Upload
lee-wilkinson
View
229
Download
0
Tags:
Embed Size (px)
Citation preview
content
sugar
glucose Sources
Absorption
Diabetes
Metabolism OF Carbohydrate
The control of blood sugar
Insulin
Diagnosis of DiabetesDiagnosis of Diabetes
Sugar level in the bloodSugar level in the blood
Different types of diabetes
Genetic Testing
sugar
Glucose (Glc), a monosaccharide or simple sugar where The living cell uses it as a source of energy and metabolic intermediate.
glucose Sources
All major dietary carbohydrates contain glucose, either as their only building block, as in starch and glycogen.
Absorption
Diabetes
is a condition that results when the pancreas produces little or no insulin, or when the cells of the body cannot use the
insulin produced effectively.
Metabolism OF Carbohydrate
carbohydrate
glycogen liver
Sugar in the
Blood
Glycogen
muscles
Lactic Acid
Sugar is
stored as a fat
oxidation
Co2 <H2o
out
The control of blood sugar
Hormones of the Pancreas
alpha cells, which secrete glucagons
beta cells, which secrete insulin
delta cells, which secrete somatostatin
gamma cells, which secrete a polypeptide of unknown function
Insulin
Insulin is a protein hormone which is secreted into the blood by the beta cells of the pancreatic islets when the
blood sugar level is high
Insulin Functions
take up glucose and convert it into glycogen
Insulin Functions
Stimulate adipose to
take of glucose and the synthesis of fat.
Stimulate liver cell to
take up glucose from the blood and convert it into glycogen
inhibiting production of the enzymes involved in breaking glycogen back down ("glycogenolysis")
inhibiting "gluconeogenesis"; that is, the conversion of fats and proteins into glucose.
HormonesFunctionStimulated by
Result
INSULIN
Glucose up take
Glycogen synthesis
Glycogenolysis
Gluconeogenesis
High level of sugarBlood sugar
GLUCAGON Glycogenolysis
Gluconeogenesis
Low
level of sugar
> 3mmol/l
Blood sugar
ADRENALIN Glycogenolysis
Glucose up take
GROWTH HORMONE
Glucose up take
Diagnosis of DiabetesDiagnosis of Diabetes
TestNormal
Mg/dl (mmol/L)
Diabetic
Mg/dl (mmol/L)
Urine Glucose
)UGT(
Renal threshold
180
)10(
<180
<)10(
Fasting plasma Glucose
)FBGT (
<100
<)6.4(
<126
(<7.3(
Random plasma Glucose
)RPGT(
<140
<)7.8(
<200
<)11(
Oral Glucose Tolerance75g
)OGTT(
<140
<)7.8(
After 2 hrs
<200
<)11(
After 2 hrs
Sugar level in the bloodSugar level in the blood
Normal, Fasting
Pre-Diabetes, Fasting
Diabetes, fasting
Below 100 mg/dl
Between 100-125 mg/dl
Higher than 126 mg/dl
Different types of diabetes
Type 1 diabetes
is caused by destruction of the insulin-producingcells of the pancreas .
Persons with type 1 diabetes must receive daily injections of insulin .
Type 1 diabetes can be hereditary and lose weight
Type 2 diabetes
is a disorder resulting from the body’s inability to produce insulin or use insulin properly .
This type of diabetes usually affects persons who are more than 45 years of age, are overweight, and who do not
exercise .
Persons with type 2 diabetes may take medication they may require insulin injections .
Symptoms
Polyuria.
Polyphagia.
fatiguePolydepsia.
Blurred vision.
Complications of diabetes
Blindness - A condition known as diabetic retinopathy is the leading cause of new cases of blindness in people between the ages of 20 and 74.
Kidney disease - Diabetes is the leading cause of diabetic nephropathy, an end-stage renal disease. Persons with diabetes account for 40% of all new cases.
Nerve disease and amputations -About 60-70% of people with diabetes have mild to severe nerve damage. Persons with severe nerve damage often undergo lower limb amputations.
Heart disease and stroke – Persons with diabetes are two to four times more likely to suffer a stroke or todevelop heart disease.
Childbirth - Women with diabetes have an increased risk of giving birth to a baby with congenital malformations if they do not receive preconception care having a large birth-weight baby.
Genetic factors
Some rare forms of diabetes result from mutations in a single gene and are called monogenic .
Monogenic forms of diabetes account for about 1 to 5 percent of all cases of diabetes in young people.
In most cases of monogenic diabetes, the gene mutation is inherited.
Most mutations in monogenic diabetes reduce the body’s ability to produce insulin.
forms of monogenic diabetes .
Neonatal diabetes mellitus (NDM)
maturity-onset diabetes of the young (MODY)
Neonatal diabetes mellitus (NDM)
NDM is a monogenic form of diabetes that occurs in the first 6 months of life .
do not produce enough insulin, leading to an increase in blood glucose.
NDM can be mistaken for the much more common type 1 diabetes, but type 1 diabetes usually occurs later than the first 6 months of
life.
In about half of those with NDM, the condition is life long and is called permanent neonatal diabetes mellitus (PNDM) .
In the rest of those with NDM, the condition is disappears during infancy but can reappear later in life; this type of NDM
is called transient neonatal diabetes mellitus (TNDM) .
Two types of Neonatal diabetes mellitus (NDM)
maturity-onset diabetes of the young (MODY)
occurs during adolescence or early adulthood .
MODY sometimes remains undiagnosed until later in life.
A number of different gene mutations have been shown to cause MODY, all of which limit the ability of the pancreas to produce insulin
This process leads to the high blood glucose levels characteristic of diabetes
People with MODY may have only mild or no symptoms of diabetes and their hyperglycemia may only be discovered during routine blood tests .
both type 2 diabetes and MODY can run in families, people with MODY typically have a family history of diabetes in multiple successive
generations
genetic testing and counseling
Testing for monogenic diabetes involves providing a blood sample from which DNA is isolated .
Abnormal results can determine the gene responsible for diabetes in a particular individual or show whether someone is likely to develop a
monogenic form of diabetes in the future .
Most forms of monogenic diabetes are caused by dominant mutations meaning that the condition can be passed on to children when only one
parent is affected .
In contrast, if the mutation is a recessive mutation, a disease gene must be inherited from both parents for diabetes to occur.
Humulin is used by more than 4 million people with diabetes around the world every day .
the CD3 antibody helped stimulate the patients’ natural insulin production and decreased their need for insulin drug therapy .
insulin pump
An insulin pump can improve blood glucose control and quality of life with fewer hypoglycemic episodes than multiple injections. The pumps correct for the “dawn phenomenon” (sudden rise of blood glucose in the morning) and allow quick reductions for specific situations, such as exercise. Many different brands are available.
injection
within 5 minutes after injection. Insulin peaks in about 4 hours and continues to work for about 4 hours. This rapid action reduces the risk for hypoglycemic events after
eating (postprandial hypoglycemia). Optimal timing for administering this insulin is about 15 minutes before a meal, but it can be also taken immediately after a meal (but within 30 minutes). Fast-acting insulins may be especially useful for meals with high
carbohydrates.
How can we produce insulin?