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Case Study: Carbohydrates and Diabetes
Key Concepts:


Overview of Diabetes Mellitus
 Major forms of Diabetes Mellitus
 Diet modification treatment: meal planning
Carbohydrates & Diabetes
 Digestion of carbohydrates
Materials Preparation:

Prior to this class, students are asked to search “news article” relating to Diabetes,
carbohydrates, and treatments for Diabetes Mellitus.
Example:
健康與醫療
A20
蘋果日報
2005-04-22
九成糖尿病人違醫生飲食建議
【本報訊】本港市民患糖尿病愈趨普遍，患者約有六十萬人。一項調查發現，九成受訪糖尿病人
未有完全遵照醫生的飲食建議，四成人也沒有自行定期測試血糖；醫學界指出，這樣糖尿病患者
的病情會因而惡化，建議患者應主動與醫護人員商量，制訂適合自己生活模式的健康餐單。
香港健康網絡於今年二至三月進行問卷調查，訪問了三百一十多位糖尿病患者。結果發現，七成
半受訪病人認知改善不良飲食習慣是控制血糖的最佳方法，四成人也知道要定期測試血糖來監察
病情。
或會令病情惡化
但調查發現，九成受訪病人沒有完全遵從醫護人員建議的飲食餐單；其中近六成人指是因為建議
的餐單很難適應日常生活模式；逾三成人則稱若按餐單飲食，會感到吃不飽。此外，調查又顯
示，四成人沒有自行定期測試血糖。
香港專科醫生學會副會長盧國榮提醒病人，沒有依從醫生建議飲食及不定期測試血糖，或會令病
情惡化。註冊營養師陳勁芝則建議：「糖尿病人應減少吸收碳水化合物，最緊要控制好粥粉
飯，少 脂肪，多 纖維食物。」
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
The statistics of Diabetes in Hong Kong and other places over the world provided by
the Department of Health (DOH) and the World Health Organization (WHO) can
distribute to students as reference:

Diabetes is a serious problem and it was the eighth commonest cause of
deaths in Hong Kong, accounting for about 1.7% of all deaths in 2002. It
claimed more than 13 300 hospital admissions and 783 deaths in 2003. In
1984, the prevalence* of diabetes in Hong Kong was reported to be less than
1%; a prevalence* of 4.5% was observed in working groups and over 10% for
the elderly in 1990s. The trend keeps increasing and in 2003/2004, the
Population Health Survey estimated that close to 214 000 (3.8%) Hong Kong
people aged 15 years and above are currently living with diabetes.
(* Prevalence is the proportion of people in the entire population who are
found to be with disease at a certain point in time.)
Diabetes affects more than 171 million people worldwide, and the figure is
likely to more than double by 2030, according to the World Health
Organization (WHO).
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
Divide students into groups of 3 to 4 per group. Each group is required to prepare
the following before class:
1.
2.
3.
4.

http://www.info.gov.hk/dh/diseases/ncd/eng/diabetes.htm
http://www.info.gov.hk/dh/diseases/ncdaware/vol-2.pdf
What is Diabetes Mellitus?
Why insulin is important to us?
How can Diabetes Mellitus be treated?
What is carbohydrate?
Prepare notes and questions to be discussed before the session:
Level of Difficulties:
[1] Prior concepts.
[2] Essential concepts.
[3] Big and global concepts.
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Notes about Diabetes Mellitus:
1.
What is Diabetes Mellitus? [1]
Diabetes Mellitus (diabetes) is sometimes called “sugar diabetes”. It is a
metabolic disorder that affects how the body uses glucose. It occurs when the
pancreas, an organ near the stomach cannot make enough insulin or when the
body cannot use the insulin properly. Blood glucose level in diabetes patients
maintains in high level after eating and cannot be utilized as a body fuel. Diabetes
was the 8th commonest cause of deaths in Hong Kong in 2002.
2.
Why insulin is important to us? [1,2]
Insulin is produced by the pancreas, and it is a principal hormone that regulates
the uptake of glucose into cells from the blood. Insulin also inhibits the production
of glucose from fats and amino acids. In the absence of insulin (type 1 diabetes –
see later) or when the body has insulin resistences (type 2 diabetes), the muscle
cells cannot take up the glucose and convert them into water and carbon dioxide
to release energy. Excess glucose remained in the bloodstream leads to diabetes.
Some other cell types such as white blood cells, lens of eyes, kidney cells and
brain cells are insulin-insensitive.
The normal and abnormal blood glucose levels:
Fasting (a period of abstinence from food, e,g. overnight fasting) blood glucose
level
5.5 mmol/L or less
Diabetes unlikely
5.5-7.8 mmol/L
Impaired glucose tolerance
7.8 mmol/L or more
Diabetes
3.
What are the major forms of Diabetes Mellitus? [1,2]
There are three major types of diabetes: type 1, type 2 and gestational diabetes.


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“Type 1 diabetes” is an autoimmune disorder in which little or even no
insulin can be produced by the pancreas. It has an early onset and usually
begins during childhood.
“Type 2 diabetes” occurs usually later in life. Although insulin can still be
produced, the effectiveness of insulin is greatly reduced due to insulin
resistance. The main causes of type 2 diabetes are related to lifestyle factors
and a majority of patients are obese and do not have enough exercise.
“Gestational diabetes” is a temporary condition with high blood glucose
during pregnancy. It is due to the influence of hormone secretion by the
placenta. In most cases, gestational diabetes is managed by diet and
exercise. Gestational diabetes goes away after the baby is born.
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4.
What are the major risk factors of Diabetes Mellitus? [2]

5.
Hereditary factors: people with a family history of diabetes mellitus are more
at risk.
 People who are middle-aged or above.
 Women who have suffered from diabetes during pregnancy or who have
given birth to big babies. (Big baby refers to a baby heavier than 4 kg at
birth.)
What are the symptoms of Diabetes Mellitus? [2]
Symptoms of type 1 diabetes develop over a short period of time (within weeks or
months), whereas type 2 diabetes are usually asymptomatic. As glucose is
secreted to urine, patients will have increased thirst and frequent urination.
Symptoms also included increased appetite (especially in type 1 diabetes), weight
loss and extreme fatigue.
6.
What are the complications of Diabetes Mellitus? [2, 3]

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7.
Heart disease
Kidney disease (Frequent urination)
Eye disease (change in vision)
Problems with erection (impotence)
Nerve damage
Slow-healing wounds or sores – foot ulcers
How can Diabetes Mellitus be treated? [2]
Diabetes Mellitus cannot be cured but it can be managed effectively by
controlling the blood glucose level in a normal range every day.




8.
Careful meal planning
Exercise and weight loss
Oral medications
Insulin injection or oral medications to control their blood glucose level
What is gestational diabetes? [2]
Gestational diabetes is a condition characterized by high blood glucose levels
during pregnancy. It is because the ability of insulin to manage glucose was
interfered by increased level of certain hormones made in the placenta. As the
placenta grows larger during pregnancy, more hormones are produced to exert
greater effect on the ability of insulin to control glucose. In normal circumstances,
pancreas is able to produce more insulin to counteract with the effect of the
hormones. However, if the insulin produced by the pancreas is not enough, high
blood glucose is resulted. This condition is called gestational diabetes.
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9.
Can glucose test screen for gestational diabetes? [3]
Glucose test screening can check for gestational diabetes. It is a type of diabetes
that some women develop during pregnancy. Gestational diabetes occurs in 1 3% of pregnancies and can cause health problems for the baby.
10. about Type I diabetes:
In response to high levels of glucose in the blood, the insulin-producing cells in
the pancreas secrete the hormone insulin. Type I diabetes occurs when these cells
are destroyed by the body's own immune system.
Diagram of Type 1 diabetes: http://health.allrefer.com/health/diabetes-type-idiabetes.html
11. Why is Type 1 diabetes related to autoimmune disorder? [1, 2]
The primary cause of Type 1 diabetes is related to an autoimmune process, in
which the immune system mistakenly recognizes the insulin producing cells (beta
cells) of the pancreas as foreign (non-self). Thus, it produces antibodies against
these cells and destroys them. As a result, the pancreas eventually is unable to
produce any insulin and the blood sugar level will become abnormally high.
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Notes about carbohydrates:
1.
What are carbohydrates? [1]
Carbohydrates are chemical compounds that act as the primary biological means
of storing or consuming energy. Carbohydrates are naturally produced by plants.
Pure carbohydrates contain carbon, hydrogen, and oxygen atoms, in a 1:2:1 molar
ratio, giving the general formula Cx(H2O)y where x and y may or may not be equal
and range in value from 3 to 12 or more.
Carbohydrates are composed of chains of simple sugars. The term polysaccharide
refers to the largest molecules, oligosaccharides contain from 3 to 10 sugars,
disaccharides are double sugars, and monosaccharides are simple sugars.
2.
Can you give me more examples of carbohydrates in our daily life? [1]
There are many examples of carbohydrates in our daily life. These include
glucose, fructose, sucrose and starch.
Glucose and fructose are regarded as the simple sugar in our daily life. Glucose,
also called the “blood sugar”, is the simplest form of carbohydrate. It is very
important to our body because it was used as the immediate source of energy in
our body. Fructose is a sugar that found in honey and recognized as the sweetest
natural sugar present. Fructose is widely used in food production as flavor
enhancer. Companies always conduct tests on one’s perception of sweetness
during food product formulation.
Sucrose and starch are more complex form of carbohydrates. Sucrose is, naturally
existing as cane or beet sugar, widely used as preservatives in food industries.
Starch is the polymer of glucose. Potato, rice, wheat, and maize are major sources
of starch in the human diet.
3.
What is monosaccharides? [1,2]
Monosaccharies share the same molecular formula: C6H12O6. Because of their six
carbon atoms, they are also called hexose. There are many monosaccharies
existing in our daily life, for example: glucose, galactose and fructose.

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
Glucose, also called the “blood sugar”, is the immediate source of energy in
our body.
Galactose is a milk sugar, which also exists in yogurt;
Fructose is recognized as the sweetest natural sugar present. Fructose can be
found in honey. It is widely used in food production as flavor enhancer.
Upon consumption, fructose is absorbed and converted into glucose by the
liver.
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4.
What is disaccharides? [1,2]
Disaccharides are composed of two monosaccharide units bound together. The
formula of these disaccharides is C12H22O11. The binding between the two sugars
results in the loss of a hydrogen atom (H) from one molecule and a hydroxyl
group (OH) from the other. The resulting linkage between the sugars is called a
“glycosidic bond”.
The most common disaccharides are sucrose (cane or beet sugar - made from one
glucose and one fructose), lactose (milk sugar - made from one glucose and one
galactose) and maltose (made of two glucoses).
Sucrose is a good preservative because it has no reactive group like other sugars.
-glycosidic bond
This is a structural diagram of sucrose
5.
What is polysaccharides? [1,2]
As the name implies, polysaccharides are large high-molecular weight and often
branched molecules constructed by joining monosaccharide units together by
glycosidic bonds. They tend to be amorphous, insoluble in water, and have no
sweet taste.The most important compounds in this class, starch, glycogen and
cellulose, are all polymers of glucose.

Starches are polymers of glucose. Starches are insoluble in water. They can
be digested by hydrolysis catalyzed by enzymes called amylases, which can
break the glycosidic bonds (alpha-linkages). Humans and other animals have
amylases, so they can digest starches. Potato, rice, wheat, and maize are
major sources of starch in the human diet.
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Why starch in sticky rice (or glutinous) is more stickier than the one in
“normal” rice? [3]
There are two types of starch in rice: amylose and amylopectin. Longer grain rice
has 22% amylose and 78% amylopectin while medium/short grain rice has 18%
amylose and 82% amylopectin, which allows the grains to separate during
cooking. Glutinous rice lacks amylose but contains high amylopectin. Relatively
higher the amylopectin, stickier is the texture.

Glycogen is the storage form of glucose in animals. It is a branched polymer
of glucose. Glycogen can be broken down in liver to form substrates for our
body use.

Cellulose is the structural components of plants .Wood is largely composed
of cellulose and lignin, while paper and cotton are nearly pure cellulose.
Cellulose is a polymer made with repeated glucose units bonded together by
glycosidic bonds (beta-linkages). Humans and many other animals lack an
enzyme to break the glycosidic bonds (beta-linkages), so they do not digest
cellulose. Certain animals (cows and rabbits, for example) can digest
cellulose, because bacteria possessing the enzyme are present in their gut.
-glycosidic bond
This is a structural diagram of cellulose
6.
How much carbohydrate is enough? [3]
60 percent of the calories we eat every day should come from carbohydrate. In
order to find out how many carbohydrates we need, simply multiply the number
of calories we need by 0.6. For example, if we need 2,000 calories per day, 2000
multiplied by 0.6 = 1,200. So we need 1,200 calories from carbohydrates. There
are 4 calories in a gram of carbohydrate. Take 1,200 calories and divide by 4 =
300 grams.
7.
Are carbohydrates a necessity for human nutrition? [2,3]
Strictly speaking, carbohydrates are not necessary for human nutrition because
proteins can be converted to carbohydrates—the traditional diet of some peoples
consists of nearly zero percent carbohydrate, and they are perfectly healthy.
However, carbohydrates require less water to digest than proteins or fats, and are
an important source of energy.
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8.
How carbohydrates digested and absorpted? [1,2]
Polysaccharides and oligosaccharides must be hydrolyzed to monosaccharide
before being absorbed. The digestible carbohydrates are broken into simpler
molecules by enzymes in the saliva, in juice produced by the pancreas, and in the
lining of the small intestine. Starch is digested in two steps: First, enzymes in the
saliva and pancreatic juice break the starch into molecules called maltose; then
enzymes in the lining of the small intestine (maltase) split the maltose into glucose
molecules that can be absorbed into the blood through specific pumps or
transporters on the epithelial cells of the small intestine. Glucose is carried
through the bloodstream to the liver, where it is stored or used to provide energy
for the work of the body.
9.
What are simple tests of carbohydrates? [2,3]
There are many tests for detecting the presence of carbohydrates: iodine tests,
Benedict’s test and Molisch test.

Iodine test is for detecting the presence of starch and glycogen. Iodine
yields a blue-black color in the presence of starch while glycogen gives a
brown-blue color. In contrast, other polysaccharides and monosaccharides
yield no color change; the iodine solution remains the characteristic brownyellow of the reagent.
a negative test (left) and a positive test (right)

Benedict’s test is for detecting the presence of reducing sugars, e.g.
fructose, glucose, galactose and lactose. Addition of Benedict’s solution
after hydrolysis of samples can produce a change of clear blue to brick red if
the sample contains reducing sugars. Benedict’s solution is an alkaline (pH
10.5) solution of copper which are reduced by sugars with the formation of
colored cuprous oxide.
a negative test (left) and a positive test (right)
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
Molisch test is a general test for detecting the presence of carbohydrates. It
can give a positive result for all carbodydrates. Monosaccharides give a
rapid positive test. Disaccharides and polysaccharides react slower. A purple
ring can be observed when the sample consists of carbohydrates or
glycoprotein. A negative result indicates the absence of carbohydrates.
a negative test (left) and a positive test (right)
10. What is the Glucose Test? [2]
This test measures the amount of glucose (sugar) in your blood. Sugar is an
important source of energy, especially for the brain. The amount of glucose in
your blood is carefully controlled by the hormonal system.
Regulation of blood glucose level [3]
(Diagram of Regulation of Blood glucose level:
http://www.howstuffworks.com/diabetes.htm)
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Blood glucose level is controlled by 2 hormones secreted by pancreas: insulin and
glucagon. When the glucose level falls too low, the liver changes some of the
glycogen into glucose to give us energy. If the glucose level stays low for a period
of time, conditions of low blood sugar level occurs.
When the glucose level rises too high, insulin is produced by pancreas to
lower it. If the blood glucose level remains too high for a time, conditions
of high blood sugar level occurs.
This system can regulate sugar to be stored or used for energy, depending on the
needs of our body. The test is also used to see how well our body is metabolizing
glucose and the function of organs involved in that process: the pancreas, the
liver, and the receptors that bring glucose into cells.
11. What is Glycemic Index? [2]
The purpose of the glycemic index is for diabetics who need to be concerned
about their blood sugar levels on a daily basis. The glycemic index is a ranking
of carbohydrates based on their immediate effect on blood glucose (blood
sugar) levels. It compares foods gram for gram of carbohydrate. Carbohydrates
that breakdown quickly during digestion have the highest glycemic indexes.
The blood glucose response is fast and high. Carbohydrates that break down
slowly, releasing glucose gradually into the blood stream, have low glycemic
indexes.
12. How can we know whether the diet is dangerous to diabetic patients? [1]
Actually, whether the diet is dangerous to diabetic patients depends on the amount
of carbohydrates in the diet. If the amount of carbohydrates is too high in one diet,
the rapid change of blood glucose may pose risk on diabetic patients.
Carbohydrate counting is a method of meal planning to record the amount of
carbohydrates that the patient eats in a day. Food labeling is an important tool for
carbohydrate counting. When patients are indicated by a registered dietitian that
their daily intake of carbohydrates should not exceed a certain level, they should
read the food label carefully and calculate whether the carbohydrate amount in
their diet fit their meal plan. If the carbohydrate content is too high for a particular
meal, patients may consider separate the diet into different meals.
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Questions for discussions:
1.
Why careful meal planning is needed? [2,3]
In order to control the blood glucose level in a normal range, diabetes patients
need to plan their meals carefully. The easiest way is to follow the diets with the
meal plan given by dietitians. The plan is usually tailored-made to individual
needs, tastes, activity level and lifestyle. Modification on eating habits such as
meal patterns maybe needed and hence some patients found that annoying and did
not follow the plan. This is very dangerous especially for patients who need oral
medications and insulin injection.
2.
What are the goals of a Diabetic diet? [2,3]
 Lower your blood glucose (sugar) level.
 Lower your blood fat (cholesterol) level.
 Lower your blood pressure.
 Help you to maintain or lose weight.
 Improve your feeling of well being.
3.
What are the types of meal plans for diabetes? [3]
There are three types of meal plans for diabetes patients.
Constant carbohydrate meal plan
People with diabetes eat a certain amount of carbohydrates in each meal and
snack. Then he or she takes insulin or other diabetes medicines at the same time at
similar doses each day.
Carbohydrate counting* meal plan
(* Carbohydrates counting means the person counts the number of carbohydrate
grams being eaten.)
People with diabetes count carbohydrates so they can match their insulin doses
with the amount of carbohydrates that they eat by reading the food labels. This
plan works best for people who take a dose of insulin (as a shot or with an insulin
pump) with each meal.
Exchange meal plan
People with diabetes use the exchange meal plan to look at proteins and fats on
their meal plan as well. Foods are divided into six groups: starch, fruit, milk, fat,
vegetable, and meat. The plan sets a serving size (amount) for foods in each
group. Each serving has about the same amount of calories, proteins,
carbohydrates, and fats. The number of servings from each food grouping may
differ for a person with diabetes, based on his/her recommended treatment plan,
diabetic goals, calorie intake, and lifestyle.
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4.
What should the diabetes patient eat? [2,3]
A good diabetic meal plan is really a balanced meal plan, and the MyPyramid** is
a good starting point for diet planning.
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Eat 6-11 servings of starches, such as bread, cereal, and starchy vegetables
spaced evenly throughout the day. (6 servings for less active women, 9
servings for less active men, & 11 servings for active men.)
Eat more fruits and vegetables - try 5 a day.
Eat sugars and sweets in moderation.
Eat less total fat.
Eat less saturated fat.
**What is the new MyPyramid? [3]
MyPyramid, proposed by the United States Department of Agriculture in 2005, is
an update on food pyramid. The new icon stresses lifestyle, activity and
moderation along with a proper mix of food groups in one's diet.
(Diagram of MyPyramid:
http://www.mypyramid.gov/images/Home_image.gif)
How many food groups are shown on the MyPyramid? [3]
MyPyramid contains eight divisions with six food groups:
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Grains, recommending that at least half of grains consumed be whole
Vegetables, emphasizing dark green vegetables, orange vegetables, and dry
beans and peas
Fruits, emphasizing variety and de-emphasizing fruit juices
Oils, recommending fish, nut, and vegetables sources
Milk, a category that includes other dairy products
Meat and beans, emphasizing low-fat and lean meats such as fish as well as
more beans, peas, nuts, and seeds
Beside food groups, what else are shown on the MyPyramid? [3]
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Physical activity, represented by a person climbing steps on the pyramid,
with at least 30 minutes of moderate to vigorous activity per day
recommended
Discretionary calories, represented by the uncolored tip of the pyramid,
including items such as candy, beer, or additional food from any other group
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5.
What else can diabetes patients do to maintain a normal glucose level besides
careful meal planning? [1]
Besides following the meal planning, patients have to stay physically active
everyday, take medications on time and check their blood glucose level
frequently. These measures can help to maintain their glucose level to a lower
level.
6.
How do diabetic patients check their blood glucose level? [2,3]
Diabetes patients can use glucose oxidase-containing reagent strips for regular
testing of their blood glucose level. The closer to normal the blood glucose level
is, the lower the chance to get complications of diabetes such as problems in
vision (damage of the retina), foot ulcers and foot infections, diabetic kidney
disease, stroke and heart diseases. Urine testing can also be used to test the
presence of glucose in urine.
A person with diabetes is advised to constantly manage their blood's sugar
(glucose) levels. After a blood sample is taken and tested, it is determined whether
the glucose level is low or high. If glucose level is too low, carbohydrates are
ingested. If glucose in the blood is too high, an appropriate amount of insulin is
injected into the body.
(Diagram of Glucose test: http://health.allrefer.com/health/diabetes-glucosetest.html)
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Reference:
Diabetes Mellitus
1. NDIC “Diabetes overview” –
(http://diabetes.niddk.nih.gov/dm/pubs/overview/index.htm)
2. Health Zone “Understanding Diabetes Mellitus” –
(http://www.cheu.gov.hk/eng/info/otherdiseases_06.htm)
3. CHP “Non-communicable disease” –
(http://www.info.gov.hk/dh/diseases/ncdaware/vol-2.pdf)
4. DOH Publication – (http://www.info.gov.hk/dh/publicat/index.htm)
5. WHO The Diabetes Programme – (http://www.who.int/diabetes/en/)
6. Diabetes Action Now: An initiative of the World Health Organization and the
International Diabetes Federation, 2004
7. Diabetes overiew – (http://www.4woman.gov/faq/diabetes.htm)
8. Discovery Home and Health website –
(http://www.discoveryhealth.co.uk/encyclopaedia/default.asp?cat=Diabetes&storyid
=117803#Condition)
9. Basic Nutrition for People with Diabetes –
(http://www.umassmed.edu/diabeteshandbook/chap06.htm#BasicNutrition)
Carbohydrates
1. Carbohydrates –
(http://www.nowfoods.com/?action=itemdetail&item_id=4990#Diet-Options)
(http://www.nowfoods.com/?action=itemdetail&item_id=19163)
2. Gestational diabetes
http://www.diabeticmommy.com/34-gestational-diabetes-diet.html
3. Carbohydrate counting
http://www.clevelandclinic.org/health/health-info/docs/2600/2619.asp?index=9825
4. The Glycemic Index
http://www.zemos.com/fn01.pdf
5. Carbohydrates vs sugar and Sugar vs Diabetes
http://prediabetesmenus.com/articles/diabetes_difference_between_carbohydrates_a
nd_sugar.asp
6. Diabetes Type 2: Carbohydrates
http://diabetestype2.writedoc.com/carbohydrates.htm
7. What are the major food components in a diabetes diet?
http://www.well-connected.com/rreports/doc42full.html
8. Diabetes: Counting Carbohydrates Meal Plan
http://www.med.umich.edu/1libr/pa/pa_diabdiet_hhg.htm
9. Dietitian Advice
http://www.diabetes-hk.org/AboutDB/dietad.html
10. Type 2 Diabetes
http://www.aictp.com/Resources/Diabetes%20Type%202%20diet%20advise.html
11. Carbohydrates in nutrition – (http://www.medicallibrary.net/sites/framer.html?/sites/carbohydrates_in_nutrition.html)
12. Carbohydrates –
(http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/C/Carbohydrates.html)
13. Biochemistry of Carbohydrates –
(http://web.indstate.edu/thcme/mwking/carbohydrates.html)
14. Carbohydrates –
(http://chemed.chem.purdue.edu/genchem/topicreview/bp/1biochem/carbo5.htm)
15. A field test for estimating sweetness preferences to improve estimates of sucrose
intakes in individuals – (http://www.unu.edu/unupress/food/8F071e/8F071E0a.htm)
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16. Digestion, absorption and energy value of carbohydrates –
(http://www.fao.org/docrep/W8079E/w8079e0k.htm)
17. Food and Nutrient Digestion – (http://www.nutristrategy.com/digestion.htm)
18. Digestion and absorption of carbohydrates –
(http://www.sciencemindmaps.com/Digestion/carbohydrates%20tutorial.htm)
19. Carbohydrate digestion – (http://www.gpnotebook.co.uk/simplepage.cfm?ID=1241120711)
20. Digestion –
(http://www.biologymad.com/master.html?http://www.biologymad.com/Digestion/
Digestion.htm)
Local news [3]
Keywords
Title
Newspaper
碳水化合物 半年減磅最多一成 胡亂瘦身會不育
《醫書直說》 食用纖維素減餐後血糖指數
美近億人奉行低碳水化合物瘦身法
成報
太陽報
信報財經新聞
狂食高蛋白變大隻妹
低糖食品卡路里一樣高
高溫煮碳水化合物易致癌
馬拉松 賽前 肌肉須貯能量 多吃碳水化合物 賽後
補充電解質
五榖類不會令血糖迅速提升
胰島素助調節肥胖 碳水化合物非瘦身死敵
糖尿病致死年增 36﹪ 有年輕化趨勢 最小不足 14
糖尿病
歲
糖尿性 高血壓 患者易腎衰竭 進行尿蛋白測試 有
助減低風險
糖尿病年輕化不容忽視
以果蠅測試中藥治糖尿
改變生活可預防糖尿病
十個港人一個患糖尿病 不知已患病者 男七成女三
成
兒童患糖尿增四倍
糖尿兼情緒病者自殺高危 三成人長困擾 輕生率高
十倍
成人二型糖尿病 蔓延至６歲小童
過重或癡肥 全港肥人 154 萬 35%受訪者懵然不知超標
男 36 吋女 32 吋腰圍超標健康高危 患糖尿病 高血
壓機會大增
港中年男士逾半大肚腩 易患代謝症候群 風險高於
常人 63 倍
港人過重排亞洲前列 半數減肥失敗 認意志力不足
85％港人食過量脂肪
港女性僅 25%超重
五成半男士過重
香港兒童趨向肥胖
港肥人比率亞洲最高
蘋果日報
文匯報
太陽報
蘋果日報
蘋果日報
星島日報
蘋果日報
Page number
Date
健康秘訣 E04
每日專題 A44
科技-醫療寰宇
P14
體育 AA6
副刊趣知廊 D03
本地新聞 A30
健康與醫療 A21
2005-04-05
2005-04-08
2004-05-08
健康與醫療 A21
時事教材 F03
2005-01-27
2004-03-23
2005-03-25
2005-03-22
2005-03-05
2005-02-24
港聞 A14
10/31/2004
健康與醫療 A21
11/12/2004
蘋果日報
蘋果日報
蘋果日報
蘋果日報
暖流 C21
健康與醫療 A17
港聞 A08
11/4/2004
6/9/2004
11/9/2003
港聞 A18
10/8/2003
蘋果日報
蘋果日報
港聞 A15
3/19/2003
港聞 A08
3/10/2003
蘋果日報
蘋果日報
蘋果日報
健康生活 E18
港聞 A17
5/6/2002
9/23/2004
港聞 A08
7/25/2004
港聞 A10
2/27/2004
港聞 A10
港聞 A6
港聞 A18
港聞 A10
體育 AA6
港聞 A02
7/24/2003
1/8/2003
9/10/2003
8/9/2003
1/20/2003
7/11/2002
蘋果日報
蘋果日報
蘋果日報
蘋果日報
蘋果日報
蘋果日報
蘋果日報
蘋果日報
16
Trial Version
Glossary
English
Abdominal
Acute complications
Age standardised mortality
rate
Amylases
Appetite
Asymptomatic
Atherosclerosis
Autoimmune disorder
Blood glucose level
Carbohydrates
Cellulose
Coma
Consciousness
Diabetes Mellitus
Diabetic acidosis
Diabetic neuropathy
Disaccharides
Fatigue
Fructose
Galactose
Glucose
Glucose
Glycogen
Glycosidic bond
Hereditary factors
Hormone
Hydroxyl group
Hypoglycemia
Insulin
Lactose
Lactose intolerance
Maltose
Metabolic disorder
Monosaccharies
Obese
Oligosacchride
Pancreas
Polysaccharides
Pregnancy
Retina
Retinopathy
Starch
Stomach
Stroke
Sucrose
Chinese
腹〔部〕
急性併發症
年齡標準化死亡率
澱粉水解酵素
食欲/胃口
無症狀
動脈粥樣硬化
自體免疫失調
血糖水平
碳水化合物
纖維素
昏迷
意識
糖尿病
糖尿病酸中毒
糖尿病神經病變
雙醣類
疲勞
果糖
半乳糖
葡萄糖
葡萄糖
肝醣
醣鍵
遺傳性原因
激素
羥基
血糖過低
胰島素
乳糖
乳糖不耐症
麥芽糖
代謝失調
單糖
肥胖
寡糖
胰〔臟〕
多醣
懷孕
視網膜
視網膜病變
澱粉
胃
中風
蔗糖
17
Trial Version
Ulcer
Urination
Urine
潰瘍
排尿
尿
18