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Carbohydrates Chem 101

Terms in this set (63)

Adavanced Glycation End Products (AGE)
Proteins that have been irreversibly modified by nonenzymatic attachment of glucose, which may contribute to the chronic complications of diabetes, is a byproduct of diabetes
Carbohydrates
Compounds composed of carbon, hydrogen, and oxygen (1:2:1) that constitute a major food class.
Diabetes Mellitus
A group of metabolic disorders of carbohydrate metabolism in which glucose is underrutilized, producing hyperglycemia
Diabetogenes
Genes that contribute to the development of diabetes; a genetic basis is identified in fewer that 5% of individuals with type 2 diabetes
Gestational Diabetes Mellitus (GDM)
Carbohydrate intolerance that arises during pregnancy
Glucose
A six carbon sugar that is premier fuel for most organisms and an important precursor of the other body constituents.
Glycated Hemoglobin
Hemoglobin that has sugar residue attached, also known as glycohemoglobin. used to monitor diabets
Glycogen
A polysaccharide having a formula of (C6H10O5) used by muscle and liver for carbohydrate storage.
Hyperglycemia
Increased glucose concentration in the blood
Hypoglycemia
decreased glucose concentration in the blood, cut off is 50mg/dL
Insulin
A protein hormone produced by the b cells of Islets of Langerhans in the pancreas. ONLY hormone that decreases blood glucose concentraions, major target organs are liver, muscle, adipose tissues, FIRST protein hormone sequenced and measured by RIA and FIRST compound produced using recombant DNA, anabolic hormone
Ketones
Compounds that arise from free fatty acid breakdown; insulin deficiency leads to increased serum ketones, which are the major contributors to the metabolic acidosis that occurs in individuals with diabetic ketoacidosis.
Lactate
An intermediary product in carbohydrate metabolism that accumulates in the blood predominantly when tissue oxygenation is decreased; an increased blood lactate concentration is called lactic academia, and may be associated with lactic acidosis
Microalbuminuria
A rate of excretion of albumin in the urine (20 to 200 mg/min) that is between normal and overt proteinuria; increased urinary excretion of albumin precedes and is highly predictive of diabetic nephropathy.
Glycogenesis
Conversion of GLUCOSE to GLYCOGEN(most important storage polysaccharide in liver and muscles), kidney synthesizes glucose in the same form, used by counterregulatory hormones to stimulate the synthesis of glucose, growth hormones stimulates ____, cortisol stimulates ___ in response to ACTH
Glycogenolysis
Conversion of GLYCOGEN to GLUCOSE, kidney synthesis of glucose in same form, counterregulatory hormones use this to get to glycogenesis, thyroxine stimulates ____
Gluconeogenesis
formation of glucose from non carbohydrate sources such as amino acids, glycerol, and lactate.
Glycolysis
Conversion of glucose or other hexoses into lactate or pyruvate
Glucose 6 Phosphate
form of glucose that is produced by both gluconeogenesis and glycogenolysis also same form produced in synthesis of glucose in kidney
Hormones that increase blood glucose
Glucagon, Epinephrine, Cortisol, and Growth Hormone
Life span of red blood cell
average 120 days
Environmental Factors that initiate diabetes
Viruses, such as rubella, mumps, and coxsackievirus
Other factors chemicals and cows milk
Insulin Resistance
decreased ability of insulin to act on the peripheral tissue and is thought to be primary underlying pathological process.
Risk factors for GDM
family history of diabetes in a first degree relative, obesity, advanced maternal age, glycosuria, and selected adverse outcomes in a previous pregnancy.
Common causes of hypoglycemia in neonatals
prematurity, maternal diabetes, GDM, and maternal toxemia
Two pathophysiological mechanisms contribute to hypoglycemia
Defective glucose counter regulation and hypoglycemia unawareness
copper reduction test or clinitest
screen neonates and infants for glucose in urine, test strip tests
Oxidation of glucose
_____occurs through hexose monophosphate shunt pathway and produces NADPH
insulin deficiency
hyperglycemia and ketosis of diabetes occurs from _____, this is alson antagonized by growth hormone, somatostatin
low insulin
lipolysis, decreased reesterficiation and increasing plasma free fatty acids occurs when ____
insulinopenia
___is the term for having deficiency of insulin (type 1)
normal glucose disposal
____ depends on: ability of pancreas to secrete insulin, ability of insulin to do its job, ability of insulin to suppress hepatic glucose production
2 families of glucose transport proteins
these are examples of?
-intestinal sodium/glucose co transporter: from lumen of small bowel and reabsorption from urine in kidney
-facilitative glucose transporters (GLUTs): located on surface of all cells
formation of GHb (glycated hemoglobin)
___ is irreversible,rate of this is proportional to glucose concentrations in blood, show pereceeding 6-8wks, are unaffected by recent activity or eating, half time is 35 days
counterregulatory hormones
these hormones raise glucose levels in blood, initial response in minutes, 3-4 hours later GH and cortisol increase glucose mobilization and decrease glucose use
glucagon
this keeps sugars from getting too low, secreated by a-cells in pancreas, major target organ is the liver, stimulates production of glucose in liver,enhances ketogenesis in liver, insulin is an inhibitor
increased glucagon
2nd to contribute to hyperglycemia and ketosis of diabetes
pituitary gland
what is growth hormone secreted by?
Growth hormone (GH)
what stimulates gluconeogenesis, enhances lipolysis, antagonizes insulin stimulated glucose uptake
cortisol
stimulates gluconeogenesis and increases break down of fat and protein, crushing syndrome (hyperglycemia) or addison disease (hypoglycemia)
thyroxine
from the thyroid gland, stimulates glyconeogenesis and increased gastric emptying and intestinal glucose absorption
somastatin
___ found in GI track, hypothalamus, cells of pancreatic islets. inhibits GH, insulin and glucagon secretions
ketone bodies
break down of free fatty acids from adipose tissue, increased glucagon:insulin ratio enhances fatty acid oxidation in the liver
type one diabetes (AKA IDDM, juvenile-onset diabetes)
only 5-10% of those with diabetes have ____, peak incidence in childhood, beta cells are destroyed by body, only 10% have an affected 1st degree family member, there has to be a trigger (rubella, mumps, coxsackevirus B, chemicals and cows milk), is INSULIN DEPENDENT, susceptibility is inherited
symptoms of type one
plyuria, polydipsia and rapid weight loss are examples of?
type two diabetes (AKA NIDDM, adult-onset diabetes)
90% of those with diabetes have this type, obesity correlated, NOT INSULIN dependent, insulin may be normal, high or low; insulin resistance is the primary defect, onset occurs 4-7yrs before diagnosis, FPG or OGTT for those 45+ and follow up every 3 years
antibodies
what are markers of B-cell autoimmunity?
islet cell cytoplasmic antibodies (ICAs)
these react with sialoglycoconjugate antigen in cytoplasm in endocrine cells of pancreatic islets
environmental factors that involved in initiating diabetes
rubella, mumps, coxsackevirus B, chemicals and cows milk these are _____
over 126 mg/dL more than once
Fasting plasma glucose (FPG) concentrations have to be _____ to be diagnosed with diabetes
oral glucose tolerance test (OGTT)
more sensitive than fasting glucose early in type 2, is the screening test for diabetes
before OGTT (oral glucose tolerance test)
must be done ___ : discontinue glucose medications. this test is preformed in the morning after 3 days of unrestricted diet followed by a 10-16hr fast, then is tested every 30mins for 2 hours. if results less than 100= no diabetes
chronic complications of diabetes
increased risk of retinopathy, nephropathy or neuropathy are all examples of ____
signs of hypoglycemia
trembling, sweating, nausea, rapid pulse, light headedness, hunger, epigastric discomfort are all ____
postprandial hypoglycemia
after eating get relief for 30-45mins is a symptom of ___
type one
counterregulatory responses are impaired in which type of diabetes
lactic acidosis
1-type A (hypoxic) associated with decreased tissue oxygenation (most common)
2-type B (metabolic) associated with disease, drugs/toxins or inborn errors of metabolism
these are types of ___
blood, serum, plasma and urine
body fluids glucose can be measured in
most used sample for glucose determinations
plasma or serum are ___, in separated non hemolyzed sterile serum glucose stable for 8 hr at 25 Celsius and 72hrs at 4 Celsius
hexokinase or glucose oxidase
to measure glucose in blood most common methods are ___
hexokinase (HK) methods
____ are methods based on coupled enzyme assay, highly accurate and precise but time consuming, serum or plasma may be used with anticoagulant. interference from phosphate esters, enzymes, drugs, bilirubin and lipemia
glucose oxidase methods
this methods catalyzes oxidation of glucose to gluconic acid, should not be used with urine, use plasma
glucose dehydrogenase method
this methods measures NADH instead of glucose because they are proportion. this method isn't used in the states
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