Podcast
Questions and Answers
Which of the following is a characteristic of Type 1 Diabetes Mellitus?
Which of the following is a characteristic of Type 1 Diabetes Mellitus?
What is the primary effect of hyperglycemia on the body?
What is the primary effect of hyperglycemia on the body?
Increased ECF osmotic pressure
Hyperglycemia is generally referred to as ______________________.
Hyperglycemia is generally referred to as ______________________.
Diabetes Mellitus
Gestational Diabetes Mellitus is a type of diabetes that develops during pregnancy and resolves after pregnancy.
Gestational Diabetes Mellitus is a type of diabetes that develops during pregnancy and resolves after pregnancy.
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Match the following types of diabetes with their corresponding characteristics:
Match the following types of diabetes with their corresponding characteristics:
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What is the primary cause of Type 1 Diabetes Mellitus?
What is the primary cause of Type 1 Diabetes Mellitus?
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Hyperlipidemia is a complication of Diabetes Mellitus.
Hyperlipidemia is a complication of Diabetes Mellitus.
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What is the term for the increased production of ketones in the body?
What is the term for the increased production of ketones in the body?
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The WHO and ADA classification of diabetes includes ______________________ types of diabetes.
The WHO and ADA classification of diabetes includes ______________________ types of diabetes.
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What is the effect of increased ECF osmotic pressure on the body due to hyperglycemia?
What is the effect of increased ECF osmotic pressure on the body due to hyperglycemia?
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Which of the following is a long-term complication of Diabetes Mellitus?
Which of the following is a long-term complication of Diabetes Mellitus?
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What is the primary action of insulin in regulating blood sugar levels?
What is the primary action of insulin in regulating blood sugar levels?
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What is the term for the increased production of ketones in the body due to Diabetes Mellitus?
What is the term for the increased production of ketones in the body due to Diabetes Mellitus?
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What is the characteristic of Diabetes Mellitus that is associated with increased infant morbidity and mortality?
What is the characteristic of Diabetes Mellitus that is associated with increased infant morbidity and mortality?
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What is the effect of hyperglycemia on the body's pH levels?
What is the effect of hyperglycemia on the body's pH levels?
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Which of the following is a criterion for the diagnosis of Diabetes Mellitus?
Which of the following is a criterion for the diagnosis of Diabetes Mellitus?
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What is the term for the process by which glucose is converted to glycogen?
What is the term for the process by which glucose is converted to glycogen?
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Which of the following is a common characteristic of Type 2 Diabetes Mellitus?
Which of the following is a common characteristic of Type 2 Diabetes Mellitus?
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What is the primary effect of hyperglycemia on the body's water balance?
What is the primary effect of hyperglycemia on the body's water balance?
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Study Notes
Glucose Metabolism
- Glucose is a major food source, primary energy source, and calories provider.
- It is used as energy (ATP) and stored as liver and muscle glycogen, fat.
- There are three types of carbohydrates: monosaccharides (e.g., glucose), disaccharides (e.g., sucrose), and polysaccharides (e.g., starch).
CHO Metabolism
- Glycolysis: metabolism of glucose to pyruvate or lactate.
- Glycogenesis: synthesis of glycogen from glucose.
- Glycogenolysis: breakdown of glycogen to glucose for energy.
- Gluconeogenesis: formation of glucose-6-phosphate (G6P) from a non-carbohydrate source.
- Lipogenesis: conversion of carbohydrates to fatty acids and adipose tissue.
- Lipolysis: breakdown of fats.
Plasma Glucose Regulation
- Plasma glucose levels are maintained within a narrow range by hormones that modulate the movement of glucose into and out of circulation.
- Primary regulators: insulin and glucagon.
- Other hormones also play a role in regulating plasma glucose levels, including epinephrine, growth hormone, cortisol, thyroxine, and somatostatin.
Insulin and Glucagon
- Insulin:
- Released when fasting plasma glucose > 126 mg/dL.
- Lowers plasma glucose levels.
- Promotes glycogenesis and glycolysis.
- Inhibits glycogenolysis and gluconeogenesis.
- Glucagon:
- Released when fasting plasma glucose < 45-50 mg/dL.
- Raises plasma glucose levels.
- Inhibits glycogenesis and glycolysis.
- Promotes glycogenolysis and gluconeogenesis.
Hypoglycemia
- Low plasma glucose levels (< 45-50 mg/dL).
- Symptoms: non-specific, including increased hunger, sweating, nausea, vomiting, dizziness, nervousness, blurring of speech and sight, and mental confusion.
Galactosemia
- Deficiency of galactose-1-phosphate uridyl transferase enzyme.
- Galactose or lactose cannot be metabolized to glucose.
- Galactose accumulates in blood (galactosemia) and urine.
- Can lead to mental retardation, cataracts, and death.
Specimen Collection and Handling
- Fasting specimen for FBS/FPG (8-10 hour fast/overnight).
- Collect in sodium fluoride tube (grey top).
- Must separate viable cells within 1 hour of collection.
- Preferred specimens: plasma, serum, whole blood, CSF, and urine.
Expected Values
- FPG: 70-99 mg/dL.
- Random (non-fasting): 70-125 mg/dL.
- 2-hour postprandial: 126 mg/dL usually indicates a problem.
- FBS should be repeated on another day to confirm diagnosis.
Lab Tests
- 2-hour Post Prandial:
- Patient has FBS drawn.
- Ingests 75 gram high carbo breakfast/drinks glucola.
- Has repeated glucose test at 2 hours.
- Oral Glucose Tolerance Test:
- Patient directions: eat an adequate carbohydrate diet at least three days prior to test.
- Obtain fasting specimen.
- Test is begun in early a.m.
- Test dose (glucose load): 75 gm for adults and 1.75 gm/kg for children.
- Patient is to remain resting, no smoking or eating during test period.
- Blood is collected at timed intervals and measured.
Clinical Application
Hyperglycemia
- Plasma glucose > 110 mg/dL.
- Generally referred to as Diabetes Mellitus.
- Immediate effects: increased ECF osmotic pressure, acidosis.
Diabetes Mellitus
- Hyperglycemia.
- Ketosis: ketonemia, ketonuria.
- Hyperlipidemia.
- Decreased blood pH.
- Glycosuria.
- Loss of electrolytes: Na+.
WHO and ADA Classification
- Type 1 diabetes mellitus:
- Less common: 10-20% of cases.
- Cause: lack of insulin secretion due to destruction of pancreatic beta cells.
- Juvenile onset diabetes.
- Most severe form of DM.
- Ketosis prone.
- Insulin dependent.
- Type 2 diabetes mellitus:
- Most common: 90% of cases.
- Causes: peripheral tissues are not able to respond to insulin, insulin secretion is delayed.
- Adult onset diabetes.
- Less severe form of DM.
- Not ketosis prone.
- Non-insulin dependent.
- Gestational diabetes mellitus:
- Diabetes mellitus that develops during pregnancy (and resolves after pregnancy).
- GDM associated with increased infant morbidity and mortality.
- GDM mothers are at increased risk of developing diabetes mellitus.
- Secondary diabetes:
- Pancreatic disease.
- Endocrine disease: excess GH, cortisol, epinephrine.
- Severe liver disease.
- Drug or chemical induced.
Glucose Metabolism
- Glucose is a major food source, primary energy source, and calories provider.
- It is used as energy (ATP) and stored as liver and muscle glycogen, fat.
- There are three types of carbohydrates: monosaccharides (e.g., glucose), disaccharides (e.g., sucrose), and polysaccharides (e.g., starch).
CHO Metabolism
- Glycolysis: metabolism of glucose to pyruvate or lactate.
- Glycogenesis: synthesis of glycogen from glucose.
- Glycogenolysis: breakdown of glycogen to glucose for energy.
- Gluconeogenesis: formation of glucose-6-phosphate (G6P) from a non-carbohydrate source.
- Lipogenesis: conversion of carbohydrates to fatty acids and adipose tissue.
- Lipolysis: breakdown of fats.
Plasma Glucose Regulation
- Plasma glucose levels are maintained within a narrow range by hormones that modulate the movement of glucose into and out of circulation.
- Primary regulators: insulin and glucagon.
- Other hormones also play a role in regulating plasma glucose levels, including epinephrine, growth hormone, cortisol, thyroxine, and somatostatin.
Insulin and Glucagon
- Insulin:
- Released when fasting plasma glucose > 126 mg/dL.
- Lowers plasma glucose levels.
- Promotes glycogenesis and glycolysis.
- Inhibits glycogenolysis and gluconeogenesis.
- Glucagon:
- Released when fasting plasma glucose < 45-50 mg/dL.
- Raises plasma glucose levels.
- Inhibits glycogenesis and glycolysis.
- Promotes glycogenolysis and gluconeogenesis.
Hypoglycemia
- Low plasma glucose levels (< 45-50 mg/dL).
- Symptoms: non-specific, including increased hunger, sweating, nausea, vomiting, dizziness, nervousness, blurring of speech and sight, and mental confusion.
Galactosemia
- Deficiency of galactose-1-phosphate uridyl transferase enzyme.
- Galactose or lactose cannot be metabolized to glucose.
- Galactose accumulates in blood (galactosemia) and urine.
- Can lead to mental retardation, cataracts, and death.
Specimen Collection and Handling
- Fasting specimen for FBS/FPG (8-10 hour fast/overnight).
- Collect in sodium fluoride tube (grey top).
- Must separate viable cells within 1 hour of collection.
- Preferred specimens: plasma, serum, whole blood, CSF, and urine.
Expected Values
- FPG: 70-99 mg/dL.
- Random (non-fasting): 70-125 mg/dL.
- 2-hour postprandial: 126 mg/dL usually indicates a problem.
- FBS should be repeated on another day to confirm diagnosis.
Lab Tests
- 2-hour Post Prandial:
- Patient has FBS drawn.
- Ingests 75 gram high carbo breakfast/drinks glucola.
- Has repeated glucose test at 2 hours.
- Oral Glucose Tolerance Test:
- Patient directions: eat an adequate carbohydrate diet at least three days prior to test.
- Obtain fasting specimen.
- Test is begun in early a.m.
- Test dose (glucose load): 75 gm for adults and 1.75 gm/kg for children.
- Patient is to remain resting, no smoking or eating during test period.
- Blood is collected at timed intervals and measured.
Clinical Application
Hyperglycemia
- Plasma glucose > 110 mg/dL.
- Generally referred to as Diabetes Mellitus.
- Immediate effects: increased ECF osmotic pressure, acidosis.
Diabetes Mellitus
- Hyperglycemia.
- Ketosis: ketonemia, ketonuria.
- Hyperlipidemia.
- Decreased blood pH.
- Glycosuria.
- Loss of electrolytes: Na+.
WHO and ADA Classification
- Type 1 diabetes mellitus:
- Less common: 10-20% of cases.
- Cause: lack of insulin secretion due to destruction of pancreatic beta cells.
- Juvenile onset diabetes.
- Most severe form of DM.
- Ketosis prone.
- Insulin dependent.
- Type 2 diabetes mellitus:
- Most common: 90% of cases.
- Causes: peripheral tissues are not able to respond to insulin, insulin secretion is delayed.
- Adult onset diabetes.
- Less severe form of DM.
- Not ketosis prone.
- Non-insulin dependent.
- Gestational diabetes mellitus:
- Diabetes mellitus that develops during pregnancy (and resolves after pregnancy).
- GDM associated with increased infant morbidity and mortality.
- GDM mothers are at increased risk of developing diabetes mellitus.
- Secondary diabetes:
- Pancreatic disease.
- Endocrine disease: excess GH, cortisol, epinephrine.
- Severe liver disease.
- Drug or chemical induced.
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Description
This quiz covers the biochemistry of carbohydrates, glucose metabolism, and its clinical applications in diagnosing diabetes and other carbohydrate disorders.
