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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{AO}}
|QuestionAuthor= {{AO}} (Reviewed by  {{YD}})
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Physiology
|MainCategory=Physiology
Line 21: Line 21:
|MainCategory=Physiology
|MainCategory=Physiology
|SubCategory=Endocrine
|SubCategory=Endocrine
|Prompt=A 58 year old woman with recently diagnosed type 2 diabetes mellitus comes to the clinic for a follow-up on her blood glucose.  Her fasting blood sugar today is 4.5 mmol/l and she is doing well on diet and exercise. You decided to further educate her on the physiology of insulin.
|Prompt=A 58-year-old woman recently diagnosed type 2 diabetes mellitus presents to the clinic for follow-up of her blood glucose concentration.  Her fasting glycemia is 81 mg/dL (4.5 mmol/L) and she is doing well on diet and exercise alone. The patient asks about her need for insulin therapy and how insulin is involved in metabolism. Which of the following cells requires insulin for glucose uptake?
 
|Explanation=Insulin is an anabolic hormone produced in the beta cells of the pancreas.  It is involved in numerous processes in the body, such as fatty acid synthesis, protein synthesis, and glucose metabolism.  In glucose metabolism, insulin is needed for the transport of glucose into cells in skeletal muscles and adipose tissue.  Some organs (brain, RBCs, intestine, cornea, kidney, liver, and beta islet cells of the pancreas) do not require insulin for glucose uptake.   
Which of the following requires insulin for glucose uptake?
<br>
|Explanation=Insulin is an anabolic hormone produced in the beta cells of the pancreas.  It is involved in numerous processes in the body such as fatty acid synthesis, protein synthesis, and glucose metabolism.  In glucose metabolism, insulin is needed in the transport of glucose into cells in skeletal muscle and adipose tissue.  Some organs e.g., brain, RBCs, intestine, cornea, kidney, liver, and beta islet cells do not require insulin action for glucose uptake.  Glucose transporters are required for uptake of glucose into many organs.  There are 4 subtypes:
Glucose transporters are required for uptake of glucose into many organs.  There are several subtypes of glucose transporters:<br>
 
*GLUT-1: RBCs, brain cells, cornea<br>
GLUT-1 – RBCs, brain cells
*GLUT-2 - Has bidirectional activity: Renal tubular cells, small intestinal epithelial cells, liver cells, and pancreatic beta cells<br>
GLUT-2 - Renal tubular cells, small intestinal epithelial cells, liver cells and pancreatic beta cells
*GLUT-3: Neurons, placenta<br>
GLUT-3 – Neurons, placenta
*GLUT-4 – Insulin-responsive transport: Skeletal muscle, adipose tissue
GLUT-4 – Skeletal muscle, adipose tissue
*GLUT-5: Intestinal epithelium
|AnswerA=Brain cells
|AnswerA=Brain cells
|AnswerAExp=Brain cells take up glucose through the activity of GLUT-1 (Glucose Transporter-1)
|AnswerAExp=Brain cells take up glucose through the activity of GLUT-1 (Glucose Transporter-1)
|AnswerB=Liver cells
|AnswerB=Liver cells
|AnswerBExp=Liver cells make use of GLUT-2
|AnswerBExp=Liver cells take up glucose through the activity of GLUT-2
|AnswerC=Skeletal muscle
|AnswerC=Skeletal muscle
|AnswerCExp=Skeletal muscle contains GLUT-4 but they require the action of insulin for glucose uptake
|AnswerCExp=Skeletal muscle contains GLUT-4 but they require the action of insulin for glucose uptake
|AnswerD=Kidney
|AnswerD=Kidney
|AnswerDExp=Kidneys contain GLUT-4 for uptake of glucose
|AnswerDExp=Liver cells take up glucose through the activity of GLUT-4
|AnswerE=Red blood cells
|AnswerE=Red blood cells
|AnswerEExp=Red blood cells contain GLUT-4 for glucose uptake
|AnswerEExp=Liver cells take up glucose through the activity of GLUT-4
|EducationalObjectives=Insulin aids in glucose uptake in skeletal muscles and adipose tissues.
|EducationalObjectives= In glucose metabolism, insulin is needed for the transport of glucose into cells in skeletal muscles and adipose tissue.  Some organs (brain, RBCs, intestine, cornea, kidney, liver, and beta islet cells of the pancreas) do not require insulin for glucose uptake.  
|References=First Aid 2014 page 308
|References=First Aid 2015 page 314
|RightAnswer=C
|RightAnswer=C
|WBRKeyword=Insulin, glucose transporters, glucose uptake
|WBRKeyword=Insulin, Glucose transporters, Glucose uptake, Insulin-responsive, GLUT
|Approved=No
|Approved=Yes
}}
}}

Latest revision as of 01:08, 28 October 2020
Author [[PageAuthor::Ayokunle Olubaniyi, M.B,B.S [1] (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Physiology
Sub Category SubCategory::Endocrine
Prompt [[Prompt::A 58-year-old woman recently diagnosed type 2 diabetes mellitus presents to the clinic for follow-up of her blood glucose concentration. Her fasting glycemia is 81 mg/dL (4.5 mmol/L) and she is doing well on diet and exercise alone. The patient asks about her need for insulin therapy and how insulin is involved in metabolism. Which of the following cells requires insulin for glucose uptake?]]
Answer A AnswerA::Brain cells
Answer A Explanation AnswerAExp::Brain cells take up glucose through the activity of GLUT-1 (Glucose Transporter-1)
Answer B AnswerB::Liver cells
Answer B Explanation AnswerBExp::Liver cells take up glucose through the activity of GLUT-2
Answer C AnswerC::Skeletal muscle
Answer C Explanation AnswerCExp::Skeletal muscle contains GLUT-4 but they require the action of insulin for glucose uptake
Answer D AnswerD::Kidney
Answer D Explanation AnswerDExp::Liver cells take up glucose through the activity of GLUT-4
Answer E AnswerE::Red blood cells
Answer E Explanation AnswerEExp::Liver cells take up glucose through the activity of GLUT-4
Right Answer RightAnswer::C
Explanation [[Explanation::Insulin is an anabolic hormone produced in the beta cells of the pancreas. It is involved in numerous processes in the body, such as fatty acid synthesis, protein synthesis, and glucose metabolism. In glucose metabolism, insulin is needed for the transport of glucose into cells in skeletal muscles and adipose tissue. Some organs (brain, RBCs, intestine, cornea, kidney, liver, and beta islet cells of the pancreas) do not require insulin for glucose uptake.


Glucose transporters are required for uptake of glucose into many organs. There are several subtypes of glucose transporters:

  • GLUT-1: RBCs, brain cells, cornea
  • GLUT-2 - Has bidirectional activity: Renal tubular cells, small intestinal epithelial cells, liver cells, and pancreatic beta cells
  • GLUT-3: Neurons, placenta
  • GLUT-4 – Insulin-responsive transport: Skeletal muscle, adipose tissue
  • GLUT-5: Intestinal epithelium

Educational Objective: In glucose metabolism, insulin is needed for the transport of glucose into cells in skeletal muscles and adipose tissue. Some organs (brain, RBCs, intestine, cornea, kidney, liver, and beta islet cells of the pancreas) do not require insulin for glucose uptake.
References: First Aid 2015 page 314]]

Approved Approved::Yes
Keyword WBRKeyword::Insulin, WBRKeyword::Glucose transporters, WBRKeyword::Glucose uptake, WBRKeyword::Insulin-responsive, WBRKeyword::GLUT
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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