Check for Understanding:

1. During the absorptive state, glucose levels are ________, insulin levels are ________, and glucagon
levels ________.

A. high; low; stay the same

B. low; low; stay the same
C. high; high; are high
D. high; high; are low

2. Starvation sets in after 3 to 4 days without food. Which hormones change in response to low
glucose levels?

A. glucagon and insulin

B. ketones and glucagon
C. insulin, glucose, and glucagon
D. insulin and ketones

3. The postabsorptive state relies on stores of ________ in the ________.

A. insulin; pancreas
B. glucagon; pancreas
C. glycogen; liver
D. glucose; liver

4. In type II diabetes, insulin is produced but is nonfunctional. These patients are described as
“starving in a sea of plenty,” because their blood glucose levels are high, but none of the glucose is
transported into the cells. Describe how this leads to malnutrition.

Insulin stimulates glucose absorption into the cells. Because insulin does not operate reliably in diabetes,
blood glucose cannot be transferred across the cell membrane to be processed. Because these patients
are incapable to metabolize glucose in their blood, they must rely on alternative sources of energy. If the
disease isn't well-managed, the inability to metabolize glucose can result in starving, even if the patient
is ingesting.

5. Ketone bodies are used as an alternative source of fuel during starvation. Describe how ketones are
synthesized.

Acetyl CoA is produced when triglycerides and fatty acids are broken down. Excess acetyl CoA produced
during this process is employed in ketogenesis, or the production of ketones. Thiolase converts acetyl
CoA to acetoacetyl CoA, leading to that production. Following that, the acetoacetyl CoA is converted to
B-hydroxybutyrate, the most prevalent ketone in the body.
Check for Understanding: Metabolism

1. Amino acids are not stored in the body. Describe how excess amino acids are processed in the cell.

The body does not store amino acids. Individual amino acids are broken down into pyruvate, acetyl CoA,
or the Krebs cycle intermediates, which are then utilized for energy or lipogenesis reactions to be stored
as fats.

2. Release of trypsin and chymotrypsin in their active form can result in the digestion of the pancreas
or small intestine itself. What mechanism does the body employ to prevent its self-destruction?

Inactive proenzymes such as trypsin and chymotrypsin are released. They are only stimulated inside the
small intestine, where they react to food proteins. This prevents the pancreas or small intestine from
breaking down unintentionally.

3. Discuss how carbohydrates can be stored as fat.

During glycolysis, carbohydrates are converted to pyruvate. The Krebs cycle begins with the conversion
of pyruvate to acetyl CoA. When there is too much acetyl CoA to go via the Krebs cycle, it is converted to
triglycerides and fatty acids, which are then deposited in the liver and adipose tissue.

4. If a diabetic’s breath smells like alcohol, what could this mean?

The glucose in the blood is not taken up and digested by the cells if diabetes is uncontrolled. Despite the
fact that blood glucose contents are high, the cells do not have any glucose to convert into energy.
Because glucose is in short supply, the body must rely on alternative energy sources, such as ketones. A
sweet alcohol odor on the breath is a side effect of utilizing ketones as fuel.

5. Describe how metabolism can be altered

An increase or decrease in lean muscle mass will result in an increase or decrease in metabolism.