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?  

  • USING BASIC LABORATORY EQUIPMENT [undo]
  • new node [undo]
  • ΚΥΤΤΑΡΙΚΗ ΔΟΜΗ ΚΑΙ ΛΕΙΤΟΥΡΓΙΑ [undo]
  • Sinteza proteinelor [undo]
  • Ορισμός 1 [undo]
  • Temporarily stop taking metformin [undo]
  • Las células HeLa se cultivan fácilmente y son altamente proliferativas [undo]
  • Introduction to the profession and to other students [undo]
  • Results [undo]
  • Increased entry of fatty acids into adipocytes [undo]
  • Decreased entry of glucose into muscle cells [undo]
  • Ramipril (ACE inhibitor) [undo]
  • Increased entry of fatty acids into adipocytes [undo]
  • Glyceryl trinitrate (organic nitrate) [undo]
  • The patient will be dissatisfied, and might not come to the next appointment and you will lose the follow up. You will also not have enough data about patient’s progress. [undo]
  • I don’t see you follow my instruction, do you not want to lift your left arm? [undo]
  • you will need to adjust the camera focus and sit further from camera [undo]
  • B, C, F [undo]
  • Emergency Department [undo]
  • Metabolism and Enzymes [undo]
  • Sacubitril-valsartan (ARNI) [undo]
  • Decreased production of glucose from the liver [undo]

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

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