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?  

  • Start B12 administration [undo]
  • Temporarily stop taking metformin [undo]
  • Digestia cu endonucleaze de restricție: Condiții optime [undo]
  • Results [undo]
  • Αποτελέσματα καρυοτύπου [undo]
  • Κάνει φασαρία. [undo]
  • Increased entry of fatty acids into adipocytes [undo]
  • Start by selecting the pipette appropriate for your volume. [undo]
  • Allow the woman with the umbrella to decide how she can best help [undo]
  • Opción 1 [undo]
  • Αέρια αίματος [undo]
  • Bisoprolol (beta blocker) [undo]
  • Interfase, profase, metafase, anafase, telofase [undo]
  • Afterload [undo]
  • B, C, F [undo]
  • Με κυτταρολογική εξέταση κατά Tzanck, βιοψία και ανοσολογικό έλεγχο [undo]
  • Methimazole, propranolol, hydrocortisone, iodine solution [undo]
  • Εισαγωγη στο Νοσοκομειο [undo]
  • Sterculia [undo]
  • Costi are 25 de ani și stă împreună cu tatăl și mama sa în minunata lor casă. [undo]
  • Εργαστηριακοί Ζυγοί II [undo]
  • Ετοιμάζει κάτι να φάει. [undo]
  • Ursodeoxycholic acid [undo]
  • Propylthiouracil, propranolol [undo]
  • Option 2 [undo]
  • Propylthiouracil, propranolol, hydrocortisone [undo]
  • Start by immersing the pipette in the liquid you intent to aspirate. [undo]
  • Aumento de la concentración de sustrato [undo]
  • Drink more water and enhance the process of losing weight [undo]
  • Začne jokati. [undo]
  • Decreased production of glucose from the liver [undo]

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

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