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What is Glucose Used for?
• Immediate carbohydrate energy &/or glycogen storage (Liver & Muscle).
• Brain, central nervous system (CNS), & red blood cell (RBC) function (liver glycogen).
– Requires a minimum of 100-150 grams carbohydrate day(continuous).
• Muscle functioning (muscle glycogen).
• Fat synthesis (excess energy intake).
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What is Glycogen?
• The storage form of glucose, “animal starch”.
• Made from dietary carbohydrate sources.
– All carbohydrate is converted to glucose then stored as glycogen or used immediately.
**Diets should be planned to meet the 45-65%of Calories AMDR & minimally the DRI for carbohydrate (130 gm/day for adults).
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Whole grain complex carbohydrates are
best.
Carbohydrate is protein sparing.
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Where is Glycogen Stored?
- • The Liver (100 grams; 400 Calories).
- – Is used for blood sugar (glucose) regulation.
• The Muscle (1-4 grams/100 grams of muscle).
- – The level increases with high carbohydrate diets & exercise.
- – Is used for the working muscle.
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How Does the Body Regulate Blood Sugar?
• By hormones that are produced in the pancreas.
• The hormones effect the liver & muscle cells.
- – Insulin: decreases blood sugar levels.
- – Glucagon: increases blood sugar level.
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Blood Sugar Regulation
Picture 1-3
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Blood Sugar Regulation
Picture 4-6
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Carbohydrate Related Disorders
• Lactose Intolerance & Lactose Mal-digestion
• Hypoglycemia
• Diabetes
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Lactose Intolerance
Physiology:
• Lactase deficiency (completely missing in“intolerance” while low activity/levels in “mal-digestion”) is strongly tied to evolution with several gene mutations identified.
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Lactose Intolerance
Symptoms:
Gas, bloating, cramps, diarrhea.
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Lactose Intolerance
Steps 1-6 (picture)
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Dairy Products and Lactose Intolerance use a product like
lactaid.
- • Consume yogurt with live cultures
- • Consume aged cheese OR
- • Avoid dairy products
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Lactose intolerance & mal-digestion are due to an inability to
digest milk sugar(lactose) not an allergic reaction to milk protein (casein).
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An allergy elicits an
immune reaction & involves antigens & antibodies.
– Antibody: Protein structures produced by immune cells that inactivate antigens(allergens).
– Antigen (allergen): Foreign protein substances that elicit an immune reaction.
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Allergic responses cause the formation of mucous in
the respiratory tract, GI distress &/or hives.
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Antibody and Allergen in an Allergic Immune Response
Picture
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Hypoglycemia
low blood sugar
Reactive:
Blood sugar levels drop after eating sugar.
– Too much insulin is secreted in response to sugar consumption. Hyperinsulinemia.
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Hypoglycemia
low blood sugar
Spontaneous:
Liver stores of glycogen are depleted, the ability to maintain blood sugar is diminished.
– Happens to everyone in between meals or when food has not been consumed. 4-6 hours during the day, 10-12 hours with sleep.
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Hypoglycemia
low blood sugar
Drug Induced:
Low blood sugar from a drug reaction.
– Improper insulin or oral hypoglycemic drug use with diabetes.
– Anti-inflammatory and thyroid medications are known to cause hypoglycemia.
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Diabetes
A chronic disease:
Is characterized by
hyperglycemia (high blood sugar).
• Affects >20 million Americans, many unaware.
• Increases heart disease, stroke, kidney disease,retinopathy, and neuropathy.
• Decreases life expectancy.
• Occurs as type 1 or type 2diabetes.
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Diabetes Type I:
Less common
- • ~5% of cases
- • Juvenile onset
- • Is more difficult to control
- • Insulin administration is essential in the control of blood sugar (Insulin-dependent diabetes)
- • Is due to a genetic and/or viral factor causing auto immunity directed against the pancreatic beta cells
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Physiology of Type 1 Diabetes
Picture 1-4
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Physiology of Type 1 Diabetes
Picture 5-7
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Diabetes Type 2
Very Common
- • ~95% of cases
- • Typically adult onset
- • May be controlled with lifestyle changes& oral hypoglycemic agents
- • Is caused by insulin resistance (decreased insulin receptor response)
- • Is predisposed by obesity & genetics.
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Physiology of Type 2 Diabetes
Picture 1-3
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Physiology of Type 2 Diabetes
Picture 1-2 drug pill
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Indications of Diabetes
• Fasting glucose level ≥ 126 mg/dl.
• 2 hour post prandial (fed) blood glucose level ≥ 200 mg/dl.
- **Normal Blood Glucose is 70-99 mg/dl
- Pre-Diabetes is 100-125 mg/d
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Overweight Contributes to Hyperglycemia:
Type II Diabetes
Picture
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Food Composition
The Glycemic Response/Index
Simple sugars & foods with a high glycemic index burn
up fast & elicit an insulin response.
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Food Composition
The Glycemic Response/Index
Complex carbohydrates sustain
energy better.
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What is the Glycemic Response/Index?
• The rise in blood sugar in response to food as compared to glucose.
• Glucose is assigned 100.
• The Glycemic Index of a food can be useful to anyone concerned with blood sugar control.
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Glycemic Response of Foods
Those with diabetes should eat foods that have a lower
glycemic response or slower entrance of glucose into the bloodstream.
• Foods with high protein, fat, & fiber lower the glycemic response.
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Glycemic Index of Foods
Picture of chart
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