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Muhammad Nashrudin Jamaludin

on 8 August 2014

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clinical biochemistry problem based learning
Diabetes: A metabolic disorder in which there is an inability to oxidize carbohydrate due to disturbances in insulin function
Biochemistry: The study of biochemical mechanisms in the body in relation to a disease.
What is diabetes?
signs and symptoms
Commonly occurs in untreated diabetic patients
Glycolysis severely limited -> cell begins to oxidize fat reserves for energy.

Fat metabolism + inadequate glycolysis = inadequate amounts of oxaloacetate to react with acetyl CoA
Cannot enter Krebs cycle
Excess of acetyl CoA leads to a build up of ketone bodies = ketosis

2 types of diabetes
Type 2 diabetes (non-insulin dependent type)
Body does not produce enough insulin
The body cannot use the insulin properly
Insulin resistance

Insulin levels are high over a long period of time
Body less sensitive to insulin (insulin resistance)
Uptake of glucose into cells decreases
Blood glucose levels rise, making the pancreas work harder to exert its physiological effect
Over time, the pancreas wears out from working overtime
No longer be able to produce enough insulin to keep blood glucose levels normal.
Leads to hyperglycemia and diabetes
Insulin increases rate of glycolysis, glycogenesis, lipid and protein synthesis.
Decreases rate of glycogenolysis and gluconeogenesis in the liver.
For people with diabetes, the opposite effects are produced.
Disrupts important biochemical processes of carbohydrate, lipid, and protein metabolism

Signs & Symptoms of Type 2 Diabetes

Increased hunger
Increased thirst
frequent urination
weight change (gain or loss)
extreme fatigue or lack of energy
blurred vision
frequent reoccuring infections
cuts and bruises that heal slowly
tingling or numbness in the hands and feet

diagnosis and treatment
Glycated hemoglobin (A1C) test
Fasting blood sugar test
Oral glucose tolerance test.

Metformin (Glucophage, Glumetza, others)
Insulin therapy
Bariatric surgery→ reducing of stomach size by about 15% (obese patients commonly undergo this surgery)

Ketone bodies are acids, hence the condition is also known as ketoacidosis.
Severe ketoacidosis, if not counteracted, can result in coma and death.

A diabetic coma is accompanied by labored breathing, a dry parched mouth and tongue, acetone breath, and often vomiting.
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