Diabetologists' question time: Part 6 of an education initiative from Practical Diabetes in partnership with the Young Diabetologists Forum and supported by Boehringer Ingelheim and Lilly

摘要

This series has been designed as a practice resource for SpRs/StRs preparing for the Royal College of Physicians Specialty Certificate Examination and as a source of CPD for others. The answers, which are determined by adherence to published national guidance (when applicable), are explained on page 278. This resource is also available online at www.practicaldiabetes.com. Question 31 A 45-year-old man was reviewed due to poor glycaemic control. He was diagnosed with type 2 diabetes about 3 years ago. He was initially treated with diet alone and then subsequently started on metformin which was eventually titrated up to a dose of lg bd. His latest HbAic is 8.4% (68mmol/mol). He is a non-smoker, drinks moderate amounts of alcohol and has a BMI of 31kg/m~2. He is also an HGV driver and eats irregularly. The decision was made to add nateglinide (a megli-tinide) to his treatment. What is the mechanism of action of meglitinides? A. Stimulation of a membrane receptor, SUR-1 B. Insulin-mediated muscle glucose uptake C. Suppression of hepatic glucose output D. Stimulation of a nuclear receptor, PPARy E. Decreased fatty acid oxidation