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 Best of Five 2.64

 

   

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BOF: 2.64

A 64-year-old male who is known to have insulin dependent diabetes mellitus presents with recurrent episodes of hypoglycaemia. This has necessitated reduction in his daily insulin dosage.

He also has decreased renal function on account of a combination of diabetic nephropathy and bilateral renal artery stenosis.

In this patient the recurrent hypoglycaemic episodes are likely to be a consequence of:

a)      Non Alcoholic Fatty Liver Disease resulting in decreased liver glycogen stores

b)      Autonomic neuropathy resulting in decreased absorption of sugar

c)      Decreased catabolism of insulin by the kidney

d)      Activation of the renin angiotensin system

e)      Decreased insulin resistance

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