In diabetic patients, round the clock tight control of hyperglycaemia achieved by multiple daily insulin injections or insulin pumps:

Correct Answer: C

Rationale: Step 1: Tight control of hyperglycemia in diabetic patients aims to reduce complications. Step 2: Multiple daily insulin injections or insulin pumps can lead to hypoglycemia. Step 3: Hypoglycemic reactions are associated with tight control methods. Step 4: Therefore, option C is correct as it highlights the higher incidence of hypoglycemic reactions with round-the-clock tight control.

Correct Answer: A

Rationale: The correct answer is A. Sulfonylureas work by increasing insulin release from the pancreas, which helps lower blood sugar levels. Nondiabetics already have a properly functioning insulin system, so sulfonylureas would not have a significant impact on their blood sugar levels. In contrast, type 1 and type 2 diabetics have insulin deficiency or resistance, making them more responsive to sulfonylureas. Obese diabetics may also benefit from sulfonylureas as they can help improve insulin sensitivity. In summary, sulfonylureas are effective in individuals with diabetes but not in nondiabetics.

Correct Answer: D

Rationale: Rationale: Rosiglitazone is the correct answer as it is not a sulfonylurea but acts by a similar mechanism to enhance insulin sensitivity in peripheral tissues, unlike sulfonylureas that directly stimulate insulin release from pancreatic beta cells. Glimepiride, Repaglinide, and Miglitol are sulfonylureas or alpha-glucosidase inhibitors, which directly stimulate insulin release or delay carbohydrate absorption, respectively, making them unsuitable choices for the question.

Correct Answer: A

Rationale: The correct answer is A: Acarbose. Acarbose inhibits intestinal brush border α-glucosidase enzymes, leading to delayed carbohydrate digestion and absorption. This mechanism helps in controlling postprandial blood glucose levels. Pioglitazone (B) improves insulin sensitivity, Metformin (C) reduces hepatic glucose production, and Guargum (D) is a dietary fiber with no direct impact on α-glucosidase enzymes.

Correct Answer: D

Rationale: The correct answer is D because glucocorticoids promote gluconeogenesis in the liver, increasing glucose production, and depress glucose uptake into skeletal muscles, leading to hyperglycemia. Choice A alone is correct as it contributes to elevated blood glucose levels. Choice B also plays a role by reducing glucose utilization in muscles. Choice C is incorrect as glucocorticoids do not directly inhibit insulin secretion. These mechanisms collectively contribute to impaired carbohydrate tolerance in individuals taking glucocorticoids.