Diabetes Education Certification Education Pathophysiology and Treatment 2

Question 1

In type 2 diabetes, which cellular mechanism primarily causes insulin resistance in skeletal muscle?

Accepted Answer

Impaired insulin receptor substrate (IRS-1) phosphorylation

Answer

Defective IRS-1 phosphorylation downstream of the insulin receptor disrupts the PI3K/Akt signaling cascade needed for GLUT4 translocation and glucose uptake in skeletal muscle.

Question 2

A patient with type 1 diabetes presents with blood glucose of 42 mg/dL and is unconscious. Which treatment is most appropriate?

Accepted Answer

1 mg glucagon intramuscular injection

Answer

An unconscious hypoglycemic patient cannot safely swallow; 1 mg IM glucagon stimulates hepatic glycogenolysis to raise blood glucose rapidly.

Question 3

Which incretin hormone primarily stimulates glucose-dependent insulin secretion and suppresses glucagon in type 2 diabetes management?

Accepted Answer

Glucagon-like peptide-1 (GLP-1)

Answer

GLP-1, secreted by intestinal L-cells, enhances glucose-dependent insulin release, suppresses glucagon, and slows gastric emptying, making it a key target for GLP-1 receptor agonist therapies.

Question 4

The Somogyi effect (rebound hyperglycemia) is best described as:

Accepted Answer

Hyperglycemia following nocturnal hypoglycemia triggered by counter-regulatory hormones

Answer

The Somogyi effect occurs when nocturnal hypoglycemia triggers a counter-regulatory hormone surge (epinephrine, glucagon, cortisol) that causes rebound morning hyperglycemia.

Question 5

Which pathophysiologic process explains why patients with diabetic ketoacidosis (DKA) develop hyperkalemia despite total body potassium depletion?

Accepted Answer

Acidosis causing intracellular potassium to shift extracellularly

Answer

In acidosis, hydrogen ions move into cells in exchange for potassium ions moving out, raising serum potassium even when total body stores are depleted.

Diabetes Practice Test

Diabetes Practice Test

Diabetes Education Certification Education Pathophysiology and Treatment 2