Download Carbohydrate Related Disorders

Module 3.4
Carbohydrate
Storage & Disorders
By Jennifer Turley and Joan Thompson
© 2013 Cengage
Presentation Overview
Storage
1.
2.
3.
4.
Blood Sugar (glucose)
Starch vs. glycogen
Glycogen (in detail)
Blood sugar regulation
 Insulin & Glucagon
Disorders
1.
2.
3.
Lactose intolerance & mal-digestion
Hypoglycemia
Diabetes
What is glucose used for?
 Immediate
carbohydrate energy &/or glycogen
storage (Liver & Muscle)
 Brain,
central nervous system (CNS), & red blood
cell (RBC) function
 Requires
a minimum of 100-150g carbohydrate day
(continuous)
 Muscle
 Fat
functioning (muscle glycogen)
synthesis (excess energy intake)
Glycogen
 The
storage form of glucose
 Made
 All
from dietary carbohydrate sources
carbohydrates are converted to glucose then 1)
used immediately or 2) stored as glycogen
Glycogen
 The
storage form of glucose
 Made
from dietary carbohydrate sources
 All
carbohydrates are converted to glucose then 1)
used immediately or 2) stored as glycogen
Diets should be planned to meet the 45-65% of
Calories AMDR & the minimum DRI for
carbohydrate (130g/day for adults).
Glycogen Storage
 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
Blood Sugar (glucose) Regulation
 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
Blood Sugar (glucose) Regulation
Insulin
Blood Sugar (glucose) Regulation
Glucagon
Carb Related Disorders
 Lactose
Intolerance & Lactose Mal-digestion
 Hypoglycemia
 Diabetes
Lactose Intolerance
 NOT
a food allergy
 Caused by lactase deficiency
 Enzyme
to break down lactose is missing
 strongly tied to evolution with several gene mutations
identified
 Symptoms:
Gas, bloating, cramps, diarrhea
Lactose Intolerance
Dairy Products & Lactose Intolerance
 Use
a product like lactaid
 Consume
yogurt with live cultures
 Consume
aged cheese
-OR Avoid
dairy products
Food Allergy vs. Intolerance
 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
 Allergic
responses cause the formation of mucous
in the respiratory tract, GI distress &/or hives
Hypoglycemia (low blood sugar)

Reactive: Blood sugar levels drop after eating sugar


Drug-induced: Improper insulin or oral hypoglycemic drug
use with diabetes.



Too much insulin is secreted in response to sugar consumption.
Hyperinsulinemia
Low blood sugar from a drug reaction
Anti-inflammatory and thyroid medications are known to cause
hypoglycemia
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
Diabetes (a chronic disease)
 Is
characterized by hyperglycemia (high blood
sugar)
 Affects
>20 million Americans, many unaware
 Increases
risk of heart disease, stroke, kidney
disease, retinopathy, and neuropathy
 Decreases
 Exists
life expectancy
as Type I or Type II
Type I Diabetes (less common)
 5%
of cases
 Juvenile
 More
onset
difficult to control (without treatment)
 Insulin
administration is essential in the control of
blood sugar
 Auto-immune
factors
disorder caused by genetic or viral
 Immune system attacks pancreatic beta cells and
disrupts ability to produce insulin
Type I Diabetes (less common)
Blood
Stream
1. Antibodies attack
the insulin
producing cells of
the pancreas.
2. No insulin is made.
3. Blood glucose/sugar
levels are high.
4. Liver & muscle cells
cannot take up
glucose because
there is no insulin
to bind the cell
receptor.
Type II Diabetes (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)
 Can
have a genetic pre-disposition or can develop
with obesity
Type II Diabetes (very common)
Blood
Stream
1. The pancreas produces
insulin.
2. Blood glucose/sugar
levels are high.
3. The insulin receptor
on the liver and muscle
cells are insensitive to
the insulin.
Diagnosis of Diabetes
 Normal
blood glucose <100 mg/dL
 Pre-diabetic
 Fasting
2
levels are between 100-125 mg/dL
glucose level ≥ 126 mg/dL
hour post prandial (fed) blood glucose level ≥
200 mg/dl.
Diagnosis of Diabetes
Diagnosis of Diabetes
 Glucose




Tolerance Test
Normal diet for 3 days prior to test
Baseline fasting blood sugar level
Glucose load. 1g carbohydrate /Kg body weight or a
max of 100g for adults
Monitor blood sugar every half hour for six hours.
How Overweight  Hyperglycemia
Case Studies: Dick & Jane
Case Studies: Dick & Jane
Food Composition:
The glycemic response/ index
 Simple
sugars & foods with a high glycemic index
burn up fast & elicit an insulin response
 Complex
carbohydrates sustain energy better.
Glycemic Response/ Index
 The
rise in blood sugar in response to food (as
compared to glucose)
 Glucose
 The
is assigned 100
Glycemic Index of a food can be useful to
anyone concerned with blood sugar control.
Glycemic Response of Foods
 Those
with diabetes should eat foods that have a
lower glycemic response (for slower entrance of
glucose into the blood stream)
 Foods
with high protein, fat, & fiber lower the
glycemic response
 Diabetics
careful
can still eat carbs… but need to be
Glycemic Response of Foods
Summary

Glucose is required by the brain, RBCs & CNS for energy

Carbohydrate is the preferred energy source of the
body

All carbohydrate is converted to glucose for energy

Excess carbohydrates are stored as glycogen (liver &
muscle)

If glycogen stores are full, excess carbohydrates are
stored as fat
(ATP)
References for this presentation are the same as those for this topic found in module 3 of the textbook
Summary

Liver glycogen maintains blood sugar for brain, RBCs &
CNS function

Muscle glycogen maintains the working muscle in high
intensity exercise

The hormones insulin & glucagon regulate blood sugar
levels

Insulin decreases & glucagon increases blood sugar
References for this presentation are the same as those for this topic found in module 3 of the textbook
Summary

Lactose intolerance occurs when the enzyme lactase is
missing

Milk allergy involves immunity

Hypoglycemia is low blood sugar. Can be reactive,
spontaneous, or drug induced

Hyperglycemia is a sign of diabetes
References for this presentation are the same as those for this topic found in module 3 of the textbook
Summary

Diabetes occurs as type 1 & type 2

Unmanaged diabetes has health implications

Individuals with diabetes should consider the glycemic
response of foods for diet planning

Selecting low glycemic index foods is useful in
controlling blood sugar rises
References for this presentation are the same as those for this topic found in module 3 of the textbook