1. Regulation of Blood Glucose Level
Dr. Shabeena Patel

2. What goes wrong when the concentration
decreases?
Hypoglycaemia
The symptoms associated
with low blood sugar
are:
tiredness, confusion,
dizziness, headaches,
mood swings, muscle
weakness, tremors,
irreversible CNS
damage, coma, death

3. What goes wrong when the concentration
increases too far?
Hyperglycaemia
The symptoms include:
Excessive thirst; frequent urination;
fatigue; unexplained weight loss;
vision problems, such as blurring;
increased susceptibility to infections
Dibetes mellitus

4. We eat food containing carbohydrates

7. Fundamental regulation /
Autoregulation
• Hormones:
• Insulin
• Glucagon
Organs: Liver
Skeletal muscles
Pancreas
Adipose tissue

8. ROLE
OF
LIVER

9. Role of liver and Sk muscle

10. Role of the Pancreas
1. Digestion – secretes digestive enzymes
2. Metabolism
• Regulation
• Carbohydrates
• Lipids
• Proteins
• Produces primary messengers (hormones)
• Insulin
• Glucagon

11. Role of adipose tissue

14. Glucose transporters
Organ Glucose transporter Classification
Brain GLUT1 Glucose dependent
Erythrocyte GLUT1 Glucose dependent
Adipocyte GLUT4 Insulin dependent
Muscle GLUT4 Insulin dependent
Liver GLUT2 Glucose sensor
GK  - cell GLUT2 Glucose sensor
Gut GLUT3-symporter ---- Sodium dependent
Kidney GLUT3-symporter ---- Sodium dependent

15. • 51 amino acids
• 2 chains linked by disulfide bonds
• 5800 Dalton molecular weight

16. MECHANISM
OF INSULIN
SECRETION

18. ADIPOSE
TISSUE AND
MUSCLES

20. insulin stimulates the synthesis of an enzyme
(glucokinase) (low affinity to glucose) [ in the
liver]
•Required to ‘trap’ glucose in the cell (only
when glucose concentration is high)

21. Most Cells
 Protein synthesis
Insulin
Control Muscle
 Glucose uptake
 Glycogen synthesis
Adipose  triglycerides
 Glucose uptake
 Glycerol production
 Triglyceride breakdown
Liver
 Glucose uptake
 Glycogen synthesis
 Fatty acid synthesis
 Glucose synthesis
Brain
No effect
Gastrointestinal
hormones
Pancreas
Beta cells
Feedback
 amino
acids
 glucose
 Insulin  Triglyceride synthesis
Amino
acids
Blood
glucose

26. Glucagon
Control
Adipose
 Triglyceride breakdown
 Triglyceride storage
Liver
 Glycogen breakdown
 Glucose synthesis
 Glucose release
Brain
No effect
Pancreas
Alpha cells
Exercise
Feedback
 Fatty acids
 Blood glucose
Epinephrine
(stress)
Amino acids

29. Glucocorticoids
• 1)Increase blood glucose:
• i) Peripheral tissues :increase protein catabolism
• Decrease uptake and utilization of glucose
• ii)Liver : Increase amino acid uptake
• Increase the transaminase activity
• Increase gluconeogenesis
• + Pyruvate carboxylase
• + PEP carboxykinase
• + Fructose -1,6-biphosphatase
• +Glucose-6- phosphatase

30. • 2)Liver: Increase liver glycogen
• + glycogen synthase activity
Glucocorticoids are catabolic to the peripheral
tissues but anabolic to the liver

32. + ACTH
synthesis
Glucocortico
id syn

33. Anterior pituitary hormones
• 1)Growth hormone:
• i)Decreases glucose uptake in tissues
• ii)Increase liver gluconeogenesis
• Chronic administration may lead to diabetes
mellitus due to stimulation and exhaution of
beta cells
• 2)ACTH: Stimulates glucocorticoids synthesis
• Raise blood glucose level

35. Thyroid hormones
• Raise blood glucose levels
• i)Increase hepatic glycogenolysis
• ii)Increase sensitivity of tissues to catecholamines
• iii)Increases destruction of insulin
• iv) Increase absorption of hexoses from intestine
• v) Increase peripheral tissue protein catabolism

36. Adipose tissue as endocrine gland

42. Causes of hyperglycemia
• 1)Diabetes mellitus
• 2)Hyperactivity of thyroid, pituitary and
adrenals
• 3)Emotional stress
• 4)diffuse pancreatic diseases
• 5)Sepsis
• 6)Asphyxia

43. Hypoglycemia
• 1)Overdosage of insulin
• 2)Insulinoma
• 3)Hypoactivity of thyroids –myxodema,cretinism
• Pituitary gland
• Adrenals- Addisons disease
• 4)Severe liver diseases
• 5)Glycogen storage diseases