laboratorul de microbiologie alimentară [undo]
  • Last [undo]
  • Exacerbation of asthma [undo]
  • Temporarily stop taking metformin [undo]
  • What happens with the Age? [undo]
  • Διάχυση [undo]
  • ΚΥΤΤΑΡΙΚΗ ΔΟΜΗ ΚΑΙ ΛΕΙΤΟΥΡΓΙΑ [undo]
  • Do home visit directly [undo]
  • Ask local cadre to help [undo]
  • You should never use antacids [undo]
  • Ζητώ καρυότυπο [undo]
  • Decreased production of glucose from the liver [undo]

Map: Michael Green_GEMD_1 (1115)
Node: 21093
Score:

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