Question

"Marc and Dan are twins who like the same activities and foods. At a recent doctor’s appointment, Dan was told that he has type 2 diabetes. He has been feeling good and has not noticed any changes in his health. He does not understand why he has diabetes but his brother does not and why he has not had any noticeable symptoms." Make sure that you address the following topics as they relate to Dan's concerns over his recent diagnosis:

1. Carbohydrate Metabolism, 2. Blood Glucose Regulation, 3. Glycemic Index, 4. Glycemic Load, 5. Treatment Options, 6. Complications

Answer 1

1. Carbohydrate Metabolism: Carbohydrate metabolis is known as Glycolysis. Where the carbohydrate metabolized in to glucose, fructose etc. Usually the carbohydrate is Partly digested in mouth by salivary amylase, In stomach there is no digestion takes place for carbohydrates and Complete digestion and absorption will be taken place at small intestine.

• Glycolysis: Whre the glucose molecules are splitted down in to carbon molecules. Hence 3 carbon molecules are developed.
• Preparatory phase: Here the 3 divided carbon molecules will convert into 2carbon molecules and carbon di oxide.This is a anerobic atage.
• Kerbs cycle: This cycle is also known as citric acid cycle, where ATP and carbon di oxide is developed
• Electron transport phase: In this phase, the largest amount of ATP is produced for body use.

2. Blood Glucose Regulation

Blood glucose value is usually regulated by number of hormones like insulin, glucagon, somatostatin etc. This is the process by which the blood glucose value is maintained within a normal range.When blood sugar rise, insulin produced from the islets of Langerhans helps the liver to convert more glucose into glycogen and store in liver.

When blood glucose level falls, the alpha cells of pancreas produce glucagon.The glucagon works up on the liver cells and stimulates the break down of glycogen in to glucose.The cells start to release the glucose into the bloodstream, thus helps to increase blood sugar levels.

3. Glycemic Index

Glycemic index is a number assigned to a particular food. This number will indicate the rise in the blood glucose value after consuming that particular food. It is usually beleived as 2 hours after the consumption of that particualr food. The number will range between 0-100.Many food items can have the same glycemic index.Based on the score the food items can be classified in to low glycemic index food, medium Glycemic index food and high glycemic index food.

4. Glycemic Load

Glycemic load also a number, which is assigned to a food item. this number will estimates how much the food will raise the persons blood glucose level after eating it. Glycemic load,also explains how much carbohydrate is presnt in a particular food item.

5. Treatment Options

1. Use of oral hypoglycemic agents: They helps to reduce excess glucose level in the blood by regulating the glucose and lipid metabolism in body. The commonly used oral hypoglycemic agents are metformin, glycomet etc.

2. By maintaining healthy weight: this will helps to avoid the intake of a balanced diet. That is diet less in carbohydrate and rich in protein , vegetables and fruits. Maintaining adequate body weight will reduce the risk of type 2 DM.

3. Following a diabetic diet: Diet ricg in vegetables, fruits and proteins. Restricting the intake of sugar, fats and carbohydrates.

4. Following healthy life styles; healthy life style including regular exercise pattern, regular sugar monitoring etc will helps to keep the blood glucose value within normal range.

5. Insulin therapy: Where, the insulin is administred to the individual as per the body needs via subcutaneous injections.Various methods of administration exist. INsulin helps to keep the blood glucose value within normal range.

6. By improving the physical activity: Increasing the physical activity helps the body to utilize the excess glucose levels and there by helps to reduce the excess glucose level.

7.By Continuous monitoring of blood glucose.

8. By reducing stress and anxiety.

6. Complications

Type 2 Diabetes mellitus is the condition, where the body cannot utilize insulin effectively. As a result, the blood glucose value start to increase highly. Untreated type 2 diabetes can cause serious complications in an individual. They includes,

• Retinopathy: Where small blood vessels in the eyes of the individual may get affected leading to blindness
• Diabetic Neuropathy: Where uncontrolled sugar level may damage the nerves in body leading to lss of sensation
• Diabetic foot wound
• Foot ulcers
• Diabetic nephropathy:Uncontrolled glucose can damage the nephrones in the kidney leading to loss of functioning.
• Delayed wound healing
• Polyurea
• Polyphagia
• Severe hyper glycemia
• Severe hyperglycemia can cause organ damage
• Atherosclerosis
• Hypertension