The document discusses carbohydrate metabolism and glucose regulation in both the fasting and postprandial states. It covers the roles of hormones and hepatic glycogenolysis in maintaining normal blood glucose levels after meals. Additionally, it describes the oral glucose tolerance test procedure, indications, contraindications, and factors that can affect the results, such as insulin levels, diet, exercise, and medical conditions.

1. Carbohydrate metabolism

2. Factors maintaining blood glucose level

3. Regulation in fasting state
• Normally, 2 to 2.5 hours after a
meal, the blood glucose level
falls to near fasting levels.
• Next 3 hours heaptic
glycogenolysis take place
• Then gluconeogenesis take place

4. Regulation in postprandial state

5. Overview of glucose regulation

6. Role of hormones in regulation of glucose
metabolism :

7. Estimation of blood glucose level

8. Oral glucose tolerance test (OGTT)
PROCEDURE
Indication
Contraindication
Preparation of patient

10. Diagnostic criteria for diabetes mellitus

11. Factors affecting GTT
• Insulin level, GTT is used to detect insulin deficiency
• Carbohydrate starvation, therefore patient is advised to take
carbohydrates-rich diet for 3 days before test
• Patient advised to take rest during and prior to test
• In liver disease the curve is elevated and prolonged
• In acute infections, cortisol is secreted and so curve is elevated and
prolonged
• Hyperthyroidism there will be steep rise in curve