Overview of carbohydrate metabolism
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Overview of Carbohydrate Metabolism:. The importance of regulating blood glucose levels. Glucose: Obligate fuel for CNS & RBC’s. CNS/Brain Dependent on glucose as primary source of fuel Uses ~120g glucose/day of total 160-200 g/d RBC Dependent on glucose Lack mitochondria.

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Overview of carbohydrate metabolism

Overview of Carbohydrate Metabolism:

The importance of regulating blood glucose levels.


Glucose obligate fuel for cns rbc s
Glucose:Obligate fuel for CNS & RBC’s

  • CNS/Brain

    • Dependent on glucose as primary source of fuel

      • Uses ~120g glucose/day of total 160-200 g/d

  • RBC

    • Dependent on glucose

    • Lack mitochondria


Regulation of blood glucose levels insulin
Regulation of blood glucose levelsInsulin

Anabolic in response to hyperglycemia

  • Liver

    • Stimulates glycogen synthesis, glycolysis, and fatty acid synthesis

  • Muscle

    • Stimulates glycogen synthesis

  • Adipose

    • Stimulates lipoprotein lipase resulting in uptake of fatty acids from chylomicrons and VLDL

    • Stimulates glycolysis for glycerol phosphate synthesis (precurser to triglycerides)


Figure 9 1 role in insulin in lowering blood glucose
Figure 9-1Role in insulin in lowering blood glucose


Regulation of blood glucose levels glucagon
Regulation of blood glucose levelsGlucagon

  • Catabolic, in response to hypoglycemia

  • Liver

    • Activates glycogen degradation, gluconeogenesis

  • Adipose

    • Stimulates lipolysis and release of fatty acids


Figure 9 2 role of glucagon in increasing blood glucose levels
Figure 9-2Role of glucagon in increasing blood glucose levels


Diabetes mellitus
Diabetes Mellitus

  • A multi-organ catabolic response caused by insulin insufficiency

  • Muscle

    • Protein catabolism for gluconeogenesis

  • Adipose

    • Lipolysis for fatty acid release

  • Liver

    • Ketogenesis from fatty acid oxidation

    • Gluconeogenesis from amino acids and glycerol

  • Kidney

    • Ketonuria and cation excretion

      • Renal ammoniagenesis (NH4+, cation excreted with KB)


Glucose toxicity
Glucose Toxicity

  • Diabetic complications

  • Glycosylation of Protein

    • Reaction of glucose to amino groups

    • May be related to pathologic changes in eye, peripheral nerves, kidneys

    • Glycosylated hemoglobin (HbA1c)

  • Polyol formation

    • Sorbitol production from aldol reductase

    • Accumulation of sorbitol results in osmotic changes and cataracts in the lens


Chapter 9 clinical case p129
Chapter 9Clinical Case (p129)


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