Carbohydrate Storage and
Disorders
By Jennifer Turley
and Joan Thompson
© 2016 Cengage
Presentation Overview
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STORAGE
Blood Sugar (glucose)
DISORDERS
Starch vs. Glycogen
• Lactose Intolerance &
Glycogen in detail
Lactose Mal-digestion
Blood sugar regulation
• Hypoglycemia
• Insulin & Glucagon
• Diabetes
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).
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).
Whole grain complex
carbohydrates are best.
Carbohydrate is protein
sparing.
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.
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.
Blood Sugar Regulation, Part 1
Blood Sugar Regulation, Part 2
Carbohydrate Related
Disorders
• Lactose Intolerance &
Lactose Mal-digestion
• Hypoglycemia
• Diabetes
Lactose Intolerance, Part 1
Physiology:
• Lactase deficiency (completely missing in “intolerance”
while low activity/levels in “mal-digestion”) is strongly
tied to evolution with several gene mutations
identified.
• Symptoms: Gas, bloating, cramps, diarrhea.
Lactose Intolerance, Part 2
Dairy Products and
Lactose Intolerance
• Use a product like lactaid
• Consume yogurt with live
cultures
• Consume aged cheese
OR
• Avoid dairy products
Allergy vs. Intolerance
• Lactose intolerance & mal-digestion are
due to an inability to digest milk sugar
(lactose) not an allergic reaction to milk
protein (casein).
• 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.
Antibody and Allergen in an Allergic Immune Response
Hypoglycemia: low blood sugar
• Reactive: Blood sugar levels drop after eating sugar.
– Too much insulin is secreted in response to sugar
consumption. Hyperinsulinemia.
• 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.
• 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.
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 2
diabetes.
Type 1
Less common
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~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
Physiology of Type 1 Diabetes, Part 1
Physiology of Type 1 Diabetes, Part 2
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.
Physiology of Type 2 Diabetes, Part 1
Physiology of Type 2 Diabetes, Part 2
1. Oral Hypoglycemic
drugs are used to make
the cells respond to the
insulin.
2. Blood sugar levels
decline.
Indications of Diabetes
• Fasting glucose level ≥ 126 mg/dl.
• 2 hour post prandial (fed) blood glucose
level ≥ 200 mg/dl.
Hyperglycemia
Normal Blood Glucose is 70-99 mg/dl
Pre-Diabetes is 100-125 mg/dl
Glucose Tolerance Test
Measures Carbohydrate Metabolism
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Normal diet for 3 days
prior to test.
Baseline fasting blood
sugar level. (Levels
≥126 mg/dl indicate
diabetes).
Glucose load. 1 gm
carbohydrate /Kg
body weight or a max
of 100 gm for adults.
Monitor blood sugar
every half hour for six
hours.
Overweight
Contributes to
Hyperglycemia
type 2 diabetes
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.
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.
Glycemic Response of Foods
• Those with diabetes should eat foods
that have a lower glycemic response or
slower entrance of glucose into the blood
stream.
• Foods with high protein, fat, & fiber lower
the glycemic response.
Glycemic Index of Foods
Some
Summary Points, Part 1
• Glucose is required by the brain, RBCs & CNS for
energy (ATP).
• Carbohydrate is the preferred energy source of the
body.
• All carbohydrate is converted to glucose for energy.
• Excess carbohydrate is stored as glycogen. (liver &
muscle)
• If glycogen stores are full, excess carbohydrate is
stored as fat.
Some
Summary Points, Part 2
• 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 while glucagon
increases blood sugar.
Some
Summary Points, Part 3
• 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.
Some
Summary Points, Part 4
• 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