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Players in glucostasis
- 1. Regulation of blood glucose level
- 4. Major Players in Glucostasis
- 8. Blood Glucose Normal Fasting 70 to 110 mg/dl Hyperglycaemic factors Hypoglycaemic factors Metabolic Regulation Absorption from GIT Glycogenolysis Gluconeogenesis Glycolysis Glycogenesis HMP shunt conversion to Other hexose Lipogenesis Protein renal excretion
- 12. Role of Pancreas in blood glucose homeostasis Low Blood Glucose High Blood Glucose Alpha cells releases Glucagon Beta cells releases Insulin Glycogenolysis and gluconeogenesis Glucose is released to blood Peripheral tissue cells Glucose uptake from blood Normal Blood Glucose + + + + + +
- 14. Role of Insulin Acts on transcriptional level to regulate synthesis of more than 100 proteins Insulin Hypoglycemic Hormone + Glycogenesis Uptake of Glucose Muscle and Adipose Glycolysis Lipogenesis Protein synthesis Lipolysis Gluconeogenesis Glycogenolysis Protein catabolism + + + + -- -- -- --
- 15. Normal Blood Glucose 70 to 110 mg/dl Hormonal Regulation Pathway Insulin Glycolysis HMP shunt Glycogenesis Glycogenolysis Gluconeogenesis Lipogenesis Lipolysis Cholesterol synthesis Protein synthesis
- 16. 1.Glucagon 2.Epinephrine or Adrenaline 3.Glucocoticoids 4.ACTH 5.Growth Hormone 6.Thyroxine
- 17. Produced by Alpha cells of the islets of Langerhans of Pancreas. Action is antagonist to insulin Increased blood Glucose
- 18. Normal Blood Glucose 70 to 110 mg/dl Hormonal Regulation Pathway Glucagon Glycolysis L HMP shunt Glycogenesis Glycogenolysis Gluconeogenesis Lipogenesis Lipolysis Protein synthesis
- 19. Produced by Adrenal Medulla . Action is on muscle Increased blood Glucose [Short term regulation]
- 20. Normal Blood Glucose 70 to 110 mg/dl Hormonal Regulation Pathway Epinephrin Glycolysis L M Glycogenesis Glycogenolysis Gluconeogenesis Lipogenesis Lipolysis
- 21. Produced by Adrenal Cortex . Required for energy production Increased blood Glucose
- 22. Normal Blood Glucose 70 to 110 mg/dl Hormonal Regulation Pathway Glucocorticoid Glycolysis L Gluconeogenesis Lipogenesis Lipolysis Release of AA [M]
- 23. Normal Blood Glucose 70 to 110 mg/dl Hormonal Regulation Pathway Insulin Glucagon Epinephrin e Glucocorticoid Glycolysis L L M L Glycogenesis -- Glycogenolysis -- Gluconeogenesis Lipogenesis Lipolysis Cholesterol synthesis Protein synthesis
- 25. Renal Regulation Tubular Maximum 260-350mg/min/1.73m2 Renal Threshold 160-180mg/dl Glycosuria 90% of filtered glucose is reabsorbed in PCT, Remaining in LH & CD. When filtered glucose load exceeds the capacity of renal tubular reabsorption When renal threshold for glucose is reduced
- 26. 00 50 100 150 200 250 300 350 400 Fasting Post absorptive Post lunch Diabetes Low renal Threshold Normal renal Threshold Renal Regulation When Renal threshold for glucose is exceeded Glucosuria results.
- 27. Renal Glycosuria Blood glucose level is normal Defect in reabsorptive ability of renal tubule Causes : Physiological High glucose intake Pregnancy Stress Anxiety Emotion Pathological Diabetes Galactosemia Heavy metal poisoning Cystinosis Fanconi’s syndrome
- 29. Causes of Glycosuria Glycosuria without hyperglycaemia: Renal tubular dysfunction, Inborn Error of CHO metabolism Glycosuria with hyperglycaemia : Diabetes, Acromegaly, Cushing’s disease, Hyperthyroidism, Ill-effect of corticosteroid drugs
- 30. Blood Glucose – Clinical Aspects Estimation • Various Chemical methods available • Glucometer Common terms • Fasting blood glucose • Post prandial glucose • Random glucose • Glucose tolerance Interpretation • Increased level – HYPERGLYCAEMIA • Decreased level - HYPOGLYCAEMIA
- 31. Fasting Blood Glucose Blood glucose estimated after Eight hours of Fasting Post Prandial Blood Glucose Blood glucose estimated after about 2 hrs of proper meal Random Blood Glucose Blood glucose estimated at any time of the day without concerning last meal Glucose Tolerance Test Estimation of glucose on 1 fasting and minimum 2 samples after 50-75gm oral glucose
- 35. Complications of Diabetes If a person does not take proper care to control Diabetes complications develop