Metabolic changes in diabetes result from insulin deficiency and profoundly affect the liver, muscle, and adipose tissue. This leads to hyperglycemia and ketoacidosis as the liver produces glucose while tissues cannot utilize it. It also causes increased mobilization of fatty acids from adipose tissue and their breakdown in the liver, resulting in the production of ketone bodies. Excess fatty acids are also converted to triglycerides and secreted into the bloodstream. The insulin deficiency shifts energy production away from carbohydrate metabolism and towards fat oxidation, cholesterol synthesis, and ketone body synthesis.

1. METABOLIC EFFECTS OF
DIABETES MELLITUS
Thamir Diab Alotaify

2. Metabolic changes in diabetes
The metabolic abnormalities of diabetes mellitus
result from a deficiency of insulin which
profoundly affects metabolism in three tissues:
liver, muscle, and adipose tissue

4. On CHO metabolism
•
Hyperglycemia and ketoacidosis: Elevated levels of blood
glucose and ketones are the hallmarks of untreated Type 1 diabetes
mellitus
•
Hyperglycemia is caused by increased hepatic production of
glucose, combined with diminished peripheral utilization

5. On lipids

increased mobilization of fatty acids from adipose
tissue,combined with accelerated hepatic fatty acid βoxidation and synthesis of Ketone bodies.
* Hypertriacylglycerolemia: Not all the fatty acids flooding
the liver can be disposed of through oxidation or ketone
body synthesis. These excess fatty acids are converted
to triacylglycerol, which is packaged and secreted in
very-low-density lipoproteins (VLDL). Chylomicrons are
synthesized from dietary lipids by the intestinal mucosal
cells following a meal .

6. ketogenesis
Cholesterol
synthesis

7. insulin↓
CVS diseases
↓CHO utilization
atherosclerosis
shift of energy production
from CHO catabolism to
another source
fat oxidation↑
↑ cholsterol
synthesis
↑acetyl coA
comma
Diabetic
ketoacidosis
(DKA)
↑Ketone bodies
synthesis

8. Major factors contributing to
hyperglycemia observed in Type 2
diabetes.
Progression of blood glucose and
insulin levels in patients with Type
2 diabetes.

9. Typical progression of Type 2
diabetes.