A 67-year-old woman visits the office for a check-up on her type 2 diabetes mellitus. Six months ago, she was diagnosed with diabetes. Although lifestyle changes were initially recommended, the patient's glycemic control did not improve significantly. The patient was started on metformin one month ago and has remained on it; however, she has been experiencing abdominal discomfort and diarrhea as a result of the therapy. She has no other medical issues. The BMI is 28 kg/m2². The physical exam is unremarkable. According to laboratory results, hemoglobin A1c is 8.2 percent. After further discussion, metformin is discontinued and glyburide is prescribed. Compared to metformin, this new therapy is most likely to increase the risk of which of the following?

Question

Quizplus · Accepted Answer

Eductional Objective: Sulfonylureas cause depolarization and L-type calcium channel opening by inhibiting the ATP-sensitive potassium channel on the pancreatic beta cell membrane. Independent of blood glucose levels, increased Ca²⁺ influx stimulates beta cell insulin release. Even when blood glucose levels are normal, sulfonylureas stimulate insulin secretion, which can result in hypoglycemia.

A 67-Year-Old Woman Visits the Office for a Check-Up on Her