Download - Ch Metabolism
![Page 1: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/1.jpg)
BIOMOLECULAR – BIOCHEMISTRY FACULTY OF MEDICINE
BRAWIJAYA UNIVERSITY
CARBOHYDRATE METABOLISM
![Page 2: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/2.jpg)
![Page 3: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/3.jpg)
![Page 4: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/4.jpg)
![Page 5: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/5.jpg)
![Page 6: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/6.jpg)
Glycogenesis
ATP
![Page 7: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/7.jpg)
DYGESTION
FOOD INTAKE : 40-45 % IS CARBOHYDRATE :
Amilopectin ( 60 % ) Glucose Fructose (fruit) Lactose (milk) Sucrose and Sacarose
![Page 8: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/8.jpg)
![Page 9: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/9.jpg)
GLUCOSE METABOLISM
IN THE LIVER :>Oxidation ENERGY >Glycogenesis Glycogen ( storage )>fatty acid TG VLDL >pentose pathway( HMP ) Ribose, NADPH>Glukonic Acid detoxification
IN MUSCLE :>Oxidation ENERGY >Glycogenesis Glycogen
IN ADIPOSE TISSUE :>TRIACYL GLYSEROL ( TG ) STORAGE
![Page 10: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/10.jpg)
IN THE BRAIN :
>Oxidation ENERGY>-Ketoglutarate NH3 detoxification >Neurotransmitter
IN THE KIDNEY :
>Glycogenesis Glycogen
![Page 11: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/11.jpg)
IN RED BLOOD CELL :
>Oxidation ENERGY >Bisphosphoglycerate( BPG ) HbO2 Dissociations >HMP pathway( Pentosa ) NADPH (Scavenger in RBC): GS-SG ------- >2G-SH H2O2 ------- >H2O + O2
(toxic)
![Page 12: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/12.jpg)
GLUCOSE
ATPGLYCOGEN
LACTOSE
TG
TCA
HMPPATHWAY
RIBOSENADPH
URONIC PATHWAY GALACTOSE
CARBOHYDRATE METABOLISM IN GENERAL
ACETYL CoA
AA
FRUCTOSE
PYRUVATELACTATE
RNADNA
PROTEIN
RESP. CHAIN
NADH, FADH
ATP
![Page 13: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/13.jpg)
CARBOHYDRATE METABOLISM
1. GLYCOLISIS 2. PYRUVATE OXIDATION ACETYL-
Co A 3. CYTRIC ACID CYCLE ( TCA CYCLE ) 4. GLUCONEOGENESIS 5. GLYCOGENESIS &
GLYCOGENOLISIS 6. H M P SHUNT 7. URONIC ACID PATHWAY 8. FRUCTOSE METABOLISM 9. GALACTOSE METAB. &
LACTOGENESIS 10. CARBOHYDRATE METABOLISM
DISEASE
![Page 14: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/14.jpg)
1. GLYCOLISIS
![Page 15: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/15.jpg)
OCCURRED IN CYTOPLASM
ENZYMATIC REACTION FOR GLUCOSE OXIDATION
AEROB : GLUCOSE PYRUVATEAN AEROB : GLUCOSE PYRUVATE LACTIC ACID
PURPOSE : 1. PRODUCE ENERGY 2. SOURCE OF PYRUVATE ATP
![Page 16: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/16.jpg)
![Page 17: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/17.jpg)
Lactate
anaerob
![Page 18: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/18.jpg)
ATP PRODUCTION FROM GLYCOLYSIS:
AEROB:
SUBTRATE LEVEL = 2 X 2 = 4 ATPRESPIRATION LEVEL (NADH) = 2 X 3 = 6 ATP + 10 ATPFOR ACIVATION NEED = -2 ATPATP TOTAL = 8 ATP
AN AEROB:
NADH NADPYRUVATE ------------------>LACTATE
SUBTRATE LEVEL = 2 X 2 = 4 ATPRESPIRATION LEVEL = 0 X 3 = 0 ATP 4 ATPFOR ACTIVATION NEED = - 2 ATP ATP TOTAL = 2 ATP
![Page 19: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/19.jpg)
2. PYRUVATE OXIDATION
![Page 20: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/20.jpg)
PYRUVATE OXIDATION
- CONNECTION BETWEEN GLYCOLYSIS AND TCA CYCLE
- ENZYME = PYRUVATE DEHYDROGENASE COMPLEX (ENZYME IN THE MYTOCHONDRIA)
- PYRUVATE SHOULD BE TRANSPORTED IN TO MYTOCHONDRIA
ATP PRODUCTION = 2 X 3 = 6 ATP. 1 MOL GLUCOSE METABOLIZE TO 2 PYRUVATE,
2 PYRUVATE 2 ACETYL Co A 1 MOL ACETYL Co A = 3 ATP
- FIRST STEP OF THE REACTION : REACTION OF PYRUVATE WITH THIAMINE DIPHOSPHATE COENZYME
![Page 21: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/21.jpg)
Pyruvate
Acetyl-CoA
NADH
Thiaminediphosphate
Thiaminediphosphate
![Page 22: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/22.jpg)
3. CYTRIC ACID CYCLE
![Page 23: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/23.jpg)
CYTRIC ACID CYCLE
FUNCTION :
1. COMMON METABOLISM PATHWAY FOR
OXIDATION OF CARBOHYDRATE, FAT AND
PROTEIN.
2. AMPHIBOLIC PATHWAY (CROSSROAD BETWEEN
ANABOLIC AND CATABOLIC PATHWAY)
3. KETO GLUTARATE ( KG) SOURCE BRAIN : DETOXICIFICATION OF NH 3
LIVER : ASPARTIC ACID FOR UREA CYCLE
4. PRODUCE ATP
![Page 24: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/24.jpg)
![Page 25: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/25.jpg)
![Page 26: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/26.jpg)
MYTOCHONDRIA
ACETYL Co A
OXALOASETATE
CYTRATE
ISOCYTRATENAD+
NADH + H+
OXALOSUCCINATE
SUCINNYL C-oAGDP
GTPSUCCINATE
FAD+
FADH+H+FUMARATE
H2O
MALATE
NAD+
NADH + H+
Citrate synthase
KoA-SHH2O
Akonitase
Isocytrate dehydrogenase
CO2
-KG
Isocytrate dehydrogenase
NAD+
NADH + H+
KG dehydrogenase kompl
Succinate tiokinase
Succinate dehydrog.
Fumarase
Malate dehydrogenase
CAC
![Page 27: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/27.jpg)
![Page 28: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/28.jpg)
![Page 29: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/29.jpg)
ATP PRODUCTION DURING TCA CYCLE :
1. SUBSTRATE LEVEL ……………… = 1 ATP2. OXIDATION RESPIRATION :
3 MOL NADH + H+ = 3 X 3 ATP = 9 ATP 1 MOL FADH + H = 1 X 2 ATP = 2 ATP +
TOTAL = 12 ATP
![Page 30: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/30.jpg)
1 MOL GLUCOSE PRODUCE :
GLYCOLISIS : = 8 ATP PYRUVATE OXIDATION: = 6 ATP TCA CYCLE : = 24 ATP + TOTAL = 38 ATP
![Page 31: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/31.jpg)
4 . GLUCONEOGENESIS
![Page 32: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/32.jpg)
GLUCONEOGENESIS OCCURRED IN LIVER AND KIDNEY
SYNTHESIS OF CH (GLUCOSE) FROM OTHER CH
SOURCE : FATTY ACID, AMINO ACID, GLYCEROL
ENDOGEN GLUCOSE SOURCE FUNCTION: TO SUSTAIN GLUCOSE BLOOD
LEVEL DURING GLUCOSE INTAKE IS LOW : STARVATION, STRESS
IMPORTANT ROLE OF GLUCOSE : 1. BRAIN ELIMINATION OF TOXIC NH 3
2. RED BLOOD CELL ENERGY & DPG SOURCE FOR HBO2 DISSOCIATIONS
![Page 33: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/33.jpg)
Fattyacid
![Page 34: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/34.jpg)
![Page 35: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/35.jpg)
![Page 36: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/36.jpg)
TO BE CONTINUED
![Page 37: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/37.jpg)
5. GLYCOGENESIS & GLYCOGENOLISIS
![Page 38: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/38.jpg)
GLYCOGENESIS & GLYCOGENOLISIS
GLYCOGENESIS : GLUCOSE GLYCOGENGLYCOGENOLYSIS : GLYCOGEN GLUCOSE
GLYCOGEN : - CH SOURCE - FOUND IN THE LIVER - 5 – 6 % OF THE LIVER IS GLYCOGEN - FOOD INTAKE CH, GLYCOGEN LIVER : 10 – 15 % - GLYCOGEN STORAGE IN THE LIVER: RUN OUT AFTER 12 – 18 HOURS PASCA ABSORBTION - GLYCOGEN IS ALSO FOUND IN MUSCLE, KIDNEY AND OTHER TISSUE
![Page 39: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/39.jpg)
![Page 40: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/40.jpg)
GLUCOSE
GLYCOGEN
GLYCOGENSYNTHASE
GLYCOGENPHOSPHORIL
ASE
GLUCOSE1-PHOSPHATE
GLUCOKINASEGLUCOSE 6-PHOSPHATASE
GLUCOSE 6-PHOSPHATE
INSULIN
![Page 41: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/41.jpg)
![Page 42: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/42.jpg)
![Page 43: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/43.jpg)
6. HMP SHUNT
![Page 44: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/44.jpg)
HMP SHUNT FUNCTIONS:1. NADPH SOURCE ( FOR REDUCTION REACTIONS)
: + ANTIOXIDANT PROCESS
+ FATTY ACID SYNTHESIS + AMINO ACID SYNTHESIS+ STEROID SYNTHESIS+ PHOTOSYNTHESIS REACTION
2. RIBOSE SOURCE FOR NUCLEOTIDE (ATP, GTP ETC) AND NUCLEIC ACID (RNA, DNA) FOR PROTEIN SYNTHESIS
3. RIBULOSE SOURCE FOR CHLOROPLAST ORGANISM , FIXATION OF CO2.
![Page 45: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/45.jpg)
toxic
ANTIOXIDANT PROCESS
![Page 46: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/46.jpg)
![Page 47: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/47.jpg)
NADPH
NADPH
SYNTHESIS OFNUCLEOTIDES,DNA AND RNA
Glucose 6-Phosphate ½ Glucose 6-Phosphate Glucose 6-Phosphate
![Page 48: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/48.jpg)
7. URONIC ACID PATHWAY
![Page 49: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/49.jpg)
7. URONIC ACID PATHWAY
- URIDINE DIPHOSPHATE GLUCORONATE, SOURCE FOR :
GLUCORONIDES
PROTEOGLICANS (collagen, connective tissue)
- ASCORBATE/ VIT. C SYNTHESIS (IN OTHER THAN PRIMATES AND GUINEA PIGS)
![Page 50: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/50.jpg)
URONIC ACID PATHWAY
(Block in primateAnd guinea pigs)
![Page 51: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/51.jpg)
8. FRUCTOSE METABOLISM
![Page 52: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/52.jpg)
FRUCTOSE METABOLISMSOURCE OF FRUCTOSE :
- FOOD (EXOGEN SOURCE)- HEKSOSE / MONOSACHARIDE IN THE LIVER CHANGE TO FRUCTOSE (ENDOGEN)
THIS PATHWAY IS IMPORTANT FOR DIABETIC PATIENT TO OBTAIN ENERGY, SINCE GLYCOLYSIS PATHWAY IS ATTENUATED IN THIS PATIENT.
BUT IF GLUCOSE CONCENTRATION IS HIGH SORBITOL INCREASE (POLLI-OL/ALKOHOL =TOXIC)
MEMBRANE CELL DAMAGE,
REACT WITH RETINAL COLLAGEN RETINO ANGIOPATHY
LENS KATARAK LENTIS
DEF. FRUKTOKINASE ESSENSIAL FRUCTOSURIADEF. ENZ.ALDOLASE B FRUCTOSE INTOLERANCE
![Page 53: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/53.jpg)
FRUCTOSE METABOLISM
DIET
FATTY ACIDESTERIFICATION
FATTY ACID SYNTHESIS
D-fructose
SORBITOL
![Page 54: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/54.jpg)
![Page 55: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/55.jpg)
9. GALACTOSE METABOLISM & LACTOGENESIS
![Page 56: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/56.jpg)
GALACTOSE METABOLISM & LACTOGENESIS
IN HEPAR: GALACTOSE GLUCOSE PHYSIOLOGIC FUNCTION : - LACTOSE ( BREAST FEEDING ) LACTOGENESIS - GLYCOLIPID - PROTEOGLYCAN - GLYCOPROTEIN. ENZYME IN GALACTOSE METABOLISM : - GALACTOKINASE - GALACTOSE –1 PURIDIN TRANSFERASE - URIDIN DIPHOSPHOGALACTOSE 4 EPIMERASE
![Page 57: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/57.jpg)
GALACTOSE METABOLISM
Glicolipid, proteoglycan, glycoprotein
![Page 58: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/58.jpg)
LACTOGENESIS
![Page 59: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/59.jpg)
10. CARBOHYDRATE METABOLISM DISEASE
![Page 60: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/60.jpg)
CH METABOLISM DYSFUNCTION
•LACTOSA INTOLERANCE•DIABETES MELLITUS ( DM )
•GLICOGENOSIS
•PENTOSURIA
•FRUCTOSURIA ESSENTIAL
•HEREDITER FRUCTOSA INTOLERANS
•GALACTOSEMIA
![Page 61: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/61.jpg)
LACTOSE INTOLERANCELACTOSE INTOLERANCE
OFTEN IN BABYOFTEN IN BABY
CAUSE : LACTASE INSUFISIENSYCAUSE : LACTASE INSUFISIENSY
LACTOSE IS NOT DYGESTLACTOSE IS NOT DYGEST
LACTOSE IN INTESTINELACTOSE IN INTESTINE
OSM. INTESTIN. LUMEN
WATER IN INTESTINE LUMEN
DIARHEA
FERMENTATION LACTOSEBY INTESTIN. BACTERIAL
GAS 2 : CO2, CH4 IRITANT
FLATULENCE VOMITE
![Page 62: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/62.jpg)
![Page 63: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/63.jpg)
DIABETES MELLITUS COMPLICATION
![Page 64: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/64.jpg)
DIABETES MELLITUS ( DM )
TYPE I = INSULIN DEPENDENT DM (IDDM) INSULIN SHOULD BE GIVEN, SINCE PANCREAS DOES NOT PRODUCE INSULIN
OCCURRED SINCE BABY JUVENILE D.M
TIPE II = NON INS. DEPENDENT DM (NIDDM) 90% OF DM PATIENT
![Page 65: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/65.jpg)
DIABETES MELLITUSDIABETES MELLITUS
ROLE OF INSULIN :ROLE OF INSULIN :1.1. Induce glycolysis key Induce glycolysis key
enzymeenzyme2.2. Inhibit Inhibit
gluconeogenesis key gluconeogenesis key enzymeenzyme
3.3. induce HMP shunt induce HMP shunt enzymeenzyme
4.4. increase Glut4 increase Glut4 5.5. Activate Activate
phosphodiesterase, phosphodiesterase, Glycogen sinthetaseGlycogen sinthetase
6.6. inhibit phosphorilaseinhibit phosphorilase
CONSEQUENCE IN CONSEQUENCE IN DM:DM:
1.1. GLYCOLYSIS GLYCOLYSIS 2.2. GLUCONEOGENESISGLUCONEOGENESIS3.3. HMP SHUNTHMP SHUNT4.4. Glukosa DIFFICULT to Glukosa DIFFICULT to
enter cell enter cell 5.5. Glycogenesis Glycogenesis 6.6. Glycogenolysis Glycogenolysis
HYPERGLYCEMIHYPERGLYCEMIAA
![Page 66: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/66.jpg)
D.M PATIENT BECAUSE OF INSULIN DEF:
1. DYSFUNCTION OF CH METAB. 2. DYSFUNCTION OF LIPID METAB.
3. DYSFUNCTION OF PROTEIN METAB.
![Page 67: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/67.jpg)
1. DYSFUNTION OF CH METABOLISM IN DM GLYCOGEN SYNTHETASE IS NOT ACTIVE >>,
PHOSPHORYLASE ENZYME TURN ACTIVE
DECREASE GLYCOGENESIS ; INCREASE GLYCOGENOLYSISDECREASE GLYCOLYSIS; INCREASE GLUCONEOGENESIS ADIPOSE TISSUE: INH IBITION OF GLUCOSE MOBILIZATION IN TO SEL GLYCOLYSIS DECREASE; HMP SHUNT DECREASE
DECREASE LIPOGENESIS ( TG FORMATION )
BLOOD SUGAR >N HYPERGLYCEMIA
GLUCOSURIA
HYPERGLYCEMIA
![Page 68: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/68.jpg)
ATP cAMP 5-AMP
PHOSPHATASE PROTEIN KINASE ( INACTIVE )
PROTEIN KINASE ( ACTIVE )
GLYCOGEN SINTHETASE ( INACTIVE )
GLYCOGEN SINTHETASE ( ACTIVE )
GLYCOGEN
GLUCOSE-1P
GLUCOSE-6PGLUCOSE
PHOSPHORILASE A
PHOSPHORILASE B
PHOSPHATASE
PHOSPHORILASE KINASE ( ACTIVE )
ADENYLATE SICLASE PHOSPHO DIESTERASE
INSULIN ( + )
( + )
![Page 69: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/69.jpg)
1. DYSFUNTION OF CH METABOLISM IN DM GLYCOGEN SYNTHETASE IS NOT ACTIVE >>,
PHOSPHORYLASE ENZYME TURN ACTIVE
DECREASE GLYCOGENESIS ; INCREASE GLYCOGENOLYSISDECREASE GLYCOLYSIS; INCREASE GLUCONEOGENESIS ADIPOSE TISSUE: INH IBITION OF GLUCOSE MOBILIZATION IN TO SEL GLYCOLYSIS DECREASE; HMP SHUNT DECREASE
DECREASE LIPOGENESIS ( TG FORMATION )
BLOOD SUGAR >N HYPERGLYCEMIA
GLUCOSURIA
HYPERGLYCEMIA
![Page 70: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/70.jpg)
GLUCOSE IN URINE INCREASE URINE OSMOLALITY POLIURIINCREASE URINE VOLUME
OSMOTIC DIURESIS DEHYDRATION DEHYDRATIN CONDITION: POLIDIPSI DM PATIENT ALWAYS THIRSTY
GLUCOSE IN URINE WASTE OF ENERGY STIMULATION OF CENTRAL APETITE
DM PATIENT NEED MORE FOOD
POLIFAGIA
CHRONIC HYPERGLYCEMIA GLYCOSILATION
COLAGEN GLYCOSILATION BLOOD VESSEL ENDOTEL ATHEROSCLEROSIS
![Page 71: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/71.jpg)
2. LIPID METABOLISM DYSFUNCTION
INSULIN DEFFICIENCY DECREASE LIPOGENESIS, INCREASE LIPOLISIS
DECREASE BODY WEIGHT
INCREASE FFA MOBILIZATION STIMULATE FFA OXIDATION IN LIVER INCREASE ACETYL CoA
KETOGENESIS KETON BODIES (ACETONE, ACETO ACETATE, HYDROXI BUTIRATE)
+
INCREASE KOLESTEROL SYNTHESIS HYPERCHOLESTEROLEMIA
GLYCOSILATION OF ATHEROSCLEROSISBLOOD VESSEL ENDOTEL
KETONEMIA
DECREASE BODY WEIGHT
KETOACIDOSIS
COMA DIABET
![Page 72: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/72.jpg)
3. PROTEIN METABOLISM DYSFUNCTION
INSULIN DEFICIENCY TRANSMEMBRANAA TRANSPORTER DECREASE
AA MOBILIZATION IN TO CELL
PROTEIN SYNTHESIS
DECREASE TRANSCRIPTIONDECREASE TRANSLATION INHIBITION OF TISSUEDECREASE REPLICATION REGENERATIONDECREASE CELL PROLIF.
WOUND HEALING impairment
![Page 73: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/73.jpg)
GLUCOSE
MUSCLE
ADIPOSE
VESSEL
BRAIN
PANCREAS
INSULIN
GLYCOGEN
GG
G
GLYCOGEN
TG
KIDNEY
GG
RED BLOOD CELL
GLUCOSE METABOLISM IN NORMAL CONDITION
LIVER
G IFGlucose
G
INTESTINE
![Page 74: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/74.jpg)
GLUCOSE METABOLISM IN DIABETIC PATIENT
G
G
GLYCOGEN
G
G
GLIYCOGEN
PYRUVATE
PROTEIN
AA
KETON BODIES
ACETYL Co A
CHOLESTEROL
G GLISERAL DEHID 3P FFA
GLUCOSURIA
TG GLYS
FFA
KB
VLDL VLDL
MUSCLE
LIVER
INTESTINE
ADIPOSE
G> 180 mg/dl VESSEL
KIDNEY
![Page 75: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/75.jpg)
STARVATIONSTARVATION
NO / DECREASE GLUCOSE INTAKENO / DECREASE GLUCOSE INTAKEALL GLUCOSE METABOLIZE BY THE TISSUEALL GLUCOSE METABOLIZE BY THE TISSUE
BLOOD GLUCOSE CONCENTRATION DECREASE BLOOD GLUCOSE CONCENTRATION DECREASE
PANCREAS : INHIBITION OF INSULIN SECRETIONPANCREAS : INHIBITION OF INSULIN SECRETIONINCREASE OF GLUKAGON SECRETIONINCREASE OF GLUKAGON SECRETION
GLYCOGENOLYSIS GLUCOSE INCREASEGLYCOGENOLYSIS GLUCOSE INCREASELOW INSULIN GLUCOSE INTO CELL LOW INSULIN GLUCOSE INTO CELL
GLUCONEOGENESIS GLUCONEOGENESIS MUSCLE ENERGY SOURCE DERIVED FROM ADIPOSE FFA MUSCLE ENERGY SOURCE DERIVED FROM ADIPOSE FFA MOBILIZATION (INCREASE LIPOLYSIS) MOBILIZATION (INCREASE LIPOLYSIS)
![Page 76: Ch Metabolism](https://reader036.vdocuments.us/reader036/viewer/2022062809/5695d0331a28ab9b02916f4f/html5/thumbnails/76.jpg)
THANK YOU