CDCES Pathophysiology of Diabetes 2

Question 1

What is the primary metabolic consequence of insulin deficiency in the liver?

Accepted Answer

Unchecked gluconeogenesis and glycogenolysis leading to fasting hyperglycemia

Answer

Insulin normally suppresses hepatic glucose production; without insulin, gluconeogenesis and glycogenolysis are unchecked, contributing to fasting hyperglycemia.

Question 2

Which describes the mechanism by which SGLT2 inhibitors lower blood glucose?

Accepted Answer

They block SGLT2 transporters in the proximal tubule, preventing renal glucose reabsorption

Answer

SGLT2 inhibitors block sodium-glucose cotransporter 2 in the kidney's proximal tubule, causing glucosuria (urinary glucose excretion) and lowering blood glucose without insulin stimulation.

Question 3

Maturity-onset diabetes of the young (MODY) is most commonly caused by which mechanism?

Accepted Answer

Single-gene mutations affecting beta-cell function or glucose sensing

Answer

MODY is a monogenic diabetes caused by single-gene mutations (most commonly in GCK, HNF1A, or HNF4A genes) that impair beta-cell function or glucose sensing.

Question 4

What is the role of amylin in glucose regulation, and how does its deficiency affect diabetes management?

Accepted Answer

Amylin suppresses glucagon, slows gastric emptying, and promotes satiety; its deficiency contributes to postprandial hyperglycemia in type 1 diabetes

Answer

Amylin (co-secreted with insulin from beta cells) suppresses glucagon, slows gastric emptying, and promotes satiety; in T1D with beta-cell loss, amylin deficiency contributes to postprandial glucose excursions.

Question 5

Which physiological mechanism explains why patients with longstanding type 1 diabetes may lose the early warning symptoms of hypoglycemia?

Accepted Answer

Repeated hypoglycemia episodes downregulate counter-regulatory hormone responses and shift the glycemic threshold for symptom generation

Answer

Hypoglycemia unawareness results from recurrent hypoglycemia that downregulates epinephrine and glucagon counter-regulatory responses and lowers the BG threshold at which symptoms appear.

(CDCES) Certified Diabetes Care and Education Specialist Practice Test

(CDCES) Certified Diabetes Care and Education Specialist Practice Test

CDCES Pathophysiology of Diabetes 2