1. Blood sugar levels Objectives 1. To understand why we need to control blood sugar levels 2. To understand the role of the pancreas and its hormones To understand the difference between exocrine and endocrine glands To recognise features and causes of diabetes (types 1 and 2) To discuss management and treatment of diabetes

2. Blood sugar levels Need to be controlled Rise after absorption of digested food For ideal health should be maintained at Fasting blood glucose: 70-99 milligrams per deciliter (3.9- 5.5 mmol/L)milligrams per decilitermmol/L 2 hours after eating (postprandial):70-145 mg/dL (3.9-8.1 mmol/L)postprandial Random (casual): 70-125 mg/dL (3.9-6.9 mmol/L) In other words below 70 or above 150 mg/dl is considered outside normal range and a cause for concern.

4. Medical effects if out of control If blood sugar is too high it will Be excreted from the kidneys Lead to deposition of fats in arteries Lead to blindness Widespread tissue damage causing heart, kidney and nerve damage If blood sugar is too low: Lead to confusion, coma and death.

5. Controlling sugar levels

6. Controlling sugar explained Carbohydrates digested using carbohydrase enzymes from salivary glands, pancreas and small intestine wall. Breakdown product is glucose Glucose absorbed into blood in small intestine wall. Blood glucose levels rise Islets of Langerhans – cells in pancreas release insulin Insulin acts on cells of body to increase uptake and storage of glucose – so preventing excess glucose levels in the blood. Glucose stored as glycogen – especially in muscles and liver.

7. Releasing sugar We need the glucose for respiration So it cannot be stored forever. When glucose levels in the blood fall Glucose released gradually from cells Response moderated by another hormone from the pancreas: Glucagon

8. Fight or Flight A very rapid response To fear or danger or surprise Body readies itself for action Body needs increased glucose supply Glucose rapidly released from cells under the influence of Adrenalin (produced by adrenal glands) Glucose levels rise rapidly to respond to need Long term health effects if not used. (Stress)

9. Endocrine and Exocrine glands Two types of glands in the body Endocrine glandsExocrine glands ProduceProduce hormonesProduce enzymes and other secretions DuctsNo ductsHave ducts DistributionHormones emptied into blood Secretions released to site of use

10. The human endocrine system

11. Sugar regulation what can go wrong! Diabetes melitus Two Types: Type 1 – early onset – or after pregnancy Autoimmune disease May be hereditary Islets of Langerhans destroyed Treated through injections of insulin May one day be able to replace islet cells with new ones produced from stem cells

12. Type 2 diabetes Closely linked to a number of factors: Obesity High sugar diet Age Hereditary More prevalent in some races than others (black africans) Cells become resistant to the uptake of glucose Can be managed by diet Can even be reversed.

13. Plenary List risk factors for type 2 diabetes Make a table comparing the features of endocrine and exocrine glands

14. Homework on endocrine illness Find out about another malfunction of the endocrine system. Do not do diabetes mellitus! 1. Name and describe the disease and its symptoms (5 points) Explain the role of the hormone involved and the endocrine gland responsible for its production. (5 points) Describe treatment, long term complications and possible causes/ risk factors. (5 points) English (5 points)