USMLE Forum Archives - USMLE Step 1 - DM
DM
conym5 - 02-15-10 09:47
56years old male with DM type 2 is treated with a single dose of NPH insulin. After adding pioglitazone the patient’s needs for insulin decreased and his glycemic control improves as verified by his reduced HbA1c. Which of the following is the most likely mechanism of action of pioglitazone?
conym5 - 02-15-10 09:47
56years old male with DM type 2 is treated with a single dose of NPH insulin. After adding pioglitazone the patient’s needs for insulin decreased and his glycemic control improves as verified by his reduced HbA1c. Which of the following is the most likely mechanism of action of pioglitazone?
The correct answer and explanation will be available after you answer.
Page 1
#3
Re: DM
conym5 - 02-16-10 09:51 Adipose tissue is now recognized as an endocrine organ, which secretes several mediators with diverse functions collectively known as adipocytokines.pioglitazone increase adiponectin levels..
#12
Re: DM mmalik - 02-17-10 03:15 Pioglitazone selectively stimulates the nuclear receptor peroxisome proliferator-activated receptor gamma (PPAR-γ) and to a lesser extent PPAR-α. It modulates the transcription of the insulin-sensitive genes involved in the control of glucose and lipid metabolism in the lipidic, muscular tissues and in the liver. As a result, pioglitazone reduces insulin resistance in the liver and peripheral tissues; increases the expense of insulin-dependent glucose; decreases withdrawal of glucose from the liver; reduces quantity of glucose, insulin and glycated haemoglobin in the bloodstream. Although not clinically significant, pioglitazone decreases the level of triglycerides and increases that of high-density lipoproteins (HDL) without changing low-density lipoproteins (LDL) and total cholesterol in patients with disorders of the lipid metabolism, although statins are the drug of choice for this.
More recently, pioglitazone and other active TZDs have been shown to bind to the outer mitochondrial membrane protein mitoNEET with affinity comparable to that of pioglitazone for PPARγ.
#35
Re: DM mtniharika - 05-17-10 00:30 My answer is: c.
Pioglitazone selectively stimulates the nuclear receptor peroxisome proliferator-activated receptor gamma (PPAR-γ) and to a lesser extent PPAR-α.It modulates the transcription of the insulin-sensitive genes involved in the control of glucose and lipid metabolism in the muscle, adipose tissue, and the liver.
#37
Re: DM babbu5508 - 05-17-10 15:01 My answer is: e.
A consistent increase in serum adiponectin and improvement in insulin sensitivity has been observed with pioglitazone (PGZ),rosiglitazone,and troglitazonesuggesting a class effect of PPAR-γ agonists as all of them lead to a reduction in hepatic fat content, an effect correlated with increase in adiponectin concentration
Page 1