Primary source of energy for brain, erythrocytes, retinal cells
Major food source and energy supply for the body
Stored as Glycogen in the liver and muscle
Diseases: Hyperglycemia and Hypoglycemia
Carbohydrates are hydrates of aldehyde or ketone derivatives
Carbohydrates contain CHO (Carbon, Hydrogen, Oxygen)
Classifications based on:
Number of carbons (Trioses, tetroses, pentoses, hexoses)
Properties (Size of the carbon, Location of the functional group, Number of sugar units, Stereochemistry of the compound)
Monosaccharides: Simple sugars with more than 3 carbons (e.g., glucose, fructose, galactose)
Disaccharides: Two monosaccharides joined by Glycosidic linkages (e.g., maltose, sucrose, lactose)
Oligosaccharides: Chaining of 2 to 10 sugar units
Polysaccharides: Linkages of many monosaccharide units (e.g., starch and glycogen)
Glycolysis: Metabolism of glucose to pyruvate/lactate for energy production
Gluconeogenesis: Formation of glucose-6-phosphate (G6P) from non-carbohydrate sources
Glycogenolysis: Breakdown of glycogen to glucose
Glycogenesis: Conversion of glucose to glycogen
Lipogenesis: Conversion of carbohydrates to fatty acids
Lipolysis: Decomposition of fats
Hypoglycemic agent
Hormone responsible for the entry of glucose into the cell
Synthesized by the cells of the Islet of Langerhans
Increases glycogenesis, lipogenesis, and glycolysis
Inhibits glycogenolysis
Hyperglycemic agent
Primary hormone responsible for increasing glucose levels
Synthesized by the A cells of Islets of Langerhans
Released during stress and fasting
Promotes glycogenolysis and gluconeogenesis
Epinephrine: Increases plasma glucose by inhibiting insulin, promotes glycogenolysis and lipolysis
Cortisol: Increases plasma glucose by decreasing intestinal entry to the cell, increases gluconeogenesis and lipolysis
Growth hormone: Increases glucose by decreasing entry of glucose into the cell, increases glycolysis
ACTH: Conversion of glycogen to glucose, promoting gluconeogenesis
Thyroxine: Increases plasma glucose, increasing glycogenolysis and gluconeogenesis
Somatostatin: Inhibits insulin, glucagon, and growth hormone
Increase in plasma glucose
Diabetes Mellitus: Metabolic disorder with a defect in insulin secretion or action
Types: Type I, Type II, Other specific types, Gestational DM
Increase in glucose in plasma and urine
Increase in specific gravity
Presence of ketones in serum and urine
Decrease in blood and urine pH
Electrolyte imbalance: Low sodium and bicarbonate, high potassium
Pancreatic islet B cell destruction
Cellular-mediated autoimmune destruction of B cells, insulin secretion deficiency (insulinopenia)
Onset in childhood or adolescence
Initiated by environmental factors or infection
Abrupt onset
Insulin-dependent
Ketosis prone
Symptoms: Polydipsia, polyphagia, polyuria, weight loss, hyperventilation, mental confusion, loss of consciousness
Complications: Nephropathy, neuropathy, retinopathy, heart disease
Due to insulin resistance with an insulin secretory defect
Common in obese individuals
Associated with age, obesity, and lack of exercise
Genetic defects: Down syndrome, Klinefelter syndrome
Pancreatic disease
Drugs and Chemicals: Dilantin and pentamidine, Thiazides and glucocorticoid
Maturity onset diabetes of youth: Rare form, inherited, autosomal dominant
Recognized during pregnancy (24 to 28 weeks of gestation)
Metabolic and hormonal changes
Complications for the baby: Respiratory distress, hypocalcemia, hyperbilirubinemia
Idiopathic Type I Diabetes: No known etiology, strongly inherited
Impaired fasting glucose: Intermediate stage between normal and diabetes level
Glucosuria
Age: 45 years old, FBG every 3 years
BMI >25
Risk factors: Physically inactive, family history, high-risk population, history of GDM (Gestational DM), hypertension, high HDL (high-density lipoprotein)
Symptoms appear at 50 to 55 mg/dL
Diagnostic hypoglycemia at <50 mg/dL
Results from imbalance in glucose utilization and production
Symptoms: Increased hunger, sweating, nausea, vomiting, dizziness, nervousness, shaking, blurring of speech and sight, mental confusion
FPG (Fasting Plasma Glucose):
Pre-diabetes: <100 mg/dL
Impaired PG: 100-125 mg/dL
DM: >126 mg/dL
OGTT (Oral Glucose Tolerance Test):
Non/Normal: <140 mg/dL
Impaired GTT: 140-199 mg/dL
DM: >200 mg/dL
Age: >25 years old
Overweight
Family history
History of abnormal glucose metabolism
Glucosuria
PCOS (Polycystic Ovary Syndrome)
Ethnic group
Impaired Fasting Glucose: Fasting Blood Glucose (FBG) between 100-126 mg/dL
Impaired Glucose Tolerance: 2-hour Oral Glucose Tolerance Test (OGTT) between 140-199 mg/dL
Fasting: >95 mg/dL
1 hour: >180 mg/dL
2 hours: >155 mg/dL