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?  

  • Ανακεφαλαιώνοντας [undo]
  • The patient has diabetes. [undo]
  • To protect our clothes underneath. White matches with any skin colour tone [undo]
  • Start caplacizumab and rituximab, without plasma exchange [undo]
  • Se îmbracă pentru a merge cu ei la spital. [undo]
  • Genotipado de ratones para el gen noveltin I: Reactivos para PCR [undo]
  • Začne jokati. [undo]
  • Se ríe de su madre. [undo]
  • Drink more water and enhance the process of losing weight [undo]
  • Βιοχημικές/ αιματολογικές εξετάσεις [undo]
  • Ask more questions - get a detailed medical history [undo]
  • Κοιλιοκάκη [undo]
  • El face zgomot. [undo]
  • Σύγχρονη καρωτιδική και αορτολαγόνια επέμβαση [undo]
  • Προτείνεις να ζητήσουμε χρήματα από την τράπεζα. [undo]
  • Ιδιοπαθής φλεγμονώδης νόσος εντέρου [undo]
  • Visitará a su madre. [undo]
  • Aορτολαγόνια παράκαμψη με διχαλωτή - Υ συνθετική πρόθεση και αγγειοπλαστική επιπολής μηριαίας αριστερά [undo]
  • Καρωτιδική αγγειογραφία/ επέμβαση, αναβολή αορτολαγόνιας επέμβασης [undo]
  • Start B12 administration [undo]
  • Αορτολαγόνια παράκαμψη με διχαλωτή - Υ συνθετική πρόθεση [undo]
  • Getting worse [undo]
  • ΑΠΟΤΕΛΕΣΜΑΤΑ ΗΧΟΚΑΡΔΙΟΓΡΑΦΗΜΑΤΟΣ [undo]
  • Secvențierea genomului [undo]
  • Χειρουργική αποκατάσταση [undo]
  • Κάνω επιπλέον ερωτήσεις για τη συνολική κατάσταση της υγείας δεδομένου πως πρόκειται για υπερήλικα [undo]
  • Diploid și haploid [undo]
  • Terbutaline [undo]
  • Definiția 1 [undo]
  • Pioglitazone [undo]
  • Remote Pathological anamnesis [undo]
  • Start [undo]
  • Furosemide (loop diuretic) [undo]
  • Αιματολογικές και βιοχημικές εξετάσεις [undo]
  • De la 1 cm până la 10 m [undo]
  • Αγγειοπλαστική αορτής και λαγονίων αρτηριών [undo]
  • Answer 2 - hypotonic is distilled water, hypertonic is 6% NaCl, isotonic is 0.9% NaCl [undo]
  • Ultrasound abdomen [undo]
  • To protect our clothes underneath. White is a universal colour which you can find in any country [undo]
  • Fluticasone [undo]
  • Comienza a llorar. [undo]
  • Go back and continue therapy [undo]
  • Other options for pain management [undo]
  • Use open-ended questions and clarify priority symptoms (pain, discharge, fever). [undo]
  • Nebulized ipratropium [undo]
  • Assess the situation to identify any potential risks to yourself or the victim. Secure the victim with the help of a third party. [undo]
  • Bring the patient to Primary Health Care [undo]
  • Admission [undo]
  • Βασίζομαι στα φυσικά χαρακτηριστικά [undo]
  • Θα στείλουμε PSA [undo]
  • Ask rapid questions using medical jargon (ischemia, necrotic tissue, perfusion). [undo]
  • Dominant and recessive [undo]
  • Adverse effect to budesonide [undo]
  • Glyceryl trinitrate (organic nitrate) [undo]
  • Dominant și recesiv [undo]
  • Πρωτεϊνοσύνθεση [undo]
  • Quit therapy for now [undo]
  • Empagliflozin [undo]
  • Απεικονιστικά [undo]
  • Gastrointestinal symptoms [undo]
  • Node 3: Address each concern in detail [undo]
  • Μεταβολισμός και ένζυμα [undo]
  • Επιλογή 2: Μόνο το B είναι σωστό [undo]
  • Validate the emotion [undo]
  • Genotip [undo]
  • do you have anyone that can help you adjust the camera? [undo]
  • Prepararea culturilor lichide [undo]
  • Νευρολογική κλινική [undo]
  • Ignore the wound complaint and focus solely on blood glucose. [undo]
  • Inhalational fluticasone [undo]
  • 5 year old boy with bronchial obstruction [undo]
  • Call intensive care [undo]
  • To protect our clothes underneath. White matches with any skin colour tone [undo]
  • Not satisfied [undo]
  • Labs [undo]
  • Μαγειρική. [undo]
  • Vital Sign [undo]
  • Traits [undo]
  • Labs [undo]
  • Whatsapp [undo]
  • α/α θώρακος [undo]
  • 37°C, ατμοσφαιρικά επίπεδα O₂, 5% επίπεδα CO₂ [undo]
  • Definition 1 [undo]
  • It is absolutely inadvisable to commence warfarin [undo]
  • History of TB [undo]
  • Ignore the emotional expression. [undo]
  • Κλινική εξέταση [undo]
  • Tell the patient to change devices without giving proper guidance. [undo]
  • Option 1 [undo]
  • Reschedule without offering alternative solutions [undo]
  • Warfarin may be commenced as an alternative to apixaban [undo]
  • Allele [undo]
  • Mental Status [undo]
  • Cranial Nerves [undo]
  • Σπινθηρογράφημα μυοκαρδίου [undo]
  • Lab Tests [undo]
  • He shouts at his mother. [undo]
  • Παιχνίδι ρόλων. [undo]
  • Digoxin (digitalis, positive inotropic drug) [undo]
  • Tell woman to calm down [undo]
  • ΗΚΓ [undo]
  • Treatment [undo]
  • Decreased production of glucose from the liver [undo]

Map: Michael Green_GEMD_2 (1116)
Node: 21117
Score:

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