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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. 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:

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  1. Overview of Carbohydrate Metabolism: The importance of regulating blood glucose levels.

  2. 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

  3. 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)

  4. Figure 9-1Role in insulin in lowering blood glucose

  5. Regulation of blood glucose levelsGlucagon • Catabolic, in response to hypoglycemia • Liver • Activates glycogen degradation, gluconeogenesis • Adipose • Stimulates lipolysis and release of fatty acids

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

  7. 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)

  8. 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

  9. Chapter 9Clinical Case (p129)

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