A 52-year-old woman visits the office for a check-up on her type 2 diabetes mellitus. The patient was diagnosed with diabetes 6 months ago and began an intensive lifestyle modification program that included increased exercise and a calorie-restricted diet; she has felt better subjectively since then but has lost only 2 kg (4.4 lb) . Vital signs are typical. 35 kg/m² is the BMI. The fasting glucose level is 155 mg/dL, and the hemoglobin A1c level is 8.0 percent. The levels of renal and liver function markers in the blood are normal. Metformin therapy is started after a discussion with the patient. Which of the following physiologic changes are most likely to result as a direct effect of this medication?

Question

Quizplus · Accepted Answer

Eductional Objective: Metformin decreases hepatic gluconeogenesis and glucose release into circulation, increases peripheral glucose uptake and utilization, and lowers circulating lipid levels. Metformin has a low risk of hypoglycemia because circulating insulin levels are unchanged or slightly decreased. Furthermore, metformin reduces caloric intake due to decreased appetite and decreased glucose absorption, resulting in modest weight loss.

A 52-Year-Old Woman Visits the Office for a Check-Up on Her