This document provides an overview of blood glucose homeostasis, starvation, and diabetes mellitus. It discusses:
1. The mechanisms that regulate blood glucose levels, including hormones like insulin and glucagon that maintain normal ranges.
2. The metabolic changes that occur during starvation, including increased gluconeogenesis and lipolysis that provide alternative fuels like fatty acids and ketone bodies.
3. An overview of diabetes mellitus, including the different types and their associated metabolic changes and complications both acute and chronic.
Lipids are a heterogenous group of
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molecules. Presentation on how they affect the body and what to do to prevent their effects.
Diabetes mellitus, disorder of carbohydrate metabolism characterized by impaired ability of the body to produce or respond to insulin and thereby maintain proper levels of sugar (glucose) in the blood.
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metabolic effect of different hormones i.e insulin, glucagon, epinephrine and cortisol with their short introduction, structures, biosynthesis, mechanism of action and individual action on carbohydrate , lipid and protein metabolism.
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Insulin and glucagon help maintain blood sugar levels. Glucagon helps prevent blood sugar from dropping, while insulin stops it from rising too high. Insulin and glucagon work together in a balance and play a vital role in regulating a person's blood sugar levels. Glucagon breaks down glycogen to glucose in the liver.
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Diabetes mellitus, disorder of carbohydrate metabolism characterized by impaired ability of the body to produce or respond to insulin and thereby maintain proper levels of sugar (glucose) in the blood.
To know more about diabetes mellitus click on the below link
https://docmode.org/about/
https://docmode.org/lectures/
metabolic effect of different hormones i.e insulin, glucagon, epinephrine and cortisol with their short introduction, structures, biosynthesis, mechanism of action and individual action on carbohydrate , lipid and protein metabolism.
Carbohydrate metabolism involves the different biochemical processes responsible for the formation, breakdown, and interconversion of carbohydrates in living organisms.
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This presentation explains metabolism of lipoproteins (Chylomicron, VLDL, LDL, HDL) in very simple way. The presentation contains lots of animation to explain metabolism of individual lipoproteins.
The digestion of certain fats begins in the mouth, where short-chain lipids break down into diglycerides because of lingual lipase. The fat present in the small intestine stimulates the release of lipase from the pancreas, and bile from the liver enables the breakdown of fats into fatty acids.
Insulin and glucagon help maintain blood sugar levels. Glucagon helps prevent blood sugar from dropping, while insulin stops it from rising too high. Insulin and glucagon work together in a balance and play a vital role in regulating a person's blood sugar levels. Glucagon breaks down glycogen to glucose in the liver.
Blood glucose regulation, glucose homeostasis, factors regulating and under S...Mohit Adhikary
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This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
10. Introduction
• Homeostasis is an adaptive mechanism in a
living organism that regulates its internal
environment and tends to maintain a stable,
constant condition under wide environmental
variations.
• It allows an organism to function effectively in
a broad range of environmental conditions
(both internal and external)1.
11. Fed-Fast Cycle (or Feed-Fast Cycle)
• Human beings usually take their food
intermittently, 2 to 4 times a day as large
meals.
• Therefore, they go through two alternating
physiological nutritional states –
• Fed or Absorptive State
• Fasting or Post-absorptive State,
• Constituting a fed-fast cycle.
12. Metabolic Fuel Molecules
• They are sources of energy (produce ATP) for the
cells.
• Glucose and fatty acids, present in blood, are the
major or principal metabolic fuel molecules.
• Other fuel molecules are amino acids (produced
from proteins) and ketone bodies (produced
from fatty acids).
13. • However, ketone bodies are more important
during prolonged fasting and starvation than
during normal physiological nutritional states.
• Dietary glucose in excess is stored as glycogen
and fatty acids as TAG. The energy/calories of
excess glucose and amino acids are stored as
TAG in adipose tissues.
14. Integration of metabolism
• Carbohydrates, lipids and proteins are the
principal foods providing essential fuel to the
body.
• Their metabolisms are interrelated, coordinated
or integrated to ensure provision of fuels to
various tissues and have an impact on health and
disease.
• Metabolic changes or adaptations occur during
blood glucose homeostasis, starvation and in
diabetes mellitus.
15. • The blood glucose level is normally
maintained within fairly narrow range.
• In a healthy individual, the normal fasting
blood glucose level is 70-110 mg /dl
(Normoglycemia).
• After ingestion of a meal (post prandial) blood
glucose level may normally rise to
120-140 mg /dl.
Mechanism of Blood Glucose Homeostasis or
Regulation of Blood Glucose Concentration
16. Fasting (8-10 hours after meal)
70-110 mg /dl
Normal blood glucose values
Postprandial (2 hours after meal)
< 140 mg /dl
Random (irrespective of meal times)
70-140 mg /dl
17. Maintenance of normal blood glucose level is
important because-
Brain, RBC and renal medulla have an obligatory
requirement for glucose as energy source.
Increased blood glucose level (Hyperglycemia) can cause
complications of Diabetes mellitus.
Decreased blood glucose level (Hypoglycemia) can cause
coma and even death mainly due to deprivation of glucose
to brain.
18. • Homeostasis mechanisms are brought into
play following a meal when the blood glucose
level rises and again during fasting, when the
level falls.
• Plasma glucose concentration is dependent
on the quantity of glucose that enters
circulation from various sources and the
amount that is utilized by tissues, as shown in
the figure below.
19. • Sources of blood glucose Utilization of blood glucose
• Dietary intake, Glycolysis & TCA cycle
• intestinal absorption
• Glycogenesis (Liver)
• Glycogenolysis (liver)
• Gluconeogenesis Fatty acid synthesis
•
TAG synthesis
Capillary
Blood
Glucose
c
c
20. • Factors regulating blood glucose level are as
follows.
– Neuronal Activity
– Hormones
• Neuronal Activity
• Eating behavior which influences the glucose
levels is controlled by hypothalamus (satiety
centre and feeding centre) in response to
falling and raising blood glucose levels.
21. • Normal blood glucose is a result of balance between
2 sets of hormones.
• 1.hyperglycemic hormones- 6 hormones which
increase bl.glucose- they are, Glucagon, ACTH,
steroid hormones, thyroid hormone, adrenal
hormones, growth hormone.
• 2. hypoglycemic hormones- hormones which
decrease blood glucose.
• Insulin is the only hypoglycemic hormone.
Hormones
22.
23. Hormones
• Insulin and Glucagon are the principal
hormones for controlling plasma glucose
levels.
• Insulin decreases the blood glucose level and
is called hypoglycemic hormone.
• Glucagon raises the blood glucose level and is
called hyperglycemic hormone.
• Insulin antagonists
24. • Hormones are the principal mediators of
metabolic changes required for glucose
homeostasis.
• They regulate activities of-
• 1) key enzymes of metabolic pathways
• (By induction/repression,
phosphorylation/dephosphorylation etc)
• 2) membrane transporters
• Important tissues involved and targeted by
hormones in the maintenance of blood glucose
level are liver, adipose tissue and skeletal
muscles.
25. Glucose-sparing effect
• Alternative fuel molecules – free fatty acids,
aminoacids and ketone bodies have
• glucose-sparing effect
• because they are utilized by cells for energy in
preference to glucose.
26. Role of Insulin in Glucose
Homeostasis
• Insulin is secreted by -cells of pancreas in
response to raising blood glucose level during
fed state.
• Insulin brings down blood glucose level
(hypoglycemic in action) by increasing
utilization of glucose by cells as shown below.
• Another action of insulin is that it inhibits the
secretion of glucagon, which is an insulin
antagonist.
27.
28. Actions of Insulin (Metabolic effects)
Extrahepatic cells Liver Capillaries Adipose Tissue
↑Glucokinase → ↑ Glucose uptake
↑ Glycogenesis
Glycogenolysis
Gluconeogenesis
↑ Glycolysis →↑ Acetyl CoA
↑ Fatty acid synthesis
↑TAG synthesis→ ↑VLDL export
↑Lipoprotein Lipase
↑ Mobilization of fatty acids
from VLDL and chylomicrons
and entry to Adipose tissue
↑ Glucose transporter
(GLUT-4)
↑ Glucose uptake into cells
Hormone-Sensitive Lipase
↑TAG synthesis
Free Fatty acid
release into blood
Blood glucose
concentration
29. Role of Glucagon in Glucose
Homeostasis
• Glucagon is secreted by -cells of the pancreas in
response to falling blood glucose level.
• Glucagon raises blood glucose level by
mechanisms shown below.
• Glucagon also mobilizes fatty acids and glycerol
from adipose tissue.
• Fatty acids are the most important alternative
fuel molecules and glycerol serves as substrate
for gluconeogenesis.
31. During the fed state
• blood glucose level tends to rise due to
intestinal absorption of glucose.,which
stimulates insulin release.
• glucose is converted to storage compounds –
glycogen in liver and triacylglycerol in adipose
tissue
• This prevents the rise of blood glucose level.
32.
33. During the fasting state
• blood glucose level tends to decrease due to
utilization of glucose by cells for energy.,which
stimulates Glucagon release.
• This causes mobilization of glucose from
glycogen, synthesis of glucose (both in liver) and
• mobilization of alternative fuel molecules – free
fatty acids (from adipose tissue) and ketone
bodies (from liver).
• Amino acids (from tissue proteins – mainly
skeletal muscles) and glycerol (from adipose
tissue) are utilized in the liver to synthesize
glucose.
34.
35. Biochemistry of Starvation
• Starvation is a state caused due to acute
deprivation of food for more than 18 hours.
• It may result from:
– An inability to obtain food Eg: famine, natural
calamities, war.
• From the desire to lose weight rapidly
36. Metabolic changes in Starvation
• are adaptations of the body to lack of fuel
supply and are an exaggeration of the normal
response of the body to fasting.
• The metabolic changes are required to:
• provide energy to brain
• provide alternative fuel molecules
• principally involve degradation of stored forms
of metabolic fuel- glycogen, TAG and proteins
37. The cause and effect chain of
metabolic changes in starvation
• Starvation (absence of food) → Basal Metabolic Rate
•
•
Falling blood glucose level
•
• Decrease in insulin secretion and an increase in glucagon
release
• ( Insulin/glucagon ratio).
•
• Changes in the metabolisms of carbohydrate, fat and proteins
• (mainly in liver, adipose tissue and skeletal muscles,
respectively)
39. Biochemical basis (mechanism)
Falling blood glucose level
Insulin/glucagon ratio
↑ Lipolysis (in adipose tissue)
↑ Plasma free fatty acids
↑ Hepatic uptake of free fatty acids
↑Triacylglycerol synthesis in liver
Fatty liver
↑ Gluconeogenesis (in liver)
Oxaloacetate (in liver)
↑ Acetyl CoA (in liver)
↑ Ketogenesis (in liver)
Ketosis - Ketoacidosis
Coma → Death
40. • Biochemical basis (mechanism) cont’d
Falling blood glucose level
Insulin/glucagon ratio
↑ catabolism of skeletal muscle protein
Muscle wasting
41. Diabetes Mellitus
• Introduction:
• Diabetes mellitus is a major public health
problem affecting about 3% of global population.
• Diabetes mellitus is the 3rd leading cause of death
in many developed countries (after heart disease
and cancer).
• India is the ‘Diabetes Capital’ of the world. The
prevalence of diabetes mellitus in urban India is
12.1% (2001-National Survey), is rising, and is
higher in South India than in the North.
42. • Definition:
• Diabetes mellitus is a metabolic disorder
characterized by hyperglycemia.
• Types:
• Type 1 diabetes mellitus
• [Formerly Insulin-Dependant Diabetes Mellitus or
IDDM, Juvenile-onset]
• destruction of insulin producing -cells leading to
absolute insulin deficiency may be caused due to
viral infection and autoimmune attack
43. • blood level of insulin is always very low
• comprises about 10 % of diabetic cases
• patients < 35 years age
• Type 2 diabetes mellitus
• [Formerly Non Insulin-Dependant Diabetes
Mellitus or NIDDM, Adult-onset]
• relative insulin deficiency with insulin resistance
due to down-regulation
• (decrease in number) of insulin receptors on cells
• blood level of insulin is either normal or high
• comprises about 90% of diabetic cases
• patients aged > 40 years and usually obese
44. • Other rarer causes of Diabetes Mellitus are:
• Hormonal – Acromegaly (↑growth hormone),
Cushing’s syndrome (↑corticosteroid),
glucagonoma, pheochromocytoma ( adrenalin),
hyperthyroidism, etc.
• Diseases of pancreas – e.g., chronic pancreatitis
• Gestational diabetes mellitus (seen during later
months of pregnancy)
45. Metabolic Changes in Diabetes
Mellitus
• The metabolic changes that occur in diabetes
mellitus are due to decrease of insulin or
rather, decrease in insulin/glucagon ratio.
• The body cells are starved of energy despite
high glucose concentration around them
(starvation in the midst of plenty).
47. Biochemical Basis for Clinical
Manifestations in Diabetes Mellitus
• Major symptoms of diabetes mellitus are-
• polyuria (increased urine output)
• polydypsia (increased thirst)
• polyphagia (increased hunger)
• weakness and weight loss in spite of
adequate calorie intake
• Other cardinal manifestation of diabetes mellitus is
glycosuria (glucosuria).
48. ↑Lipolysis
Insulin/glucagon ratio
Blood glucose level
> 180mg/dl ( Renal threshold ) ↑Loss of
Glucosuria Hyperglycemia adipose
tissue
↑ conc of glucose ↑ Gluconeogenesis
in renal tubular fluid
↑ Protein metabolism
↑ Muscle wasting
Osmotic diuresis Glu uptake feeding centre
in muscles chronically active
in brain
Polyuria Weakness Hunger(polyphagia) Weight loss
49. Polyuria
↑ Osmotic pressure in extra cellular fluid
Tissue dehydration (in brain)
+
Thirst centre
↑ Thirst (polydypsia)
50. Biochemical basis of Glucosuria in
Diabetes mellitus
• Normally, when blood glucose levels are within
normal limits, all the glucose that is filtered by
the glomerulus is completely reabsorbed by the
renal tubules. So, glucose is not excreted in urine.
• In diabetes mellitus, glucosuria i.e. excretion of
glucose in urine, occurs because of an abnormal
increase of blood glucose level (hyperglycemia)
above the renal threshold of 160 to 180 mg/dL.
51. Biochemical Basis for Complications
of Diabetes Mellitus
• Diabetes mellitus has both acute (short term) and
chronic (long term) complications
• Acute Complications:
• Diabetic ketoacidosis (seen commonly in Type 1
diabetes mellitus)
• Hyperosmolal non-ketotic coma (seen commonly
in Type 2 diabetes mellitus) are the acute
complications of untreated diabetes mellitus.
• The mechanisms of these complications are as
follows.
52. 1) Mechanism of Ketoacidosis in Type 1 Diabetes
Mellitus
Insulin/glucagon ratio
↑ Lipolysis (in adipose tissue) ↑ Gluconeogenesis (in liver)
↑ Plasma free fatty acids Oxaloacetate (in liver)
↑ Hepatic uptake of free fatty acids ↑ Acetyl CoA (in liver)
↑ Ketogenesis (in liver)
Ketoacidosis (in type 1 diabetes mellitus), Hyperkalemia
Coma → Death
53. 2) Mechanism of Hyperosmolal Non-ketotic
Coma in Type 2 Diabetes Mellitus
Insulin/glucagon ratio
Hyperglycemia
Osmotic pressure in extra cellular fluid
Dehydration of brain tissue
Hyperosmolal coma → Death
54. Chronic (long term) Complications of
Diabetes Mellitus and their Biochemical Basis
• The long-term complications of diabetes mellitus
include cataract, polyneuropathy, retinopathy,
nephropathy, myocardial infarction, stroke,
gangrene, fatty liver, etc.
• These complications are thought to be due to the
direct consequences of either-
• 1) high blood glucose levels (hyperglycemia) or
• 2) decreased insulin/glucagon ratio.
55. 1) Hyperglycemia
Non-enzymatic glycosylation (glycation) of proteins
Atherosclerosis (in arteries) – Angiopathy
Macrovascular disease Microvascular disease
(Due to damage to arteries) (Due to damage to the arterioles)
Myocardial infarction Retinopathy and
Nephropathy
Stroke
Gangrene
56. 1) Hyperglycemia(cont’d)
Substrate flux
Activation of the polyol pathway
Glucose
Sorbitol production
Osmotic effect due to accumulation of sorbitol
Cataract (in lens)
Polyneuropathy ((In Schwann cells)
57. 2) Insulin/Glucagon ratio
↑ Lipolysis (in adipose tissue)
↑Plasma free fatty acids in blood
↑ Hepatic uptake of free fatty acids
↑ Hepatic triacylglycerol synthesis
Fatty Liver
58. Diagnosis of Diabetes Mellitus
• In addition to clinical symptoms, tests useful in
the diagnosis are-
• Estimation of plasma glucose: Blood samples are
drawn under fasting, postprandial or random
conditions.
• Normal values:
• Fasting (8-10 hours after meal) 70-110 mg /dl
• Postprandial (2 hours after meal)< 140 mg /dl
• Random (irrespective of meal times) 70-140
mg /dl
59. WHO Criteria for Diagnosis of
Diabetes Mellitus
• Fasting plasma glucose –– > 125 mg/dL
• Or
• 2 hour plasma glucose –– > 200 mg/dL
• Or both
•
• Glycosuria is seen usually in at least one urine
sample.
• Higher values indicate more severe diabetes
mellitus
60. Glycosuria
• Glycosuria refers to excretion of (any) sugar in
urine.
• Glucosuria (excretion of glucose in urine) is
the most common form of glycosuria.
• Urine tests for Glycosuria or Glucosuria are
used most often to screen for, confirm a
diagnosis of or monitor the control of
diabetes mellitus.
62. Renal glycosuria
• In this condition, glucosuria (excretion of
glucose in urine) occurs even when blood
glucose levels are normal.
• Biochemical basis of Renal Glucosuria
• normal renal threshold for glucose is 160 to 180
mg/dL.
• But, due to defect in renal tubules in Renal
glycosuria ,The capacity of renal tubules to
reabsorb glucose is decreased– lowering the
renal threshold for glucose.
• Hence glucose is excreted in urine
,even though blood glucose levels are
normal.
It is normoglycemic glucosuria.
63. Renal glycosuria..contd..
• Blood glucose estimation can differentiate
diabetes mellitus from renal glycosuria. Blood
glucose level will be higher than normal in
diabetes mellitus and normal in renal
glycosuria.
• Harmless condition, doesn’t require any
treatment.
64. Glycated hemoglobin- HbA1C
• Non enzymatic addition of glucose to Hb
is called glycosylation of Hb.,and such Hb
is called glycated Hb.
• Extent of Hb glycation is directly
proportional to blood glucose levels and
it is irreversible.
• Glycated Hb remains in circulation for the
entire life span of RBC(120 days)
• Normal value is <5.5% (4-5.5%)
67. Significance of HbA1C
-HbA 1C level increases in diabetes.
HbA 1C levels reflect average blood glucose conc.
Or glycemic control of previous 8-10 weeks.
-Since extent of Hb glycation is directly
proportional to blood glucose levels, levels
indicate severity of diabetes, hence used for
monitoring the response to treatment.
-Hence it has a prognostic significance.
68. • Interpretation of HbA1C Values
• <5.5% - non diabetic or very good control of
diabetes.
• 5.5 – 7% - adequate control
• > 7% - poor control