Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which of the following is most likely to occur in people with type 2 diabetes?

1. Decreased hepatic gluconeogenesis

2. Increased synthesis of beta cells

3. Decreased release of glucagon

4. Decreased release of incretins

The correct answer is: Decreased release of incretins

In individuals with type 2 diabetes, there is often a decrease in the secretion of incretins, which are hormones that play a significant role in glucose metabolism. Incretins, such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are normally released in response to food intake and help stimulate insulin secretion from the pancreas, inhibit glucagon release, and promote satiety. In type 2 diabetes, the incretin response is impaired due to varying factors, including insulin resistance and dysfunctional beta cell function. This impairment contributes to elevated blood glucose levels because the body fails to properly regulate insulin and glucagon in response to glucose intake. Furthermore, this reduction in incretin action can also lead to challenges in achieving optimal postprandial glucose levels. On the other hand, individuals with type 2 diabetes may experience increased hepatic gluconeogenesis due to insulin resistance, increased synthesis of beta cells may not occur effectively given the context of the disease, and there is typically an increased rather than a decreased release of glucagon in type 2 diabetes. Thus, the decrease in incretin levels is a significant characteristic associated with the pathophysiology of type 2 diabetes.