Try it
Biochemistry · Carbohydrate metabolism: SGLT2 inhibition
Sample itemA patient with type 2 diabetes is started on a new tablet. Soon afterwards he has glucose in his urine despite only modestly raised plasma glucose, and develops genital candidiasis. Which transporter is inhibited?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Sodium-glucose cotransporter 2 in the proximal tubule
SGLT2 in the early proximal tubule reabsorbs most filtered glucose. Gliflozins inhibit it, causing glucosuria and a fall in plasma glucose independent of insulin. The sugar-rich urine predisposes to genital mycotic infections.
Option by option
A. Sodium-glucose cotransporter 2 in the proximal tubule (correct)
Correct. SGLT2 inhibition blocks renal glucose reabsorption, causing glycosuria and fungal infections.
B. Glucose transporter 2 in the beta cell
GLUT2 in the beta cell senses glucose for insulin release, and its inhibition would not produce urinary glucose loss.
C. Sodium-glucose cotransporter 1 in the jejunum
SGLT1 in the jejunum absorbs dietary glucose and galactose; inhibition would cause diarrhoea rather than glycosuria.
D. Glucose transporter 4 in skeletal muscle
GLUT4 is the insulin-responsive transporter of muscle and fat, and blocking it would not cause glycosuria.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
More Biochemistry questions
- Nucleotide metabolismA 4-year-old boy has intellectual disability, dystonia, self-mutilation and hyperuricaem…
- VitaminsA patient with megaloblastic anaemia and mild neurological signs has raised serum methyl…
- Amino acid metabolismA baby has a mousy odour, fair skin and developmental delay. Which enzyme is deficient?
- Glycogen storage diseasesA child has severe fasting hypoglycaemia, hepatomegaly, lactic acidosis and hyperuricaem…