Glucose Metabolism and Abnormalities
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Glucose Metabolism and Abnormalities

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Questions and Answers

Which of the following is a characteristic of Type 1 Diabetes Mellitus?

  • Insulin independent
  • Delayed insulin secretion
  • Juvenile onset diabetes (correct)
  • Peripheral tissues are not able to respond to insulin
  • What is the primary effect of hyperglycemia on the body?

    Increased ECF osmotic pressure

    Hyperglycemia is generally referred to as ______________________.

    Diabetes Mellitus

    Gestational Diabetes Mellitus is a type of diabetes that develops during pregnancy and resolves after pregnancy.

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

    Match the following types of diabetes with their corresponding characteristics:

    <p>1 = a) Insulin dependent, Ketosis prone 2 = b) Peripheral tissues are not able to respond to insulin Gestational = c) Develops during pregnancy, resolves after pregnancy</p> Signup and view all the answers

    What is the primary cause of Type 1 Diabetes Mellitus?

    <p>Destruction of pancreatic beta cells</p> Signup and view all the answers

    Hyperlipidemia is a complication of Diabetes Mellitus.

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

    What is the term for the increased production of ketones in the body?

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

    The WHO and ADA classification of diabetes includes ______________________ types of diabetes.

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

    What is the effect of increased ECF osmotic pressure on the body due to hyperglycemia?

    <p>Increased thirst and urination</p> Signup and view all the answers

    Which of the following is a long-term complication of Diabetes Mellitus?

    <p>Loss of electrolytes</p> Signup and view all the answers

    What is the primary action of insulin in regulating blood sugar levels?

    <p>Promoting glycogenesis and glycolysis</p> Signup and view all the answers

    What is the term for the increased production of ketones in the body due to Diabetes Mellitus?

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

    What is the characteristic of Diabetes Mellitus that is associated with increased infant morbidity and mortality?

    <p>Gestational Diabetes Mellitus</p> Signup and view all the answers

    What is the effect of hyperglycemia on the body's pH levels?

    <p>Decreased blood pH</p> Signup and view all the answers

    Which of the following is a criterion for the diagnosis of Diabetes Mellitus?

    <p>Symptoms of diabetes plus random plasma glucose concentration &gt; 200 mg/dL</p> Signup and view all the answers

    What is the term for the process by which glucose is converted to glycogen?

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

    Which of the following is a common characteristic of Type 2 Diabetes Mellitus?

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

    What is the primary effect of hyperglycemia on the body's water balance?

    <p>Increased urine production</p> Signup and view all the answers

    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.

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