Gluconeogenesis is decreased by

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Explanation

Insulin is a hypoglycemic hormone, meaning its primary role is to lower blood glucose levels.
It is secreted by the pancreatic beta cells in response to high blood sugar (hyperglycemia), such as after a meal.
A key mechanism by which insulin lowers blood glucose is by actively inhibiting (decreasing) gluconeogenesis, the metabolic pathway that produces new glucose in the liver.
Insulin suppresses the expression of key enzymes required for gluconeogenesis, such as PEPCK and Glucose-6-phosphatase.
Simultaneously, insulin promotes the uptake and storage of glucose in muscle and fat cells, further reducing blood glucose levels.

Option A: Glucagon has the opposite effect. It is a hyperglycemic hormone that stimulates or increases gluconeogenesis to raise blood glucose levels, particularly during fasting.
Option B: Epinephrine (adrenaline) is a stress hormone that increases gluconeogenesis to rapidly elevate blood glucose for the 'fight-or-flight' response.
Option C: Glucocorticoids, such as cortisol, increase gluconeogenesis. They are released during prolonged stress and act to raise blood glucose by promoting the synthesis of glucose from amino acids.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Hormonal regulation of gluconeogenesis as background academic context rather than a clinical decision trigger.
This concept is the foundation of understanding and managing diabetes mellitus. In Type 1 diabetes, the lack of insulin leads to unchecked gluconeogenesis, causing severe hyperglycemia.
In clinical settings, nurses will observe that stressed patients (e.g., post-surgery, with sepsis) often have high blood sugar levels. This is due to the release of counter-regulatory hormones like epinephrine and cortisol, which stimulate gluconeogenesis.
Understanding this allows nurses to anticipate the need for blood glucose monitoring and potential insulin administration in stressed patients, even if they don't have a history of diabetes.

How to Approach the Question

First, define the key term in the question: 'Gluconeogenesis' is the body's process of creating new glucose.
Next, analyze the action word: 'decreased'. The question is asking which hormone stops or reduces the creation of new glucose.
Consider the body's logic: The body would only want to decrease glucose production when blood sugar is already high.
Evaluate the function of each hormone option in relation to blood sugar.
Recall that Insulin's primary job is to lower high blood sugar. Therefore, it must be the hormone that inhibits glucose production.
Recall that Glucagon, Epinephrine, and Glucocorticoids are all 'counter-regulatory' hormones that act to raise blood sugar. They would therefore increase, not decrease, gluconeogenesis.

Concept Tested & Keywords

QAj7btsz5xEyafoe2CPQfA

E6 Harper's Illustrated Biochemistry2023 (pp 26-793 of 813) p. 172-174

E6 Physiology Guyton 4SAE Part 3 p. 5-7

E6 Biochemistry U Satyanarayana— Part 2 (pp 421-820 of 840) p. 305-307

Practise the full RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.