CC CARBOHYDRATES

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130 Terms

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130

grams or 520 kcal per day

The minimum recommended intake of

carbohydrates necessary for survival is_______________

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the central nervous system, red blood

cell production, and tissues dependent on

glucose

130

grams or 520 kcal per day level is recommended only to

support_________________; it does not support any physical

activity.

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Carbohydrates

______________are the immediate sources of

energy for the body.

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monosaccharide glucose

The____________ serves as the

major entry point for all foodstuffs to the

metabolic pathways of the body

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Exogenous carbohydrates

______________ are usually

obtained from plant products. They are

commonly in the form of starch.

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Glycogen or "animal starch"

_______________easily

disintegrates upon death of the animal. Thus,

meats are not good sources of carbohydrates.

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the liver and in the muscles

When there is excess of carbohydrates, the

body stores them in the form of glycogen in

___________________.

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Muscle

glycogen

These carbohydrate stores constitute the

body's endogenous carbohydrates. ___________, however, is available only for the

muscles and not for other tissues.

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monosaccharides, disaccharides, and

polysaccharides

Carbohydrates are classified into

________________ depending on the chemical

complexity of the molecule

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Monosaccharides

building blocks of carbohydrates. They include

glucose, fructose, and galactose

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Disaccharides

made up of two monosaccharide units. Examples

of these are sucrose (glucose + fructose), maltose

(glcose + glucose) and lactose (glucose +

galactose)

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Polysaccharides

polymers of monosaccharides

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Starch, cellulose and glycogen

_______________are all

polymers of glucose. They just differ in how the

glucose units are joined together.

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starch, sucrose,

lactose and cellulose

The usual carbohydrates taken in by the

body are in the form of _________________.

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the

body does not have the necessary enzymes

to degrade this polysaccharide.

Of these, cellulose is not changed as it passes

through the gastrointestinal tract because_______________

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Cellulose fibers

However, it contributes to the bulk of the stool

as it is formed in the colon._____________ are

therefore important in the normal passage of

wastes through the gastrointestinal tract.

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salivary amylasw

Carbohydrate digestion starts in the mouth

where the enzyme ________________ is

secreted by the salivary glands.

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starch dextrins,

maltose and glucose

The enzyme

amylase converts starch into ________________.

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the

breakdown of starch into smaller fragments

In Digestion

The end result of this enzymatic digestion is_____________

which are still large enough to be absorbed in

the intestines.

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in

the brush border of the cells lining the lumen

of the small intestine.

In Digestion

These products plus the other disaccharides

(lactose and sucrose) ingested are then

acted upon by disaccharidases located _________________.

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brush border enzymes

The __________ act on maltose,

isomaltose, a-limit dextrins, sucrose, and

lactose to form the monosaccharides glucose,

fructose, & galactose.

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Stool

In Digestion

Cellulose remains unchanged and is

eventually excreted via ______.

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the

intestines.

In Digestion

In certain instances, the body may not

tolerate the presence of disaccharides in _________

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intestinal ulcers

In Digestion

Body may not tolerate disaccharides in intestines. This happens when certain brush border

enzymes are genetically absent or are

destroyed when there are ___________

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lactase deficiency,

(with lactose-fermenting bacteria)

In Digestion

For example, when there is___________, this results

in the formation of gases leading to

abdominal cramps and flatulence "Lactose

Intolerance".

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monosaccharides

Can be absorbed by the intestines

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Glucose and Galactose

______________are absorbed from

the lumen of the intestine principally by an

active process involving cotransport with

sodium.

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Cotransport

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facilitated

diffusion

Glucose and galactose then leave the mucosal cells by____________ as they enter the portal circulation.

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passive diffusion

In Digestion

In

contrast, fructose is absorbed from the lumen of

the intestine by______________.

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portal circulation

Once the monosaccharides reach the liver

via the__________, interconversion of

hexoses occurs.

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Glucose

Interconversion of hexoses occurs, converting fructose and galactose to__________

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galactokinase and

galactose-1-phosphate uridyl transferase

Specifically, galactose is converted to

glucose by the action of two important

enzymes, namely, _____________________

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Galactosemia

Absence of any of these enzymes results in the

leakage of galactose in the circulation, a

condition called ___________.

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galactilol &

cataract formation

An important

consequence of galactosemia is the accumulation of a

by-product called__________ which contributes

to ____________.

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the

different extrahepatic tissues in need of

an energy source.

After the interconversion process, the liver

dispatches the glucose molecules to _________________

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glycolytic pathway

Embden-Meyerhof pathway

Glucose enters the ___________ or the

_____________ which extracts

energy from glucose and convert it in the

form of adenosine triphosphate (ATP).

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Glycogen

When not needed, the glucose is stored in the

liver in the form of ____________

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Glycogenesis

The process of

building glycogen from glucose is called

______________.

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Glycogenolysis

During starvation, however, when the

tissues run out of glucose fuel, the

glycogen stores from the liver are

mobilized. The glycogen is converted to

glucose via a process called______________

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100 g

The glycogen reserve, however is only about

________

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10-18 hours

After about ____________ fasting, it

becomes depleted.

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Muscle Protein

Therefore, to further maintain the blood

glucose level within normal, the__________must be mobilized

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amino acids

Muscle Proteins are degraded to form _________

many of which are glucogenic, i.e., they can

be converted into glucose.

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gluconeogenesis

The amino acids produced, particularly

alanine, are brought to the liver where they

are converted into glucose, a process called___________

.

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stored

triglycerides

Concurrently, there is degradation of _________________ in the adipose (fat) tissue to

provide an alternative energy source for the

tissues.

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acetyl CoA

Fatty acids are also brought to the liver where

they are converted to_____________, the

precursor of ketone bodies

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Ketone bodies

___________________serve as an important source

of energy for many vital organs including the

brain and the heart especially in cases of

starvation.

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proteolysis

Moreover, the utilization of fatty acids and

ketone bodies, spares the proteins from further__________

which could result in reduction of

muscle mass.

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all possible pathways

It is apparent that ______________ are

utilized by the body just to ensure that the

level of glucose in the circulation is within

normal range.

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50-110 mg/dL

(2.8- 6.2 mmol/L).

The level of glucose in a fasting individual is

maintained within the range of__________________

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Insulin

Only__________ is active as a hormone. This hormone pushes & store glucose into the tissues.

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ẞ cells of the Islet of Langerhans

Insulin is Produced

by the______________________ of the

pancreas as a pro-hormone called pro-insulin.

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Pro-insulin

________________ is processed by cleavage to form

C-peptide and insulin.

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One is to one

____________ ratio between insulin and C-peptide.

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the rapid

elimination of insulin.

As calculated, however, the ratio of Cpeptide

to insulin is 5:1. This is due to_________________

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C-Peptide

________________has become

a marker for endogenous production of insulin

to differentiate it from administration of

exogenous insulin.

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Hyperinsulinism

A high level of C-peptide (>1.9 ng/mL)

suggests__________________ which is

characterized by severe hypoglycemia.

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glucose

is the most important

stimulus of insulin secretion.

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amino acids particularly arginine

_______________________________

stimulate the ẞ cells to secrete insulin. This

happens after a protein-rich meal.

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the intestinal

peptide secretin and other GI hormones

______________________________

stimulate secretion of insulin. These hormones

are released usually after ingestion or food.

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inhibiting gluconeogenesis and

glycogenolysis.

Effects on Carbohydrate Metabolism

In the liver, insulin decrease production of

glucose by__________________

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increases

glycogenesis

In the muscle and the liver, insulin_______________

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increases glucose uptake.

In the muscle and the adipose tissue, insulin___________

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bind with

its receptor on these cells

The increase in the glucose uptake has been

attributed to the ability of insulin to___________________

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glucose transporters (especially GLUT-4

which is very rich in the muscles and adipose

tissues

Insulin also triggers the increase in the number

of ___________________ in the cell membrane.

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decrease in fatty acid levels

Effects on Lipid Metabolism: the immediate

effect of insulin on lipid metabolism is the

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triglyceride degradation (lipolysis)

Effects on Lipid Metabolism: Insulin decrease

____________________ in the

adipose tissue.

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hormone-sensitive

lipase

Insulin decrease

triglyceride degradation (lipolysis) by inhibiting the ____________________present in the adipose.

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increasing transport of glucose into the

adipocytes providing the glycerol-3-

phosphate needed in triglyceride synthesis.

Moreover, Insulin decreasing triglyceride degradation promotes triglyceride synthesis by_____________________

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needed fatty

acids in the synthesis of triglycerides.

Insulin also increases the activity of the

lipoprotein lipase or lipemia clearing factor in

the plasma. This provides the____________________

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insulin stimulates

the entry of amino acids into the cells. It also

promotes the synthesis of proteins in most

tissues.

Insulin Effects on Protein Synthesis

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Glucagon

is a polypeptide hormone secreted

by the a-cells of the pancreatic Islets.

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counter-regulatory hormones

Glucagon, together with other hormones e.g.,

epinephrine, cortisol, and growth hormone

are ______________________ i.e., they

oppose many actions of insulin.

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"hyperglycemic

glycogenolytic factor."

Glucagon is also called the

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the liver

Unlike insulin, glucagon has only one target

tissue______________

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1. Glycogenolysis

2. Gluconeogenesis

Glucagon increases glucose by activating the following processes

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hepatic lipolysis

Moreover, Glucagon increases____________. Thus,

there is an attendant increase in glucose and

fatty acids.

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elevated levels of blood sugar

and insulin which increases after a meal.

The release of glucagon is markedly

depressed by________________

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Blood Glucose

Glucagon secretion is stimulated by the following

factors:

A decrease in_____________ is the primary stimulus for

glucagon secretion. During an overnight fast,

elevated glucagon levels prevent

hypoglycemia.

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AMINO ACID

Glucagon secretion is stimulated by the following

factors:

______________ from food stimulate

the release of both glucagon and insulin.

Glucagon prevents hypoglycemia that would

otherwise occur as a result of increase insulin

secretion after a protein meal

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Epinephrine

Nonrepinephrine

_____________from adrenal medulla and

_____________ from sympathetic innervations

of the pancreas both stimulate the release of

glucagon.

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stress, trauma, and excessive

exercise

During periods of __________________, the elevated epinephrine levels

override the effects on the a-cell of circulating

substrates.

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Elevated

Depressed

In these situations, regardless of the

concentration of blood glucose, glucagon

levels are ___________ in anticipation of

increased glucose use. In contrast, insulin

levels are ______________.

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cyclic adenosine

monophosphate (cAMP)

Epinephrine produced by the adrenal

medulla activates the adenylate cyclase

which produces__________________

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phosphorylase

High levels of cAMP activate the enzyme

______________ causing increase

glycogenolysis.

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hormone-sensitive lipase of

adipocytes.

cAMP also stimulates the breakdown of triglyceride

by activating the_______________

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Cortisol

_____________is a glucocorticoid produced by the

adrenal cortex.

They play a role in the long-term regulation of

glucose metabolism.

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the

adrenocorticotrophic hormone (ACTH)

Cortisol is produced by________________

produced by the anterior pituitary gland

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promoting

protein catabolism and deamination.

Cortisol’s main activity is to stimulate

gluconeogenesis. It does this by_______________

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glucose metabolism in the peripheral

tissue

Cortisol inhibits____________

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Cortisol and growth hormone

are less

important in the short-term maintenance of

blood glucose concentration.

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Growth Hormone

 This is produced by the anterior pituitary.

 It has an antagonistic action on insulin.

 It inhibits the uptake of glucose by cells and

lipogenesis from carbohydrates

It promotes release of fatty acids from

adipocytes.

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T3 and T4

The thyroid hormones ______________, promote the

absorption of glucose in the intestinal tract.

 They also stimulate glycogenolysis and

accelerates the degradation of insulin.

 In effect, they increase glucose levels in the

blood.

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Somastostatin

 produced by D cells of the pancreas.

 inhibits pituitary, gastrointestinal, & pancreatic

hormones

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Diabetes Mellitus (DM)

 a major health problem in the Philippines.

 a heterogeneous group of syndromes

characterized by an elevation of fasting

blood glucose caused by a relative or

absolute deficiency of insulin

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glucagon ratio is very low.

The metabolic alterations are caused by

inadequate release of insulin aggravated by

an excess in glucagon. With diabetes mellitus,

the insulin

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Polyuria

classic manifestations of DM

as the filtered blood passes through

the renal tubules, more water is absorbed by

the hyperosmotic ultrafiltrate thus increasing

the urinary output.

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Polydipsia

classic manifestations of DM

this is excessive thirst

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Polyphagia

classic manifestations of DM

this is excessive hunger