A 48-year old female presents to her physician with concern of worsening fatigue over the past months. She reports feeling tired out all the time and unable to concentrate. Nothing seems to make it better, not even rest. She has not seen a physician in a number of years other than for routine OB/gyn care and reports having gradually put on 40-50 lbs. over the past 10 years. (Current weight 253; height 65.5 inches) She undergoes an oral glucose tolerance test and based on that data (and other laboratory values) she is diagnosed with type 2 diabetes. Further testing shows she is also hypertensive and has hyperlipidemia. What isthe metabolic connection between type 2 diabetes and hyperlipidemia? Be specific in your discussion and include relevant enzymesrelated to lipid metabolism. Circulating levels of which lipoproteins would be consistent with a diagnosis of hyperlipidemia? Be specific and include rationalesfor why some lipoproteins may be elevated and others not. This individual is prescribed metformin to help manage her blood glucose levels. Describe the proposed mechanisms by which metformin reduces blood glucose levels and increases beta-oxidation. Be sure to include a discussion of AMP Kinase in your answer.

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A 48-year old female presents to her physician with concern of worsening fatigue over the
past months.
She reports feeling tired out all the time and unable to concentrate. Nothing seems to
make it better, not even rest. She has not seen a physician in a number of years other
than for routine OB/gyn care and reports having gradually put on 40-50 lbs. over the
past 10 years. (Current weight 253; height 65.5 inches)
She undergoes an oral glucose tolerance test and based on that data (and other
laboratory values) she is diagnosed with type 2 diabetes. Further testing shows she is also
hypertensive and has hyperlipidemia.
What isthe metabolic connection between type 2 diabetes and hyperlipidemia? Be specific in
your discussion and include relevant enzymesrelated to lipid metabolism.

Circulating levels of which lipoproteins would be consistent with a diagnosis of hyperlipidemia?
Be specific and include rationalesfor why some lipoproteins may be elevated and others not.

This individual is prescribed metformin to help manage her blood glucose levels. Describe the
proposed mechanisms by which metformin reduces blood glucose levels and increases
beta-oxidation. Be sure to include a discussion of AMP Kinase in your answer.

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