CARBOHYDRATES PART 2
1. Digestion of carbohydrates begins in the _____
Mouth
During mastication (chewing), __________ acts briefly on dietary starch in a random manner, breaking it to some shorter glucose chains
salivary amylase (ptyalin)
2. As soon as the partially digested carbohydrates reach the Stomach, salivary amylase (ptyalin) will be deactivated by the _______. No Carbohydrate digestion takes place in the ______
stomach
2. As soon as the partially digested carbohydrates reach the Stomach, salivary amylase (ptyalin) will be deactivated by the _______. No Carbohydrate digestion takes place in the ______
stomach
• Maltose---(_____) glucose + glucose
• Sucrose---(______) glucose + fructose
• Lactose ---(_______) glucose + galactose
1. Maltase
2. Sucrase
3. Lactase
only monosaccharides can be absorbed:
3. Small Intestine
glucose & galactose absorbed by _____
ACTIVE TRANSPORT
fructose absorbed by _____
FACILITATED DIFFUSION
fructose absorbed by _____
FACILITATED DIFFUSION
three fates of glucose:
1. Energy,
2. stored as glycogen,
3. released to the blood which can be utilized by other cells in the body
Resistant/undigested starches/ fibers may be partially digested by bacteria and incorporated in the feces
4.Large Intestine
Regulation of Blood Glucose
The human body requires that the blood glucose level is maintained in a very narrow range, which is regulated by two hormones, _____ and ______ which are both secreted by the endocrine pancreas.
1. Insulin
2. Glucagon
secreted by the beta cells of the pancreas in response to high blood glucose, although a low level of insulin is always secreted by the pancreas. After a meal, the amount of insulin secreted into the blood increases as the blood glucose rises. Likewise, as blood glucose falls, insulin secretion by the pancreatic islet beta cells decreases.
In response to insulin, cells (muscle, red blood cells, and fat cells) take glucose in from the blood, which ultimately lowers the high blood glucose levels back to the normal range .
1. Insulin
secreted by the alpha cells of the pancreas when blood glucose is low. Blood glucose is low between meals and during exercise. When blood glucose is high, no glucagon is secreted from the alpha cells.
has the greatest effect on the liver although it affects many different cells in the body. Glucagon's function is to cause the liver to release stored glucose from its cells into the blood. also the production of glucose by the liver out of building blocks obtained from other nutrients found in the body, for example, protein.
2. Glucagon
A normal fasting (no food for eight hours) blood sugar level is between
70 and 99 mg/dL
A normal blood sugar level two hours after eating is less than
140 mg/dL
When operating normally the body restores blood sugar levels to a range of
80 to 110 mg/dL
Elevated blood glucose ____
Low blood glucose ______
= Hyperglycemia
= Hypoglycemia
a disorder of energy metabolism due to failure of insulin to regulate blood glucose
results in hyperglycemia
long term consequences include increased risk of heart disease, kidney disease, blindness, neural damage
Diabetes Mellitus (DM)
common acute symptoms OF Diabetes Mellitus (DM)
1. excessive thirst (polydipsia)
2. increased urine production (polyuria)
3. hunger/increase food intake (polyphagia)
4. weight loss
(formerly known as insulin dependent diabetes mellitus or Juvenile diabetes mellitus)
accounts for about 10% of cases, typically but not exclusively in children
occurs when b cells of the pancreas are destroyed
insulin cannot be synthesized
without insulin, blood glucose levels rise because the tissues are unable to access the glucose
death occurs shortly after onset unless given injections of insulin
1. Diabetes mellitus Type I
(formerly known as insulin dependent diabetes mellitus or Juvenile diabetes mellitus)
accounts for about 10% of cases, typically but not exclusively in children
occurs when b cells of the pancreas are destroyed
insulin cannot be synthesized
without insulin, blood glucose levels rise because the tissues are unable to access the glucose
death occurs shortly after onset unless given injections of insulin
1. Diabetes mellitus Type I
(formerly known as non-insulin dependent diabetes mellitus or adult-onset diabetes mellitus)
occurs when cells of body are unable to respond to insulin
called “insulin insensitivity” or “insulin resistance”
blood glucose levels rise
insulin secretion increases in an attempt to compensate
leads to hyperinsulinemia
common among obese, and with family history of DM type II
2. DM Type II
(formerly known as non-insulin dependent diabetes mellitus or adult-onset diabetes mellitus)
occurs when cells of body are unable to respond to insulin
called “insulin insensitivity” or “insulin resistance”
blood glucose levels rise
insulin secretion increases in an attempt to compensate
leads to hyperinsulinemia
common among obese, and with family history of DM type II
2. DM Type II
● Uncontrolled diabetes can lead to the following complications:
1. Diabetic retinopathy
2. Diabetic neuropathy
3. Diabetic nephropathy
presenting with visual symptoms of curtain falling, floaters, or decreasedvisual acuity that cannot be corrected with refraction
Diabetic retinopathy
presenting with numbness, loss of balance, and tingling and pain of the toes and feet usually worse at night, foot ulcers, and foot deformity
Diabetic neuropathy
is asymptomatic at an early stage but microscopic albuminuria is asign. It is the leading cause of chronic kidney disease, which manifests as poorly controlled blood pressure or resistant hypertension, fatigue, edema, and congestion.
Diabetic nephropathy
It is recommended that annual screening using laboratory examinations for all adults ____ years old and up, and for patients of any age with at least one risk factor.
35
It is recommended that annual screening using laboratory examinations for all adults ____ years old and up, and for patients of any age with at least one risk factor.
35
Screening: FBS (strong recommendation) OR HbA1c (Weak)
In asymptomatic adults with initial positive screening test, confirm the diagnosis of DM
using ANY of the following tests:
a) repeat FBS,
b) repeat HbA1c, or
c) 75-gram Oral Glucose Tolerance Test (75 g OGTT).
Screening: FBS (strong recommendation) OR HbA1c (Weak)
In asymptomatic adults with initial positive screening test, confirm the diagnosis of DM
using ANY of the following tests:
a) repeat FBS,
b) repeat HbA1c, or
c) 75-gram Oral Glucose Tolerance Test (75 g OGTT).
The diagnosis of Diabetes Mellitus can be made based on the following criteria:
1. Plasma glucose > 126 mg/dL (7.0 mmol/L) after an overnight fast (Fasting Blood Glucose or FBS)
2. Two-hour plasma glucose > 200 mg/dl (11.1 mmol/l) during an Oral Glucose Tolerance Test
3. HbA1c ≥ 6.5% (48mmol/mol)
The diagnosis of Diabetes Mellitus can be made based on the following criteria:
1. Plasma glucose > 126 mg/dL (7.0 mmol/L) after an overnight fast (Fasting Blood Glucose or FBS)
2. Two-hour plasma glucose > 200 mg/dl (11.1 mmol/l) during an Oral Glucose Tolerance Test
3. HbA1c ≥ 6.5% (48mmol/mol)
Fasting is defined as no caloric intake for at least 8 hours up to a maximum of 14 hours,
1. Plasma glucose > 126 mg/dL (7.0 mmol/L) after an overnight fast (Fasting Blood Glucose or FBS)
The test should be performed as described by the World Health Organization, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water after an overnight fast of between 8 and 14 hours,
2. Two-hour plasma glucose > 200 mg/dl (11.1 mmol/l) during an Oral Glucose Tolerance Test
is caused by the action of acids on the enamel surface. The acid is produced when sugars (mainly sucrose) in food or drink react with bacteria present on the tooth surface. The acid produced leads to a loss of calcium and phosphate from the enamel; this process is called demineralization.
Dental caries
Dental caries is caused by the action of acids on the enamel surface. The acid is produced when sugars (mainly sucrose) in food or drink react with bacteria present on the tooth surface. The acid produced leads to a loss of calcium and phosphate from the enamel; this process is called ___________.
demineralization