8 July 1A

As per IDF Atlas 11th edition (2025), people living with Diabetes in Pakistan are.

• 220 million

• 34.5 million

• 19 million

• 32 million

Which of the following are part of the "ominous octet" associated with the pathogenesis of type 2 diabetes? Select more than one if apply

• Increase glucose reabsorption in the kidneys

• Decreased glucose uptake in the skeletal muscles

• Decreased lipolysis in the adipose tissue

• All of the above

What does glucagon promote in the liver

• Breakdown of glycogen

• Breakdown of glucose

• Production of glycogen

• Release of insulin

Untreated hypoglycaemia may lead to

• Permanent cognitive impairment

• Loss of consciousness

• Death

• All of above

All the following T2DM therapies are weight neutral/providing weight benefit except

• DPP-4 inhibitors

• GLP-1 Ras

• Sulphonylureas

• SGLT-2 inhibitors

The hormones released under stress conditions are

• Estrogen & Androgen

• Lactogen

• Growth hormone

• Adrenaline & Cortisol

What is Somogyi effect?

• A hypoglycaemic episode whether it causes symptoms or not stimulates secretion of Insulin antagonistic hormones.

• In the insulin deficient person with diabetes, these hormones act unopposed to cause hyperglycaemia.

• As a result the person with diabetes may wake up with an early morning elevated blood glucose level.

• All of above

GLP-1 is a natural incretin hormone secreted by in response to food intake.

• Stomach

• Pancreas

• Kidneys

• Intestine

Glucose dependant secretion of insulin in response to nutrient intake is called

• GLP-1

• Incretin effect

• GIP

• All of the above

GLP-1 stimulates insulin secretion and suppresses glucagon secretion, but only when glucose levels are elevated, thus protecting against hypoglycaemia

• True

• False

• I don't know