Carbohydrate digestion, absorption and blood sugar homeostasis Flashcards

1
Q

what are the 3 types of carbohydrates

A
  • monosaccharides (glucose, fructose, galactose)
    -disaccharides (maltose,sucrose,lactose)
  • polysaccharide (starch,glycogen,cellulose)
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2
Q

what are the structures of polysaccharides

A
  • starch in potatoes,rice, cornflakes
  • amylose and amylopectin
  • amylose- 1 chain
  • attached by alpha 1,4
  • branched chain has different bonds
  • then there’s alpha 1-6
  • glycogen found in the body of animal we consume
  • linear chain connected by alpha 1-4
  • cellulose - linear attached with alpha 1-4 but the branches chains 1-4
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3
Q

what is glands are important in the carbohydrate digestion in the oral cavity

A

parotid gland, submandibular gland, = both mechanical
serous cells- salivary alpha amylase

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4
Q

what enzyme is involved in carbohydrates digestion in the mouth

A

salivary amylase
- secreted by serous acini of parotid and sub mandibular salivary glands
- optimal pH=6.7
- action begins in the oral cavity and is assisted by mechanical breaking up of polysaccharides during chewing
- mode of action; hydrolysis of alpha 1-4 linkage in polysaccharides producing a mixture of oligosacharides
- works for 1-2 hours in the stomach before being deactivated by the gastric acids

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5
Q

what enzymes are involved in intestinal digestion of carbohydrates

A
  1. pancreatic amylase
    - secreted form the pancreatic exocrine acini into the duodenum through he pancreatic duct
    - optimum pH=6.7-7.0
    - mode of action: hydrolysis of alpha 1-4 linkage
    - responsible for digestion of more complex carbohydrate that take longer to break down to disaccharides or oligo saccharides
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6
Q

what are the brush border enzymes

A

maltase, sucrase and lactose
- found on the membrane surface of the micro villi of the epithelial cells lining the small intestines
- optimal pH =7.8
- mode of action: hydrolysing disaccharides into monosaccharides

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7
Q

how are carbohdyrate digested in the GIT

A
  • lactase break down lactose to glucose and galactose
    -lactose intolerance - deficiency in lactase
  • avoiding milk and dietary products
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8
Q

how are carbohydrates absorbed

A
  • occurs in small intestine
  • villi
    -microvilli - increases SA which facilitates absorption
  • the absorbable form of carbohydrates is monosaccharides
  • glucose and galactose enter the epithelial cells of the intestine through the apical border via active transport using sodium dependant co transporters, Sodium potassium pump requires energy
  • they leave the cells through the basolateral side using faciliated diffusion and glucose co-trasnporter 2 (GLUT-2) into the circulation
  • Fructose enters (GLUT-5) and leaves (GLUT-2) the epithelial cells using facilitated diffusion (no energy required)
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9
Q
A
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9
Q

what are the 3 mechanisms of diffusion

A

passive diffusion
facilitated diffusion
active transport

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10
Q

how is glucose and galactose absorbed

A
  • epithelial cells and brush bordere
  • glucose cannot enter cell membrane so is carried by SGLT1 using sodium
  • enter cell together , sodium released releasing energy so the glucose will be released
  • fructose binds with sodium and the SLGT2 leave
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11
Q

how is fructose absorbed

A
  • uses Glut5
  • released inside by facilitated diffusion
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12
Q

what factors affect carbohydrate absorption

A
  • faster through intact mucosa
  • absorption is decreased if there is some inflammation or injury to the mucosa
  • Thyroid hormones increase the rate of absorption of glucose
  • Mineralocorticoid: e.g. Aldosterone increase the rate of absorption
  • Sodium concentration : high concentrations increase the rate of absorption
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13
Q

what is th main nutrient for the brain and retina

A

under non starvation conditions, GLUCOSE is the main nutrient for the Brian and retina

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14
Q

what is the sole nutrient for red blood cells?

A

glucose

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15
Q

how many calories do glucose produce?

A

3.75 K - calories of energy/gm

16
Q

describe briefly the Krebs cycle

A

Glucose molecule is taken and broken down into pyruvate and ATP

17
Q

what is insulin and where is it secreted by

A

insulin Is a hormone secreted by the beta cells in the islets of langerhans of the pancreas and is responsible for regulating levels of glucose in blood by stimulating body cells to take glucose

18
Q

what is glucagon and what is it secreted by

A

Glucagon is a hormone secreted by the alpha cells in the islets of Langerhans of the pancreas; and is responsible for converting glycogen stored in the liver to glucose and releasing it in the blood when blood glucose levels are low

19
Q

what are described as antagonists

A

insulin and glucagon

20
Q

what is the structure and synthesis of insulin?

A
  • insulin is a small protein: MWT =6000
  • 2 pp chains A &B linked by a disulphide bond
21
Q

what is the role of insulin in glucose uptake by body cells

A
  • insulin works through stimulating GLUT4
22
Q

what is the normal blood glucose levels when fasting or after a meal?

A

fasting = 80=90mg/100ml
after a meal = 120-140mg/100ml

23
Q

what is the effect of insulin deficiency on cells?

A
  • reduce tissue uptake of glucose
  • intracellular hypoglycaemia or extracellular hypoglycaemia
24
Q

what happens in intracellular hypoglycaemia?

A
  • glucogeneiss and gluconeogenesis
  • breakdown of fats
  • high levels or ketones
    diabtetic ketoacidosis

or decreased protein synthesis, lethargy, polyphagia
- decreased gamma globulins
- susceptibility to infections
- impaired wound healing

25
Q

what happens in extracellular hyperglycaemia?

A
  • hyperosmoitc plasma
  • dehydration of cells
  • hyperglycaemic coma

blood glucose > renal threshold
- glucosuria- urine has a high SG
- osmotic diuresis
- polyuria
-poludipsia
-hypokalamia
-hyponatramia

26
Q

what are the symptoms of diabetes

A

-fatigue
- excessive thirst and appetite
- blurred vision
- dry mouth
slow healing sores
- unusual weight loss or gain
- nausea and perhaps vomiting
- yeast infections
- itching in groin or vagina
- increased urination

27
Q

what are the complications of diabetes

A

macrovascualr
- Brain; cerebrovascular disease, stroke, transient ischemia , cognitive impairment
- heart; coronary syndrome, myocardial infarction, congestive heart failure
-extremities; diabetic food, skin ulcers,amputation

Microvascular
- Eye: retinopathy, cataract,glaucoma
- kidneys nephropathy: micoralbuminemia, renal failure
- Nerve neuropathy: peripheral autonomic

28
Q

what are the dental complications of diabetes

A
  • dry mouth
  • gum and periodontal disease
  • loss of teeth
  • impaired and delayed healings
  • infections
29
Q

what is the dental management of diabetic patients?

A
  • regular visit to dentist and dental hygienist
  • maintenance of oral hygiene
  • regular periodontal check and management
  • antibiotic coverage fr surgeries (surgical extraction, implants)
  • controlled blood sugar levels before any surgical intervention
  • mouth wash
  • artificial saliva if required