FSHN 350 - Carbohydrates (Unit 2.1)

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What are the pathways of carb metabolism

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1

What are the pathways of carb metabolism

  • glycogenesis

  • glycogenolysis

  • glycolysis

  • gluconeogenesis

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What is Glycogenesis

  • making glycogen from glucose

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What is Glycogenolysis

  • break glycogen into glucose

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What is Glycolysis

  • breakdown of glucose into pyruvate

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What is Gluconeogenesis

  • produce glucose from a non-carb intermediate

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Important tissues for glucose metabolism

  • liver

  • muscle

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The liver

  • takes up 20% of glucose

  • uses GLUT 2 to transport to get into the cell

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The muscles

  • take up 80% of glucose

  • uses GLUT 4 to transport to get into the cell

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How is muscle selfish

  • once muscle reaches its glucose limit, it stops taking up more -

  • once muscle breaks down glycogen into glu, it does not release it into the blood

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Process of making G6P

  • glucose enters the cell

  • phosphate attached to glucose (ATP --> ADP)

  • forming G6P

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GLUT transporters

  • Glu enters the muscle cell via GLUT 4, phosphorylated by hexokinase -- making G6P

  • Glu enters the liver cell via GLUT 2, phosphorylated by glucokinase -- making G6P

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Enzymes that make G6P

  • hexokinase in the muscle

  • glucokinase in the liver

  • both phosphorylate glucose into G6P

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3 fates of G6P

  • G6P --> glycogen (glycogenesis)

  • G6P --> back to glucose (glycogenolysis)

  • G6P --> glycolysis

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What, where and when of Glycogenesis

  • glucose --> glycogen

  • in muscles and liver

  • when in periods of energy excess

  • anabolic

  • consumes energy

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Steps of Glycogenesis with Enzymes

Glucose --(a-b)----> G6P ---(c-e)----> Glycogen a - hexokinase (muscle) b - glucokinase (liver) c - glycogenin d- glycogen synthase e - branching enzyme

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What are the steps of Glycogenesis

  1. glucose --> G6P

  2. G6P --> G1P

  3. G1P --> UDP-glucose

  4. UDP-glucose + glycogenin = Glycogen (short chain of Glu)

  5. Glycogen chains extended w/ glycogen synthase

  6. Glycogen adds branching via branching enzyme

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Glycogenin

  • enzyme in glycogenesis that attaches to UDP-glucose to make a short glu chain

  • attaches via α 1-4 bonds

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Glycogen synthase

  • enzyme that extends the short glu chain (glycogen chain)

  • extends via α 1-4 bonds

  • when G6P conc. increase, conc. of Glycogen synthase increase, meaning more glycogen is going to be made

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Branching enzyme

  • enzyme that creates branching points after glycogen has been created

  • creates branches via α 1-6 bonds

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Regulation of Glycogenesis

  • G6P inhibits hexokinase in muscle (negative feedback)

  • G6P does NOT inhibit glucokinase in liver

  • G6P increases Glycogen synthesis

  • Epi and glucagon inhibit Glycogen synthesis

  • insulin directly regulates glucose uptake in muscle (via GLUT 4)

  • insulin indirectly regulates glucose uptake in liver

  • insulin increases activity of glucokinase

  • insulin activates glycogen synthase

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When would we be using Glycogenolysis

  • when we need to break glycogen into glucose

  • fasting, starving, working out

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What, where and when of Glycogenolysis

  • glycogen --> glucose units

  • in liver and muscle

  • when in periods of energy deficit

  • catabolic

  • Glycogen phosphorylase will use a phosphate to take Glu off, making G1P

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Glycogenolysis (muscle)

  • Glycogen --> G1P --> G6P --> Glycolysis

  • muscle does not want to give up any Glu so it won't go back to Glu but will go to Glycolysis

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Glycogenolysis (Liver)

  • Glycogen --> G1P --> G6P --> Glycolysis

  • Glycogen --> G1P --> G6P --> Glucose

  • will make glucose when the body needs more

  • liver is the master Glu regulator

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Insulin and glucagon in the pathways

  • insulin increases Glycogen synthase (make glycogen)

  • glucagon and epi increase Glycogen phosphorylase (make G1P)

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What, where and when of Glycolysis

  • break down Glu into pyruvate

  • cytoplasm

  • when in periods of energy demand

  • functions in anaerobic and aerobic conditions

  • catabolic

  • yields energy

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Glycolysis steps (investment phase)

  1. Glucose ---(ATP-->ADP)---> G6P

  2. F6P ---(PFK)---> F1,6BisP

  3. F1,6BisP--> 2 G3P carbon molecules

  • 2 mol ATP invested to make 2-G3P

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How is PFK regulated

  • AMP + (positive feedback, high conc. of AMP, b/c ATP broken down into AMP, so we need more ATP)

  • ATP - (negative feedback, high conc. of ATP, so stop making so much)

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Glycolysis steps (payoff phase)

  1. make ATP from NAD+ ---> NADH

  2. make ATP via substrate level

  3. making pyruvate + ATP via substrate level

  • we use pyruvate kinase to make pyruvate

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Product of Glycolysis

  • 4 ATP

  • 2 NADH

  • 2 pyruvate

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Regulation of Glycolysis

  • AMP -- always increase

  • Insulin - increase

  • F1,6BisPhosphate -- increase

  • ATP -- always decrease

  • Citrate -- decrease

  • Acetyl CoA -- decrease

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How to get electrons into the mitochondria

  • Malate-Aspartate shuttle

  • Glycerol-Phosphate shuttle

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Malate-Aspartate shuttle

  • e- passed from NADH to oxaloacetate (OAA), forming malate

  • malate easily enters mitochondria

  • malate gives e- to new NAD and forms NADH (in the mitochondria)

  • NADH goes to the ETC to make ATP

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Glycerol-Phosphate shuttle

  • e- passed from NADH to DHAP, forming glycerol-phosphate

  • glycerol-phosphate easily enters mitochondria

  • glycerol-phosphate gives e- to new FAD and forms FADH (in the mitochondria)

  • FADH goes to the ETC to make ATP

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Liver overview

  • Glu enters -- via GLUT 2

  • Glu phosphorylated -- via glucokinase (GK)

  • insulin activates (GK)

  • insulin activates glycogen synthase

  • Glycogen phosphorylase -- break Glycogen into G1P

  • Glu-6-Phosphatase -- breaks down G6P into Glu

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Muscle overview

  • Glu enters -- via GLUT 4 (insulin dependent)

  • Glu phosphorylated -- via hexokinase (HK) inhibited by G6P (negative feedback)

  • G6P has negative feedback on HK

  • insulin activates (HK)

  • insulin activates glycogen synthase

  • Glycogen phosphorylase -- break Glycogen into G1P

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Liver story (Glycogenesis)

  • Glu enters the cell via GLUT 2

  • Glu gets phosphorylated by glucokinase, making G6P

  • G6P converted to G1P

  • G1P ultimately uses Glycogenin to make a Glu chain

  • Glycogen chain extended with Glycogen synthase

  • Glycogen branches out with the branching enzyme

  • the presence of insulin will activate GK and glycogen synthase

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Liver story (Glycogenolysis)

  • Glycogen broken down by glucose phosphorylase into G1P

  • G1P --> G6P

  • G6P --> Glu via Glucose 6 phosphatase

  • glucagon receptors help with the release of Glu

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what does high G6P mean?

  • a lot of G6P means a lot of glycogen can be formed, so a lot of glycogen synthase is going to be needed

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Liver story (Glycolysis)

  • Glycogen broken down by glycogen phosphorylase into G1P

  • G1P --> G6P

  • G6P --> Glycolysis

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Muscle story (Glycogenesis)

  • Glu enters the cell via GLUT 4 (insulin dependent)

  • Glu gets phosphorylated by hexokinase, making G6P (G6P has negative feedback on HK)

  • G6P converted to G1P

  • G1P ultimately uses Glycogenin to make a Glu chain

  • Glycogen chain extended with Glycogen synthase

  • Glycogen branches out with the branching enzyme

  • the presence of insulin will activate HK and glycogen synthase

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Muscle story (Glycogenolysis)

  • cannot make Glu because muscle has no Glucose 6 Phosphatase

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Muscle story (Glycolysis)

  • Glycogen broken down by glycogen phosphorylase into G1P

  • G1P --> G6P

  • G6P --> Glycolysis

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3 fates of pyruvate

  • make Acetyl CoA

  • make lactate

  • make ethanol

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Pyruvate --> Acetyl CoA

  • CO2 released

  • NADH created (NAD+ --> NADH)

  • via PDH enzyme

  • inhibited by ATP, NADH and Acetyl CoA

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Pyruvate --> Lactate

  • NADH --> NAD+

  • via LDH enzyme

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When do we make lactate

  • when the rate of pyruvate formation, exceeds the rate of Acetyl CoA formation

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What pathways need NAD to function

  • Glycolysis

  • TCA

  • pyruvate --> Acetyl CoA

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Importance of NAD+ in forming lactate

  • we need NAD for the TCA

  • the pyruvate --> lactate reaction allows for other reactions to occur because NAD+ is produced in this reaction (NADH --> NAD+)

  • other reactions: the ones mentioned above

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Lactate transportation

  • intracellular lactate shuttle

  • intercellular lactate shuttle

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Intracellular lactate shuttle

  • stays in the cell that made it

  • lactate goes to mitochondria to undergo oxidation to pyruvate via mitochondrial LDH

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Intercellular lactate shuttle

  • lactate can enter the circulation and go to other tissues

  • via the Cori Cycle

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Lactate misconceptions

  • it is a waste product produced by metabolism

  • is formed only under anaerobic conditions

  • is the cause for muscle soreness

  • all are wrong

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Cori Cycle

  • intercellular shuttle

  • if rate of lactate production in cell is too high, it ships it out

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Cori Cycle story

  • lactate accumulates in skeletal muscle and skeletal muscle lacks glucose 6 phosphatase

  • it ships the lactate to the liver so the lactate can be converted into Glu via gluconeogenesis

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MCT

  • intracellular

  • lactate enters the mitochondria via the MCT

  • lactate then forms pyruvate

  • then go to the TCA and make ATP

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What, where, when of Gluconeogenesis

  • making Glu from non-carb

  • liver, kidney, intestine

  • when low blood Glu

  • consume energy

  • yield NADH

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When does Gluconeogenesis happen

  • when we are fasting

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Gluconeogenesis story

  • say you ate at 7:00 and then went to bed

  • immediately after - the body will break down that food for Glu

  • 4 hours after - glycogen stored in the liver will be broken down

  • 12-18 hours after - glycogen stores are empty so body goes through gluconeogenesis to increase blood Glu

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What enters Gluconeogenesis

  • pyruvate

  • lactate

  • glycerol from mono, di and triglycerides

  • glycogenic amino acids

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Steps of Gluconeogenesis

  • pyruvate --(1+2)--> phosphoenolpyruvate --> reverse to glycolysis --> Fructose 1,6 BisPhosphate --(3)--> Fructose 6 phosphate --> G6P --(4)--> Glucose

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Gluconeogenesis enzymes

  1. pyruvate carboxylase

  2. PEP carboxykinase

  3. fructose 1,6 bisphosphatase

  4. glucose 6 phosphatase

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Regulation of Gluconeogenesis

  • opposite of glycolysis

  • AMP -

  • ATP +

  • Citrate +

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Pentose phosphate pathway

  • detour off glycolysis

  • NO ATP made

  • produce NADPH and R5P

  • high after a carb high diet

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NADH in pentose phosphate pathway

  • used for lipid synthesis

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R5P in pentose phosphate pathway

  • used for synthesis of nucleotides and nucleic acids

  • can lead to increased levels of uric acid

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Glycogen storage diseases

  1. McArdle's Disease (GSD-V)

  2. Von Gierke's Disease (GSD 1)

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McArdle's Disease (GSD-V)

  • exercise intolerance

  • low lactate levels after intense exercise

  • happens in skeletal muscle

  • no glycogen phosphorylase (so glycogen cannot be broken down when exercising)

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Von Gierke's Disease (GSD 1)

  • most common glycogen storage disease

  • severe hypoglycemia (low blood Glu)

  • high glycogen in the liver and kidney

  • can lead to an enlarged liver -- hepatomegaly

  • can't get rid of glycogen once its formed

  • glucose 6 phosphatase is inhibited

  • eat lower carb diets to solve issue

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Fructose metabolism

  • absorption into the cell via GLUT 2

  • not insulin dependent

  • liver takes 20% Glu and 75% fructose

  • fructose --fructokinase--> fructose 1 phosphate

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Where does fructose join glycolysis

  • fructose enters at the 2-G3P step

  • so after the investment phase

  • it bypasses the rate limiting step (which has PFK)

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Once fat is created the liver can

  • burn it

  • store it

  • package into VLDL

  • VLDL carries and ships triglycerides

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3 ways fructose increases risk of disease

  • increase fatty liver

  • increase risk heart disease b/c of VLDL

  • increase levels of uric acid

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Increase of fructose meaning

  • means ATP depletion

  • which makes AMP

  • AMP creates uric acid

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What is uric acid

  • risk factor for heart disease and gout

  • gout -- painful inflammation

  • linked to diabetes

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Glucose vs Fructose metabolism

  • both use GLUT 2 to enter cell

  • both phosphorylated by glucokinase and fructokinase

  • fructose dangerous b/c its a fast pathway (b/c it bypasses PFK)

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How fructose increase risk of heart disease

  • increases gout b/c ATP depletion

  • increase VLDL

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What does fructose lead to

  • it bypasses PFK and increases Acetyl CoA conc.

  • this is converted to fat and can lead to:

  • obesity, fatty liver and increased VLDL

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What is Type 1 diabetes

  • the body can not make insulin

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What is Type 2 diabetes

  • the body can make insulin, it just cannot utilize it

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Type 1 effect

  • no insulin means:

  • GLUT 4 transporters do not work - so tissues starve for Glu

  • Glu stuck outside the cells

  • people must inject Glu

  • lack of insulin = increase break down of fat

  • high fate loss = high ketone production (dangerous)

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Type 2 effect

  • cannot use insulin means:

  • Glu cannot get into the cell

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What leads to Type 2

  • over nutrition leads to type 2

  • obesity is the biggest risk factor

  • most common type (95% of people get this one)

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4 areas impacted by lack of insulin

  • fat

  • liver

  • muscle

  • blood

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Fat

  • increase lipolysis -- breakdown of fat

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Liver

  • increase hepatic glucose output -- increased Glycogenolysis, so Glu

  • increase VLDL -- bad cholesterol

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Muscle

  • decreased Glu uptake

  • decreased glycogen synthesis

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Blood

  • decreased vasodilation

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First step towards diabetes

  • insulin intolerance

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Insulin intolerance effects

  • less Glu taken by insulin

  • so body makes more insulin to compensate

  • increased intolerance leads to increased production of insulin

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Insulin intolerance story

  • insulin production increases as insulin resistance/tolerance goes up

  • Glu will stay normal (during this time) b/c of increased insulin production

  • pancreatic beta cells reach Beta Cell Failure as resistance goes up and production cannot meet that

  • this is when diabetes occurs

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Diagnosing diabetes (3 tests)

  • check A1C

  • being over 126 mg/dL (fasting)

  • being over 200 mg/dL (75g Glu)

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A1C test

  • the percent of hemoglobin in blood, that is bound to Glu

  • over 6.5% = you have diabetes

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Fasting test

  • test bloog Glu after 8 hrs of fasting

  • over 126 mg/dL = you have diabetes

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75g Glu test

  • take a 75g sugary drink in water, wait 2 hours

  • over 200 mg/dL = you have diabetes

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Limitations of these tests

  • you could have fasting blood Glu and be on your way to diabetes

  • there are different reactions for those that drink 75g (different body sizes)

  • A1C cannot be used in pregnant moms

  • b/c has a wide snapshot range, detects for 3 month range, not for right this second

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Glucagon and diabetes

  • increases gluconeogenesis

  • increases glycogenolysis

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Types 1 and 2

  • both have increased glucagon

  • associated with hyperglucagonemia

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What does high glucagon mean for diabetes

  • glucagon means more Glu from non carbs and more Glycogen broken into Glu

  • all this Glu makes diabetes worse because insulin already can't do it's job

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Gestational diabetes

  • women that are not diabetes, end up having high blood Glu during pregnancy

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