Carbohydrates Overview and Metabolism
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Questions and Answers

What immediate product is produced when starch is hydrolyzed by amylase?

  • Maltose (correct)
  • Glucose
  • Lactose
  • Glycogen
  • Salivary amylase remains active in the stomach, where the pH is acidic.

    False (B)

    What is the first step in glucose metabolism?

    Glucose is converted to glucose-6-phosphate using ATP.

    Glucose combined with ATP is converted to ________ in the first step of the metabolic pathway.

    <p>glucose-6-phosphate</p> Signup and view all the answers

    Match the enzyme to its source:

    <p>Salivary Amylase = Salivary glands Pancreatic Amylase = Pancreas Hexokinase = Liver Intestinal Enzymes = Small intestine</p> Signup and view all the answers

    What is the primary storage form of carbohydrates in the body?

    <p>Glycogen (B)</p> Signup and view all the answers

    All carbohydrates must be digested to glucose to be utilized by the body.

    <p>True (A)</p> Signup and view all the answers

    Name the two categories of disease states involving carbohydrates.

    <p>Hyperglycemia and hypoglycemia</p> Signup and view all the answers

    Carbohydrates are compounds containing C, H, and ___.

    <p>O</p> Signup and view all the answers

    What characteristic distinguishes reducing carbohydrates from non-reducing carbohydrates?

    <p>Active ketone or aldehyde group present (C)</p> Signup and view all the answers

    Match the following types of carbohydrates with their corresponding number of carbon atoms:

    <p>Trioses = 3 Tetroses = 4 Pentoses = 5 Hexoses = 6</p> Signup and view all the answers

    All carbohydrates are reducing sugars except for sucrose.

    <p>True (A)</p> Signup and view all the answers

    What is the main functional group in aldoses?

    <p>Aldehyde group (C)</p> Signup and view all the answers

    Name the simplest aldose sugar.

    <p>Glyceraldehyde</p> Signup and view all the answers

    Ketoses have their carbonyl group located at the end of the carbon chain.

    <p>False (B)</p> Signup and view all the answers

    The most common hexose monosaccharides include glucose, galactose, and __________.

    <p>fructose</p> Signup and view all the answers

    What aids in the storage of glucose as glycogen in the body?

    <p>Insulin</p> Signup and view all the answers

    Match the following sugar classifications with their definitions:

    <p>Monosaccharides = Simple sugars that cannot be hydrolyzed Disaccharides = Sugars composed of two monosaccharides Oligosaccharides = Sugars composed of a few (3-10) monosaccharides Polysaccharides = Sugars composed of many monosaccharides</p> Signup and view all the answers

    In which projection does the hydroxyl group at the anomeric carbon (C1) appear below the plane?

    <p>Alpha Configuration (C)</p> Signup and view all the answers

    Ribose is an example of a hexose monosaccharide.

    <p>False (B)</p> Signup and view all the answers

    What is the primary source of energy for humans?

    <p>Glucose</p> Signup and view all the answers

    Which hormone is primarily responsible for increasing blood glucose levels?

    <p>Glucagon (C)</p> Signup and view all the answers

    Epinephrine decreases blood glucose levels during times of stress.

    <p>False (B)</p> Signup and view all the answers

    Which hormone decreases intestinal entry of glucose into cells?

    <p>Cortisol</p> Signup and view all the answers

    Growth hormone increases blood glucose by decreasing the entry of glucose into the ______.

    <p>cells</p> Signup and view all the answers

    Which hormone enhances the release of cortisol?

    <p>ACTH (D)</p> Signup and view all the answers

    Match the hormones with their primary functions:

    <p>Insulin = Decreases blood glucose levels Glucagon = Increases blood glucose levels Cortisol = Increases gluconeogenesis Epinephrine = Increases glycogenolysis</p> Signup and view all the answers

    Thyroxine (T4) helps increase plasma glucose levels by reducing gluconeogenesis.

    <p>False (B)</p> Signup and view all the answers

    What is the main function of human placental lactogen during pregnancy?

    <p>Increase gluconeogenesis</p> Signup and view all the answers

    Which of the following statements about Type 1 Diabetes is true?

    <p>It requires absolute insulin replacement to prevent ketosis. (A)</p> Signup and view all the answers

    Testing for diabetes should begin at age 35 for all individuals.

    <p>True (A)</p> Signup and view all the answers

    Name one autoantibody associated with Type 1 Diabetes.

    <p>Anti-glutamic acid decarboxylase (GAD65)</p> Signup and view all the answers

    Individuals with a body mass index (BMI) of _____ kg/m2 or greater should be considered for diabetes screening.

    <p>25</p> Signup and view all the answers

    Match the following risk factors with their descriptions for screening diabetes:

    <p>First-degree relative with diabetes = Family history increases the risk. High-risk race/ethnicity = Certain racial groups have higher diabetes prevalence. Physical inactivity = Lack of exercise contributes to insulin resistance. History of CVD = Past cardiovascular issues are linked to diabetes risk.</p> Signup and view all the answers

    Which of the following statements best describes Type 2 Diabetes?

    <p>It is associated with strong genetic predisposition. (A)</p> Signup and view all the answers

    Individuals with Type 2 Diabetes are typically ketosis prone.

    <p>False (B)</p> Signup and view all the answers

    Name one common complication associated with Diabetes Mellitus.

    <p>Nephropathy</p> Signup and view all the answers

    Type 2 Diabetes is primarily characterized by __________ resistance.

    <p>insulin</p> Signup and view all the answers

    What is a recommended test for monitoring long-term complications of Diabetes Mellitus?

    <p>Serum Creatinine (A)</p> Signup and view all the answers

    Match the following terms with their correct descriptions:

    <p>Nephropathy = Kidney damage due to diabetes Retinopathy = Eye damage due to diabetes Cardiovascular Disease = Heart-related issues due to diabetes Neuropathy = Nerve damage due to diabetes</p> Signup and view all the answers

    Gestational Diabetes Mellitus typically resolves after pregnancy.

    <p>True (A)</p> Signup and view all the answers

    In a patient with diabetes mellitus, increased glucose levels in __________ can indicate hyperglycemia.

    <p>plasma</p> Signup and view all the answers

    Flashcards

    Monosaccharide

    A simple sugar that cannot be broken down into a simpler sugar by hydrolysis.

    Reducing Sugar

    Carbohydrate that contains an active ketone or aldehyde group that can reduce other compounds.

    Non-reducing Sugar

    Carbohydrate that lacks an active ketone or aldehyde group, thus cannot reduce compounds.

    Glucose

    Primary source of energy for humans, central to carbohydrate metabolism.

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    Sucrose

    Common non-reducing sugar (table sugar).

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    Fischer Projection

    Represents the position of the hydroxyl group AWAY from the aldehyde functional group in a carbohydrate molecule.

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    Haworth Projection

    Shows the position of the -OH group in the anomeric C1 of a carbohydrate molecule.

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    Stereoisomers (D/L)

    Mirror image versions of molecules with the same chemical formula, but different configuration around a chiral center.

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    Carbohydrate Classification

    Categorization of carbohydrates based on the number of carbon atoms (triose, tetrose, pentose, hexose), the position of the carbonyl group (aldehyde or ketone), and the number of sugar units.

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    Carbohydrate Function

    Carbohydrates are the primary source of energy for the body, stored as glycogen in the liver and muscles.

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    Aldose vs. Ketose

    Carbohydrates are classified as aldoses (aldehyde group) or ketoses (ketone group) depending on the position of the carbonyl group (C=O).

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    Carbohydrate Formula

    Carbohydrates have a general formula of Cx(H2O)y, signifying they are made of carbon, hydrogen, and oxygen.

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    Types of Diabetes

    Groups of diseases categorized by hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar).

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    Starch digestion products

    Starch, a complex carbohydrate, is broken down by amylase into maltose.

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    Glucose metabolism pathways

    Glucose can be processed through various pathways like Embden-Meyerhoff, Hexose Monophosphate, and Glucogenesis.

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    Amylase function

    Amylase is an enzyme that breaks down starch into smaller sugars like maltose.

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    Glucose-6-phosphate formation

    Glucose is converted to glucose-6-phosphate, using ATP and an enzyme called hexokinase, as the initial step in its metabolism.

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    Hormonal glucose regulation

    Hormones control glucose uptake and utilization in cells.

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    Autoantibodies in Type 1 Diabetes

    Antibodies that target components of the pancreas, specifically the insulin-producing beta cells. Examples include anti-islet cell antibodies, anti-glutamic acid decarboxylase (GAD65) antibodies, and anti-insulin antibodies.

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    Screening for Diabetes in Adults

    Regular testing for diabetes is recommended for adults with overweight or obesity (BMI ≥25 kg/m2) and additional risk factors such as a family history of diabetes, high-risk ethnicity, history of heart disease, hypertension, high cholesterol, or polycystic ovary syndrome.

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    Prediabetes Screening

    People with prediabetes (A1C ≥5.7%, impaired glucose tolerance or impaired fasting glucose) should be tested for diabetes annually.

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    Lifelong Diabetes Testing

    Individuals diagnosed with gestational diabetes (GDM) during pregnancy should have regular diabetes testing at least every 3 years for the rest of their lives.

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    Insulin

    A hormone produced by beta cells in the pancreas, responsible for lowering blood glucose levels by promoting glucose uptake into cells, glycogen synthesis, and protein synthesis.

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    Glucagon

    A hormone produced by alpha cells in the pancreas, responsible for raising blood glucose levels by stimulating glycogen breakdown (glycogenolysis) and gluconeogenesis.

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    Epinephrine (Adrenaline)

    A hormone produced by the adrenal medulla, released during stress, and responsible for rapidly raising blood glucose levels by stimulating glycogen breakdown and inhibiting insulin release.

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    Cortisol

    A hormone produced by the adrenal cortex, released in response to stress, and responsible for increasing blood glucose levels by promoting gluconeogenesis, inhibiting glucose uptake, and stimulating lipolysis.

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    Growth Hormone

    A hormone produced by the anterior pituitary gland, responsible for increasing blood glucose levels by promoting glycogen breakdown and inhibiting glucose uptake.

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    Thyroxine (T4)

    A hormone produced by the thyroid gland, responsible for increasing blood glucose levels by stimulating gluconeogenesis, glycogenolysis, and glucose absorption from the gut.

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    Somatostatin

    A hormone produced by delta cells in the pancreas and hypothalamus, responsible for inhibiting the release of insulin, glucagon, and growth hormone, ultimately increasing blood glucose levels.

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    ACTH (Adrenocorticotropic Hormone)

    A hormone produced by the anterior pituitary gland, responsible for stimulating the release of cortisol from the adrenal cortex, ultimately increasing blood glucose levels.

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    Type 2 Diabetes Complications

    Long-term consequences of having type 2 diabetes, including damage to the kidneys (nephropathy), nerves (neuropathy), eyes (retinopathy), and cardiovascular system.

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    What is a key difference between Type 1 and Type 2 diabetes?

    Type 1 diabetes involves an autoimmune attack on the pancreas, leading to a complete lack of insulin production. Type 2 diabetes involves insulin resistance and insufficient insulin production.

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    Gestational Diabetes

    A form of diabetes that develops during pregnancy due to hormonal changes or metabolic imbalances. Generally resolves after pregnancy.

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    What are signs of hyperglycemia?

    Elevated levels of glucose in the blood and urine. Other signs include increased urine specific gravity, electrolyte imbalances, and presence of ketones in the blood and urine, which may result in acidosis.

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    How is diabetes insipidus different from SIADH?

    Diabetes insipidus involves a lack of antidiuretic hormone (ADH), leading to increased serum osmolality and decreased urine osmolality. SIADH involves excess ADH, resulting in decreased serum osmolality and increased urine osmolality.

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    What tests are helpful for monitoring long-term diabetes complications?

    Tests such as serum blood urea nitrogen (BUN), serum creatinine, urine albumin, and lipid levels help assess kidney, nerve, and cardiovascular health in individuals with diabetes.

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    What are some regular tests recommended for people with diabetes?

    Regular blood glucose monitoring, HbA1c testing, microalbuminuria test, estimated glomerular filtration rate (eGFR), and point-of-care testing (POCT) are recommended for diabetes management.

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    Study Notes

    Carbohydrates Objectives

    • Students will be able to classify carbohydrates into groups.
    • Students will be able to discuss the metabolism of carbohydrates in the body, including the hormones involved.
    • Students will be able to differentiate between different types of diabetes based on clinical and laboratory findings according to the ADA.

    Carbohydrates

    • Carbohydrates are a major food source for energy, primarily stored in the liver and muscle as glycogen.
    • Diseases related to carbohydrates are classified into hyperglycemia and hypoglycemia.
    • Carbohydrates are derivatives of aldehyde or ketone, based on the location of the carboxyl group.
    • Carbohydrates are composed of monosaccharides, disaccharides, oligosaccharides, and polysaccharides.

    Carbohydrates-Glucose

    • Glucose is the only carbohydrate directly used for energy and stored as glycogen with the help of insulin.
    • All sugar molecules must be digested into glucose, a monosaccharide.

    General Description of Carbohydrates

    • Carbohydrates are compounds containing carbon (C), hydrogen (H), and oxygen (O).
    • The general formula for carbohydrates is Cx(H2O)y.
    • All carbohydrates contain C=O and -OH functional groups.
    • The classification of carbohydrates is based on four structural properties: the size of the base carbon chain, the location of the CO function group, the number of sugar units, and the stereochemistry.

    Carbohydrate Classification

    • Carbohydrates can be grouped based on the number of carbons in the molecule (e.g., trioses, tetroses, pentoses, hexoses).
    • Glucose and fructose are examples of hexoses.

    Carbohydrate Stereochemistry

    • Mirror image forms (D and L) are based on the position of the -OH group on the chiral carbon.
    • D-sugars have the -OH group on the right side of the chiral carbon.
    • L-sugars have the -OH group on the left side of the chiral carbon.

    Chemical Properties of Carbohydrates

    • Some carbohydrates act as reducing agents—these can reduce other compounds.
    • Non-reducing carbohydrates lack the aldehyde or ketone group.

    Classification based on number of units

    • Monosaccharides
    • Disaccharides
    • Oligosaccharides
    • Polysaccharides

    Monosaccharides

    • Simple sugars that cannot be further hydrolyzed.
    • May contain three to six carbons.
    • Common examples include glucose, fructose, and galactose.

    Glucose

    • The primary energy source for humans.
    • Central to carbohydrate metabolism.

    Fructose

    • Also known as fruit sugar
    • Component of sucrose.

    Galactose

    • Glucose precursor, converted into glucose for bodily functions.
    • Galactosemia is a deficiency in processing galactose.

    Others (Ribose and Deoxyribose)

    • Important pentose sugars.

    Question 1

    • Glucose is the only monosaccharide directly used by cells for energy.

    Question 2

    • Hydrolysis of lactose by lactase yields glucose and galactose.

    Question 3

    • Starch is hydrolyzed by amylase to produce maltose.

    Glucose Metabolism

    • Glucose is absorbed and can enter three metabolic pathways.
    • The ultimate goal is conversion of glucose to CO2 and H20.

    Hormone Regulation

    • Hormones regulate the entry and fate of glucose within the body.

    Pancreas

    • Two functionally different tissue types exist:
    • Endocrine (hormone-releasing): Includes the islets of Langerhans containing four cell types releasing insulin, glucagon, gastrin, somatostatin.
    • Exocrine (enzyme-secreting)

    Pancreatic Disorders

    • Major diseases include diabetes mellitus (DM), islet cell tumors, acute/chronic pancreatitis, pancreatic cancer, and cystic fibrosis.

    Hormones Regulating Glucose Metabolism

    • Glucagon
    • ACTH (Adrenocorticotropic hormone)
    • Growth Hormone
    • Cortisol
    • Human Placental Lactogen
    • Epinephrine (adrenaline)
    • Thyroxine (T4)
    • Insulin
    • Somatostatin

    Insulin

    • Primary hormone for glucose entry into cells.
    • Synthesized by Beta cells of the islets of Langerhans.

    Glucagon

    • Primarily responsible for increasing blood glucose.
    • Synthesized by alpha cells of the islets of Langerhans.

    Epinephrine

    • Produced by the adrenal medulla, increases bloodglucose during stress.

    Cortisol

    • Produced by the adrenal cortex. Increases blood glucose through mechanisms including gluconeogenesis and lipolysis.

    Growth Hormone

    • Produced by the anterior pituitary gland, increases blood glucose.

    Thyroxine (T4)

    • Produced by the thyroid gland, increases blood glucose.

    Somatostatin

    • Acts like insulin, inhibits insulin, glucagon, and growth hormone.

    ACTH

    • Enhances cortisol release and fatty acid release, promotes gluconeogenesis.

    Human Placental Lactogen

    • Increases during pregnancy, and functions to increase gluconeogenesis, and promote insulin resistance.

    Hyperglycemia

    • An increase in blood glucose concentration that is toxic to beta cells.

    Characteristics of uncontrolled hyperglycemia

    • Polyuria, ketonuria and glycosuria are seen in uncontrolled hyperglycemia.

    Diabetes Classification

    • Type I (insulin deficiency): Typically autoimmune-mediated.
    • Type II (insulin resistance): More common and often related to lifestyle and genetics.
    • Gestational: Develops during pregnancy.
    • Other specific types: caused by other factors.

    Risk Factors for Diabetes

    • Obesity
    • Family history
    • History of Gestational diabetes (GDM)
    • High-risk race/ethnicity
    • Hypertension
    • Low HDL cholesterol
    • Elevated triglycerides

    Metabolic Syndrome

    • Collection of factors related to increased risk for diabetes and heart disease.

    Type 2 Diabetes Classification

    • Prediabetes
    • Diabetes

    Complications of Diabetes Mellitus

    • Nephropathy (Kidney disease)
    • Neuropathy (nerve damage)
    • Retinopathy (eye disease)
    • Cardiovascular disease

    Laboratory Findings in Hyperglycemia

    • Increased glucose in plasma and urine
    • Presence of ketones in serum and urine
    • Decreased blood and urine pH (acidosis)
    • Electrolyte imbalance

    Diabetes Insipidus (DI)

    • Serum osmolality decreases.
    • Urine osmolality decreases.

    SIADH (Syndrome of Inappropriate Antidiuretic Hormone)

    • Serum osmolality decreases
    • Urine osmolality increases

    Tests for Long-term Diabetes Complications

    • Serum BUN (Blood Urea Nitrogen)
    • Serum creatinine
    • Urine albumin
    • Lipids
    • Blood glucose
    • HbA1c
    • Microalbumin
    • Estimated Glomerular Filtration Rate (eGFR)
    • POCT

    Gestational Diabetes Mellitus (GDM)

    • Diabetes onset during pregnancy due to metabolic and hormonal changes.
    • Usually resolves after pregnancy but increases risk of later-onset Type 2 diabetes.

    Gestational Diabetes Mellitus Characteristics

    • Insulin resistance, decreased insulin secretion.
    • Higher prevalence among obese women, older women, those with previous GDM, and certain ethnic groups.

    Hypoglycemia

    • Imbalance between glucose production and utilization.
    • Can be life-threatening if glucose levels fall to dangerously low levels.

    Fasting Hypoglycemia

    • Hypoglycemia occurring after fasting
    • May be caused by tumors (insulinomas), hepatic dysfunction, glucocorticoid deficiency, or sepsis

    Lactose intolerance

    • A marked decrease in intestinal lactase leads to impaired lactose hydrolysis..
    • The buildup of lactose leads to discomfort, cramping and diarrhea.

    Galactosemia

    • Defects in galactose metabolism result in elevated galactose (in plasma).
    • A serious complication, requiring a diet restricted of galactose.

    Glycogen Storage Diseases

    • Inherited disorders related to glycogen metabolism.

    Diagnostic tests for Glucose Metabolic Alterations

    • Fasting Blood Sugar (FBS)
    • Postprandial Blood Sugar (2 hours after meal)
    • Oral glucose tolerance test(OGTT)
    • HbA1c
    • POCT
    • Ketone tests
    • Microalbuminuria
    • Glycomarkblood Test
    • Fructosamine Assay
    • C-Peptide test

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    Description

    This quiz focuses on the classification of carbohydrates, their metabolism in the body, and differentiation of diabetes types based on clinical findings. Understanding the role of glucose as the primary energy source and its storage as glycogen is also covered. Perfect for students seeking a comprehensive understanding of carbohydrates.

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