Glucose-Lowering Drugs for Type 2 Diabetes

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1. 1

   What is metformin's primary antihyperglycemic action?

   A Decreasing hepatic glucose production B Triggering glucose-independent insulin release C Blocking intestinal protein digestion
2. 2

   How do sulfonylureas stimulate insulin secretion from pancreatic beta cells?

   A They open ATP-sensitive potassium channels B They bind SUR1 and close ATP-sensitive potassium channels C They activate nuclear PPAR-gamma receptors
3. 3

   Which combination of effects is characteristic of GLP-1 receptor agonists?

   

   A Increased glucagon secretion and faster gastric emptying B Reduced renal glucose reabsorption and glucose-independent insulin release C Glucose-dependent insulin release, glucagon suppression, and slower gastric emptying
4. 4

   The image highlights a sodium-glucose transporter on the luminal membrane of an early proximal renal tubule cell. Which drug class inhibits this transporter?

   

   A SGLT2 inhibitors B DPP-4 inhibitors C Alpha-glucosidase inhibitors
5. 5

   What is the pharmacological action of DPP-4 inhibitors such as sitagliptin?

   A They directly activate insulin receptors B They slow the degradation of endogenous incretin hormones C They permanently inhibit pancreatic glucagon synthesis
6. 6

   Which receptor is activated by the thiazolidinedione pioglitazone?

   A GLP-1 receptor B Mineralocorticoid receptor C PPAR-gamma nuclear receptor
7. 7

   An unconscious patient with severe hypoglycemia has no intravenous access. Which treatment is most appropriate?

   

   A Administer glucagon by an approved non-intravenous route B Give oral glucose tablets immediately C Administer rapid-acting insulin
8. 8

   The highlighted insulin action curve begins within minutes, peaks at about one hour, and lasts approximately 3–5 hours. Which insulin category does it represent?

   

   A Intermediate-acting insulin B Rapid-acting insulin C Ultra-long-acting insulin
9. 9

   Which insulin is formulated to provide prolonged, relatively peakless basal coverage?

   A Regular insulin B NPH insulin C Insulin glargine
10. 10

    Which serious complication associated with SGLT2 inhibitors may occur even when blood glucose is only modestly elevated?

    A Euglycemic diabetic ketoacidosis B Severe hyperprolactinemia C Acute cholinergic crisis
11. 11

    Which medication is generally associated with the greatest average weight reduction?

    A Glyburide B Semaglutide C Sitagliptin
12. 12

    For most SGLT2 inhibitors, what medication adjustment is recommended before scheduled surgery to reduce ketoacidosis risk?

    

    A Continue the medication through surgery B Take half the usual dose on the morning of surgery C Stop the medication at least three days before surgery
13. 13

    Which drug delays carbohydrate digestion by inhibiting enzymes at the intestinal brush border?

    A Acarbose B Pioglitazone C Linagliptin
14. 14

    Which medication should generally be avoided in a patient with symptomatic heart failure because it can worsen fluid retention?

    

    A Acarbose B Pioglitazone C Sitagliptin
15. 15

    A patient develops a soft, thickened lump after repeatedly injecting insulin into the same abdominal area. Which practice best prevents this problem?

    

    A Inject through clothing to reduce skin irritation B Use the exact same point for consistent absorption C Rotate injection points systematically within approved regions
16. 16

    At which estimated glomerular filtration rate is metformin contraindicated?

    A Below 30 mL/min/1.73 m² B Below 60 mL/min/1.73 m² C Below 90 mL/min/1.73 m²