“Claude Bernard and Von Mering (1889), discovered in the same year that pancreatectomy causes diabetes”
“Fredrick Banting (1921), successfully, extracted insulin, gaining the Nobel prize for this great discovery”.
“Leonard Thompson (14 year old boy) & Elizabeth Hughes (aged 14 years), were the first patients to be treated with insulin in 1922.
Dear Mom,.. I look entirely different gaining every hour strength & weight....it is truly miraculous....I wish you could see the expression on there faces, they are so astounded in my unheard of progress.. Leonard, April, 1922
+ It includes all the biochemical reactions that start in the cell after the absorption of food stuff. + Metabolism may be: Anabolism: building up, needs energy. Catabolism: breaking down, gives energy. METABOLISM
Important Terminology In Carbohydrate Metabolism Glycolysis: Glucose breakdown & utilization that occurs in cells. The breakdown of glycogen to glucose. Glycogenolysis:
Formation of glucose from fatty acids & amino acids (new glucose formation). Glycogenesis: Glycogen formation that occurs in liver & muscles for storage of carbohydrates (as glycogen). Gluconeogenesis:
í Organic substance composed of carbon, hydrogen & oxygen. í CHO are the first source of energy for the organism. CARBOHYDRATES
Simple sugarComplex sugar * Rapidly-absorbed CHO * Monosaccharides directly absorbed. * Glucose - Fructose - Galactose. * Slowly-absorbed CHO. * Disaccharides to polysaccharides need to be broken down to be absorbed as simple sugar. * Starch - Maltose. CLASSIFICATION OF CHO
Fate of Absorbed Glucose G Glycogenesis Glycolysis Muscle Cells 50 % G Glycolysis Lipogenesis G Glycogenesis Glycolysis Liver Cells 30 % Fat Cells 5 %
INSULIN SECRETION GLUCOSE GK G-6-P PK PYRUVATES ATP Ca2+ DEPOLARIZATION + + + _ _ _ K + INSULIN Glu t 2 Blood Glucose
Insulin Secretion Curve Biphasic insulin response to a constant glucose stimulation (IVGTT - hyperglycemic Clamp) Insulin rate Time (min) Basal 460
Early Peak Late Phase Insulin secretion pattern
Insulin Secretion Pattern Early peak: rapid.. Prestored insulin to prevent the marked increase of the blood glucose level. Late phase: slow.. Newly fabricated insulin to normalise the blood glucose level.
New Criteria: Diagnosis of D. Mellitus American Diabetes Association
Diabetes: Clinical Features Symptoms: Polyuria Polydypsia=thrit Polyphagia=appetite Asthenia & Loss of weight Signs: No specific signs may be signs of complications Signs: No specific signs may be signs of complications