Regulation Of Blood glucose

Dr Jaiprakash Mohanraj
 Lecture content for this topic
• Maintenance of blood glucose
• Action of Insulin
• Action of glucagon
• Hypothalamic Regulation
• Clinical Relevance
• Oral Glucose Tolerance Test

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Dr Jaiprakash Mohanraj
 Introduction
• The concentration of blood glucose is regulated within
narrow limits.
• In the post-absorptive state, the concentration of blood
glucose in most mammals is maintained between 4.5
and 5.5 mmol/L.
• After the ingestion of a carbohydrate meal, it may rise to
6.5–7.2 mmol/L.
• In starvation it may fall to 3.3–3.9 mmol/L.
• A sudden decrease in blood glucose will cause
convulsions, as in insulin overdose, owing to the
immediate dependence of the brain on a supply of
glucose.

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Dr Jaiprakash Mohanraj
Introduction

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Dr Jaiprakash Mohanraj
 Maintenance of blood glucose
• Blood glucose is derived from the diet,
gluconeogenesis, & glycogenolysis.
– The digestible dietary carbohydrates yield
glucose, galactose, and fructose that are
transported via the hepatic portal vein to the
liver where galactose and fructose are readily
converted to glucose.
– Glucose is formed from gluconeogenesis.
– Glucose is also formed from liver glycogen by
Glycogenolysis.
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Dr Jaiprakash Mohanraj
 Regulation of blood glucose
• Metabolic & hormonal mechanisms regulate the
concentration of the blood glucose.
• Glucokinase is important in regulating blood
glucose after a meal.
• Insulin plays a central role in regulating blood
glucose.
• Glucagon opposes the actions of insulin.
• Other hormones affect blood glucose.
– Anterior pituitary gland hormones
– Glucocorticoids
– Epinephrine

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Dr Jaiprakash Mohanraj
Regulation of blood glucose

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Dr Jaiprakash Mohanraj
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Dr Jaiprakash Mohanraj
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Dr Jaiprakash Mohanraj
promote
promote uptake ofglucose
uptake of glucose into
into certain
certain
tissues tissues
promote
promote intracellular glucose
intracellular glucose
metabolism
metabolism
promote
promote glycogen synthesis
glycogen synthesis
 Glucagon supports
(1)Glycogenolysis
(2)Gluconeogenesis
(3)Ketogenesis

Glucagon inhibits
(1)Glycolysis
(2)Glycogenesis
(3)Lipogenesis

Other hormones
exerting similar
effects:
adrenaline
cortisol
growth hormone
 INSULIN

GLUCAGON

Changes in plasma glucose,

insulin and glucagon after a
carbohydrate-rich meal.
HYPOTHALAMIC REGULATION
 Clinical Relevance
• Glucosuria occurs when the renal threshold for
glucose is exceeded.
• Hypoglycemia may occur during pregnancy & in
the neonate.
• The body’s ability to utilize glucose may be
ascertained by measuring its glucose tolerance.
– Hypoglycemic state.
– Euglycemic state.
– Hyperglycemic state.

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Dr Jaiprakash Mohanraj
 Glucose tolerance test.

Blood glucose curves of a normal and a diabetic individual after oral

administration of 50 g of glucose. Note the initial raised concentration in the
diabetic. A criterion of normality is the return of the curve to the initial value
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within 2 hours. Dr Jaiprakash Mohanraj
 Summary

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Dr Jaiprakash Mohanraj
End of Slides

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Dr Jaiprakash Mohanraj