NBME 21 Stimulation of the peroxisome proliferator-activated receptor γ (NBME Answers)

Retired NBME 21 Answers

nbme21/Block 1/Question#21 (reveal difficulty score)
A 40-year-old man with type 2 diabetes ...
Stimulation of the peroxisome proliferator-activated receptor γ 🔍 / 📺 / 🌳 / 📖
tags: pharm endo repeat

+11 upvote downvote
submitted by sgarzon15(11)

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Thank you glitter zone of sketchy pharm. I shall never forget you

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cr why not C?. It´s not supose that it improve the efectivity of insulin? +

divya because insulin uptake by adipose and muscle tissue is not limited to thiazolidinediones but also and mainly by metformin. and glitazones' primary MOA is PPAR gamma stimulation which then increases insulin sensitivity to other tissues. +2

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submitted by ∗madojo(212)

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Going over the other answer choices:

Blocking ATP sensitive potassium channels in the pancreatic beta cells to increase insulin secretion would be drugs like Sulfonylureas or Meglitinides for example like Glyburide.
Increasing endogenous GLP1 or GIP levels are drugs like Sitagliptan and Saxagliptan. They have GLP in them
Increasing peripheral glucose uptake would be the biguanides like metformin.
Stimulating transcription regulator PPAR-gamma decreases insulin resistance and is the MOA of thiazolidenediones like Pioglitazone.

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submitted by cr(5)

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why not C?. It´s not supose that it improve the efectivity of insulin?

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yb_26 thiazolidinediones (pioglitazone) increase insulin sensitivity (in muscles and liver) through activation of peroxisome proliferator-activated receptor-gamma (PPAR) I think they are asking about primarily mechanism of action, that's why it is E +

cienfuegos UW explanation regarding the genes upregulated 1. GLUT4: insulin responsive on adipocytes/skeletal increases G uptake 2. adiponectin: cytokine secreted by adipocytes increases # of insulin responsive adipocytes and stims FA oxidation 3. PPAR family also plays significant role in pathogenesis of metabolic syndrome +2

poisonivy Also, I think the word uptake shouldn't be right when speaking about insulin, it does increase insulin sensitivity and therefore glucose uptake +9

brotherimodu @poisonivy That's why I didn't choose C and went with E since it was more specific +

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submitted by ∗namesthegame22(13)

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Pioglitazone is an oral thiazolidinedione that is used for the treatment of type 2 diabetes mellitus. it binds to peroxisome proliferator-activated receptors (PPARs): act as transcription factors to regulate metabolism and promote insulin sensitivity.

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