A 56-year-old man with type 2 diabetes mellitus comes to the physician for a follow-up examination. Three months ago, the patient was started on metformin therapy after counseling on diet, exercise, and weight reduction but it failed to reduce his hyperglycemia. A new medication has been added. In the next follow up, he reports a new episodes of headaches, nausea, sweating, and feeling like he is going to pass out. During the most recent episode, his fingerstick glucose was 50 mg/dL. Vital signs are within normal limits, and physical examination shows no abnormalities. Laboratory results show hemoglobin A1c is 6.7%. The medication most likely causing this patient's current symptoms works by targeting which of the following?

Question

A 56-year-old man with type 2 diabetes mellitus comes to the physician for a follow-up examination. Three months ago, the patient was started on metformin therapy after counseling on diet, exercise, and weight reduction but it failed to reduce his hyperglycemia. A new medication has been added. In the next follow up, he reports a new episodes of headaches, nausea, sweating, and feeling like he is going to pass out. During the most recent episode, his fingerstick glucose was 50 mg/dL. Vital signs are within normal limits, and physical examination shows no abnormalities.  Laboratory results show hemoglobin A1c is 6.7%.  The medication most likely causing this patient's current symptoms works by targeting which of the following?

Quizplus · Accepted Answer

Eductional Objective: Sulfonylureas inhibit the ATP-sensitive potassium channel on the pancreatic beta cell membrane, inducing depolarization and L-type calcium channel opening. The increased Ca²⁺ influx stimulates beta cell insulin release independent of blood glucose concentrations. Sulfonylureas can induce hypoglycemia because they stimulate insulin secretion even when blood glucose levels are normal.

A 56-Year-Old Man with Type 2 Diabetes Mellitus Comes to the Physician