Introduction to Biochemistry.

Carbohydrates & its function.

Diabetes mellitus – Types & its

function Presented by
Vizay Pratap Singh
(2023)
 INTRODUCTION TO
BIOCHEMISTRY.
HISTORY
• The universe formed 14 billion years ago through a cataclysmic explosion of energy-rich subatomic
particles, forming atoms, molecules, rocks, planetoids, and Earth. Life arose on Earth 4 billion years
ago, using energy from chemical compounds and sunlight.
• Living matter consists of six essential elements: carbon, hydrogen, oxygen, nitrogen, phosphorus,
sulfur, and others. Other essential elements include calcium, potassium, sodium, chlorine,
magnesium, iron, copper, cobalt, and fluorine.
DEFINITION
• It is studies of chemical processes in living organisms, including molecule structure, metabolism
regulation, disease molecular basis, & drug development, as a sub-discipline of chemistry & biology.
 1.The cell, the
fundamental

CELLS
unit of life and
biological
activity, was
first
3.The
introduced by 7.Understanding
biochemistry the biochemistry
Schleiden and
of cells is the of cells is crucial
Schwann in
study of all the for understanding
1838. life's fundamental
chemical processes and
processes that developing new
allow cells to drugs and
function and 2.However, the therapies for
diseases.
survive. complexities of
cell structure
4.These were first
6. The
processes include revealed in 1940. biochemistry of
metabolism, cells is influenced
protein synthesis,
by the cell's
DNA replication,
environment,
RNA
such as nutrients,
transcription, and
5.Enzymes oxygen, and
signal
catalyze these stressors.
transduction.
processes, and
their activity is
tightly
regulated.
 CARBOHYDRATES & ITS
FUNCTION
DEFINITION
• Carbohydrates are aldehydes or ketones with at least two hydroxyl groups,
produced through hydrolysis. They can contain nitrogen, phosphorus, or
sulfur.
INTRODUCTION • There are three major size classes: monosaccharides, oligosaccharides,
• Carbohydrates, abundant and polysaccharides, with the term "saccharide" derived from the Greek
biomolecules, are word "sakcharon.“
converted into plant
products through
• * “Acetic acid and formaldehyde, both organic compounds with similar carbon,
photosynthesis, serving as hydrogen, and oxygen atom ratios, are not carbohydrates due to their different
dietary staples and structure and function.”
energy-yielding pathways. • * “Rhamnose and Deoxyribose are carbohydrates with a non-general formula, while
Glycans, glycan polymers,
uronic acids and deoxy-sugars like fructose are examples.”
and glycoconjugates play
crucial roles in cell wall
structures.
 CLASSIFICATION OF
FUNCTION of Carbohydrates CARBOHYDRATES

• Carbohydrates, also known as sugars, are categorized into three

major groups:
• Carbohydrates are the most abundant
dietary source of energy (4kcal/g) for • MONOSACCHARIDES
all organisms, precursors for many
organic compounds, and structural • OLIGOSACCHARIDES
components of many organisms.
• They participate in cell membrane
• POLYSACCHARIDES
structure and cellular functions like
growth, adhesion, and fertilization.
• It also serve as the storage form of Mono- and oligosaccharides are sweet, crystalline, and soluble in water,
energy (glycogen) to meet the body's making them commonly known as sugars.
immediate energy demands.
• They are found in plants, insects, and
microorganisms.
1. MONOSACCHARIDES
INTRODUCTION
 It is the simplest form of carbohydrates.
 They are either aldehydes or ketones
with two or more hydroxyl groups.
 Glucose and fructose, six-carbon
monosaccharides, have five hydroxyl
groups, with many carbon atoms
attached to chiral centers, resulting in
many natural sugar stereoisomers.
Definition
• Monosaccharides are the fundamental form of
carbohydrates, which can be combined with
similar molecules to form larger polymers like
cellulose.
# STEREOISOMERISM
• Stereoisomerism is a type of isomerism
where molecules have the same molecular
formula and sequence of bonded atoms
but differ in their 3-D orientations in
space.
• This differs from structural isomers,
which share the same molecular formula
but differ in bond connections or order.
• There are two types of stereoisomers:
enantiomers, or optical isomers, which are
related by reflection and are non-
superposable, and diastereomers, which
are not related through reflection.
• It is the existence of molecules with the
same numbers of atoms and formula but
differ in chemical and physical properties
due to different spatial arrangements of
their atoms.
TYPES OF STEREOISOMERISM

1. Enantiomers (mirror images) - D-glyceraldehyde and L-glyceraldehye are'mirror' images of each

other, with the number of possible isomers determined by the number of asymmetric carbon
atoms in the molecule. E.g., for Glucose, I = 24 = 16 (8 D & 8 L form).
2. Diastereomers - Pairs of isomers with opposite configurations at two or more chiral centers
but are not mirror images, such as mannose and glucose .
3. Epimers - Epimers are sugars with asymmetric atoms at one chiral center, such as glucose and
mannose, and glucose and galactose, respectively, when compared to C.
4. Anomers - Two stereo isomers (α & β from) of a sugar differ only in configuration around
the carbonyl carbon atom, with the a-isomer having the H-atom above the ring plane in the
Haworth projection.

Anomers
Classification of Monosaccharides
Monosaccharides (Empirical formula) Aldose Ketose
Function of it.
Trioses (C3H6O3) Glyceraldehyde Dihydroxyacetone
• Monosaccharides are
Tetroses (C4H8O4) Erythrose Erythulose essential energy
sources, building
Pentoses (C5H10O5) Ribose Ribulose
blocks of complex
Hexoses (C6H12O6) Glucose Fructose carbohydrates, and
components of
Heptoses (C7H14O7) Glucoheptose Sedoheptulose glycoproteins and
glycolipids.
Properties of Monosaccharides • They are broken
1. Physical Properties - They are colorless, crystalline solids at room temperature, down in cells to
soluble in water, and have multiple OH groups for hydrogen bonding. Some have a
produce energy, and
sweet taste, unlike sugars, which are generally soluble in water.
can be linked to
2. Chemical Properties - They are reducing sugars that can be oxidized using mild proteins and lipids for
oxidizing agents like Tollens' or Benedict's reagents. One of their most important
reactions is the oxidation of the aldehyde group, which can be achieved using any mild important functions
oxidizing agent. in cell structure and
3. Biochemical Importance - Monosaccharides are essential for energy production and signaling.
storage in organisms, with most breaking down glucose to harvest energy. Other
monosaccharides form long fibers, serving as cellular structures.
2. OLIGOSACCHARIDES
Introduction & Definition
 Oligosaccharides(Greek:oligo-few),
composed of 2-10 monosaccharide
molecules, are hydrolyzed and are
further categorized into disaccharides
and trisaccharides based on the
number of monosaccharide units.
 Oligosaccharides, a saccharide polymer
with a small number of
monosaccharides, can perform various
functions such as cell recognition and
adhesion.
Type of Oligosaccharides
1. Disaccharides – Sucrose, Lactose, Maltose,
Cellobiose, Trehalose, Gentiobiose, Melibiose.
2. Trisaccharides – Rhamninose, Gentianose,
Raffinose (= Melitose), Rabinose, Melezitose.
3. Tetrasaccharides – Stachyose, Scorodose.
4. Pentasaccharides – Verbascose.
The molecular composition of the 3 legume
oligosaccharides (viz., raffinose, stachyose &
verbascose) is shown below:
α-Galactose (1-6) α-Glucose (1-2) β-Fructose
Raffinose
α-Galactose (1-6) α-Galactose (1-6) α-Glucose
(1-2) β-Fructose Stachyose
α-Galactose (1-6) α-Galactose (1-6) α-
Galactose (1-6) α-Glucose (1-2) β-Fructose
Verbascose
Properties
1. Physical Properties - They are naturally
present in various plant foods and are soluble
in water.
2. Chemical Properties - Oligosaccharides, typically
present as glycans, have various functions such as
cell recognition and adhesion, and are linked to
lipids or amino acid side chains in proteins through
N- or O-glycosidic bonds.
3. Biochemical Importance - Oligosaccharides, which
act as prebiotics for gut bacteria, offer numerous
health benefits such as a stronger immune system,
reduced appetite, and improved gut health. Common
types include fructooligosaccharides (FOS),
galactooligosaccharides (GOS), human milk
oligosaccharides (HMO), gluco-oligosaccharides, lactulose-
derived galactooligosaccharides (LDGOS),
xylooligosaccharides (XOS), arabinooligosaccharides
(AOS), and cyclodextrins (CD).
Function
• Prebiotics - Oligosaccharides,fermented by gut
bacteria, provide health benefits like improved
gut health, reduced inflammation, and enhanced
immune system by producing short-chain fatty
acids.
• Cell recognition & adhesion - Oligosaccharides,
found on cell surfaces, are crucial for cell
recognition and adhesion, influencing processes
like cell signaling, wound healing, and immune
function.
• Nutrient absorption - Oligosaccharides can
enhance the absorption of essential nutrients
like calcium and iron.
• Protein folding - Oligosaccharides are crucial for
proteins to fold into their correct shape, which
is essential for their proper function.
Examples of oligosaccharides' functions in the body include their role in
digestion, energy production, and the production of proteins are given below :-

• Fructooligosaccharides (FOSs) found in fruits and vegetables like onions,

garlic, and asparagus have been linked to improved gut health, reduced
inflammation, and enhanced immune system function.
• Galactooligosaccharides (GOSs) are found in dairy products like milk and
yogurt and offer similar health benefits to fructose monosaccharides (FOSs).
• Human milk oligosaccharides (HMOs) are crucial in breast milk, protecting
infants from infections, promoting brain development, and aiding in immune
system development.
POLYSACCHARIDES Can be classified into two main types

Homopolysaccharides - Monosaccharides, such as starch, glycogen,

and cellulose, are composed of a single type of monosaccharide unit.

Heteropolysaccharides - These are composed of multiple

monosaccharide units, such as hyaluronic acid, heparin, and
Introduction chondroitin sulfate.
Polysaccharides (Greek: poly-many) are high
molecular weight monosaccharide polymers, usually It can also be classified according to their structure
tasteless and non-sugars, found in two types:
homopolysaccharides and heteropolysaccharides,
which form colloids with water.
Linear polysaccharides - Linear structures, such as starch and
cellulose, consist of monosaccharide units linked in a straight chain.
Definition
A polysaccharide, also known as a glycan, is a Branched polysaccharides - These are branched structures with
large molecule composed of multiple monosaccharide units linked in multiple directions, such as glycogen
monosaccharides, simple sugars, which are and chitin.
bonded together by special enzymes that
name is “glycosyltransferases” .

They are found in various foods, including plants,
animals, & microorganisms, & are commonly found
in various sources are given below :-
• Plants - Starch and cellulose are the most abundant
polysaccharides in plants, found in grains, potatoes,
and vegetables, and in plant cell walls.
• Animals - Glycogen, a primary polysaccharide found
in animal liver and muscle tissue, is the primary type
of sugar found in animals.
• Microorganism - Glycogen, a primary polysaccharide
found in animal liver and muscle tissue, is the
primary type of sugar found in animals.
Polysaccharides, found in fruits and vegetables, are
crucial for a healthy diet as they provide energy,
promote gut health, and have antioxidant and anti-
inflammatory properties.
Few examples of particular Polysaccharides &
their roles
• Starch, a glucose-containing carbohydrate found in
grains, potatoes, and vegetables, is the primary energy
storage carbohydrate in plants.
• Glycogen, a glucose-unit-based homopolysaccharide, is
the primary energy storage carbohydrate in animals,
found in liver & muscle tissue.
• Cellulose, a glucose-based homopolysaccharide, is the
primary structural component of plant cell walls,
ensuring plant strength & rigidity.
• Chitin, a homopolysaccharide composed of N-
acetylglucosamine units, is the primary structural
element in the exoskeletons of insects & other
crustaceans.
• Hyaluronic acid, a heteropolysaccharide composed of N-
acetylglucosamine & glucuronic acid units, is present in
the extracellular matrix of all tissues & plays a crucial
role in cell signaling & hydration.
• Heparin, a heteropolysaccharide composed of N-
acetylglucosamine, glucuronic acid, & sulfate units, is
present in blood & mast cells and plays a crucial role in
blood coagulation & inflammation.
• Chondroitin sulfate, a heteropolysaccharide composed of
N-acetylglucosamine & galactose units, is found in
cartilage & connective tissue & aids in joint lubrication
& protection.
Metabolism of Carbohydrates

Carbohydrate metabolism is the process of breaking

down carbohydrates into smaller molecules like
glucose, which can be used for energy or stored for
later use, as carbohydrates are the body's primary
energy source.
2. Anabolism of carbohydrates
Carbohydrate metabolism involves two main stages:
catabolism, which breaks down carbohydrates into • The anabolism of carbohydrates begins in the
smaller molecules, and anabolism, which synthesizes liver, where glucose is converted into glycogen, a
carbohydrates from smaller molecules. storage form that can be released when the
body needs energy.
• It can also occur in muscles & the brain, where
1. Catabolism of carbohydrates
glucose is converted into other carbohydrates
like pyruvate & acetyl-CoA, which can be used
• Carbohydrates are broken down in the mouth through
for energy or stored for later use.
salivary amylase, followed by digestion in the stomach
and stomach, where gastric acid kills bacteria.
• This complex process is essential for life, as
• They are then broken down into smaller molecules in the carbohydrates are used for energy, tissue
small intestine and absorbed into the bloodstream. building, & energy storage.
• The liver converts these carbohydrates into glucose, the
body's main energy source.
• When needed, glucose is broken down into smaller
molecules like pyruvate and acetyl-CoA through glycolysis,
which can occur with or without oxygen.
• If oxygen is present, pyruvate is converted into acetyl-
CoA, which enters the Krebs cycle, producing carbon
dioxide, water, and energy.
 The list contains important enzymes
involved in carbohydrate metabolism.
• Alpha-ketoglutarate
• Salivary amylase: This enzyme degrades starch
into smaller carbohydrates. dehydrogenase: This enzyme
• Amylase: degrades polysaccharides into smaller converts alpha-ketoglutarate
sugars like maltose. to succinyl-CoA.
• Lactase: Degrades lactose (milk sugar) into
glucose and galactose. • Succinyl-CoA synthetase:
• Sucrase: Degrades sucrose (table sugar) into Converts succinyl-CoA to
glucose and fructose. succinate.
• Maltase: Degrades maltose into two molecules
of glucose.
• Fumarase: Converts fumarate
• Glycogen synthase: This enzyme converts to malate.
glucose into glycogen. • Malate dehydrogenase: This
• Glycogen phosphorylase: This enzyme converts enzyme converts malate to
glycogen into glucose.
• Hexokinase: Converts glucose to glucose-6- oxaloacetate
phosphate.
• Phosphofructokinase: Converts fructose-6-
phosphate to fructose-1,6-bisphosphate.
• Pyruvate kinase: Converts pyruvate to
phosphoenolpyruvate.
• Citrate synthase: Combines acetyl-CoA with
oxaloacetate to produce citrate.
• Isocitrate dehydrogenase: This enzyme
converts isocitrate to alpha-ketoglutarate.
 DIABETES MELLITUS
Introduction
• Diabetes mellitus is the third
leading cause of death in
developed countries, affecting
6-8% of the population.
Complications include blindness,
renal failure, amputation, heart
attacks, and stroke. Diabetes
insipidus is another disorder
characterized by large urine
excretion.
Definition
Dubbed as a disease of fuel
• Diabetes mellitus is a metabolic
scarcity in plenty;
disease characterized by high blood
Starving the cells bathed in sugar levels over time, causing
symptoms like frequent urination,
ample glucose quantity; increased thirst, and hunger.
Attributed to insufficient or
Untreated, it can lead to severe
inefficient insulin; complications, including acute
Affecting several tissues by ketoacidosis and nonketotic
hyperosmolar coma, heart disease,
metabolic complications
stroke, kidney failure, blindness, and
nerve damage.
Factor Affecting Diabetes Mellitus
• Type 2 diabetes is a genetic
condition influenced by factors such
as weight, physical activity, diet,
race, ethnicity, age, gestational
diabetes, polycystic ovary syndrome
(PCOS), medical conditions, and
medications.
• Overweight and obesity are major risk
factors, while inactivity and a diet
high in processed foods, sugary
drinks, and unhealthy fats increase
the risk.
• Certain racial and ethnic groups, such
as African Americans, Hispanic
Americans, and Native Americans, are
at higher risk.
• The risk increases with age, and
women with gestational diabetes are
at higher risk for future
development.
• Environmental factors like exposure
to chemicals, air pollution, and low
socioeconomic status also contribute
to the risk.
TYPE OF DIABETES
MELLITUS
There are three primary types of diabetes are given
below :-
• Type 1 diabetes is an autoimmune disease
where the body's immune system destroys beta
cells in the pancreas, responsible for producing
insulin, which helps cells use glucose for energy,
leading to hyperglycemia when glucose builds up
in the blood.
• Type 2 diabetes, affecting 90% of diabetics, is
a condition where the body becomes resistant
to insulin, causing cells to fail to respond
properly, leading to hyperglycemia despite the
pancreas producing enough insulin.
• Gestational diabetes, a type of diabetes that
develops during pregnancy and typically subsides
after childbirth, increases the risk of type 2
diabetes in later life for women.
In addition to the three major kinds of diabetes,
there are other less prevalent types
• Monogenic diabetes is a condition resulting
from a single gene mutation.
• Secondary diabetes is a condition resulting from
another medical condition, such as a pancreatic
disorder or Cushing's syndrome.
• Neonatal diabetes is a rare condition that
typically develops in infants under six months
old.
Diabetes is graded according to its severity
• Prediabetes, a condition where blood sugar levels are
higher than normal but not enough to be diagnosed as
diabetes, increases the risk of developing type 2
diabetes.
• Diabetes mellitus is a condition diagnosed when blood
sugar levels consistently exceed a certain level.
• Diabetes complications refer to long-term health issues
like heart disease, stroke, kidney failure, blindness, and
nerve damage that can result from diabetes.
SYMPTOMS OF DIABETES
MELLITUS

Diabetes mellitus symptoms vary based on the type and management, but common
ones include:
•Increased thirst
•Frequent urination
•Extreme hunger
•Unexplained weight loss
•Fatigue
•Blurred vision
•Slow-healing sores
•Numbness or tingling in the hands or feet
•Darkened skin patches on the neck or underarms

Insulin
Insulin, a polypeptide hormone produced by
pancreatic islets, significantly influences
carbohydrate, fat, and protein metabolism. It's
anabolic and promotes glycogen, triacylglycerols, and
proteins. Insulin is a significant hormone in
biochemistry and medicine, being the first to be
isolated, purified, and synthesized.
Structure of Insulin
Human insulin, weighing 5,734, consists of 51 amino
acids arranged in two polypeptide chains, with chain
A having 21 amino acids and chain B having 30.
Both chains are connected by interchain disulfide
bridges and an intrachain disulfide link in chain A.
Biosynthesis of Insulin
• Insulin is a hormone produced by the beta cells
of the islets of Langerhans of the pancreas,
with the gene for this protein synthesis
located on chromosome 11.
• It consists of two precursors, preproinsulin and
proinsulin, which are sequentially degraded to
form insulin and a connecting peptide (C-
peptide).
• Although C-peptide has no biological activity,
its estimation in the plasma serves as a useful
index for insulin endogenous production.
• Insulin and proinsulin combine with zinc in
beta cells, storing it in cytosol granules and
released through exocytosis.
Regulation of Insulin Secretion
The human pancreas secretes 40-50 units of
insulin daily, with a normal plasma concentration
of 20-30 U/ml, & factors influencing insulin
release from beta cells are discussed.
Factors Stimulating Insulin Secretion
Factors Inhibiting Insulin
Secretion
i. Glucose, administered orally, is the
primary stimulus for insulin release, with a
rise in blood glucose levels signaling insulin Epinephrine, a potent
secretion, especially when combined with a inhibitor of insulin
carbohydrate-rich meal. release, is released by
ii. Amino acids, particularly arginine and the adrenal medulla in
leucine, stimulate insulin secretion, emergency situations like
especially after consuming a protein-rich stress, extreme exercise,
meal, causing a temporary increase in
and trauma, promoting
plasma amino acid concentration.
iii. Gastrointestinal hormones, including energy metabolism by
secretin, gastrin, and pancreozymin, are mobilizing glucose from
released after food ingestion to enhance the liver and fatty acids
insulin secretion. from adipose tissue.

Formation of
Insulin from

Degradation of Insulin
Insulin's 4-5 minute
plasma half-life allows
rapid metabolic changes
due to circulating insulin
levels, beneficial for
therapeutic purposes.
Insulinase, a liver and
kidney protease enzyme,
degrades it.
Metabolic Effects of Insulin
Insulin is a crucial molecule
that regulates the body's
metabolism, exerting both
anabolic and anticatabolic
effects on carbohydrates,
lipids, and proteins.
1. Effects on carbohydrate metabolism
In a normal person, half of their ingested glucose is used for
energy, with the other half converted to fat and glycogen.
Insulin deficiency severely impacts this relationship, as insulin
influences glucose metabolism, lowering blood glucose levels
through its promotion and inhibition of glucose utilization
and production.
• Effect on glucose uptake by tissues : Insulin is essential for
glucose uptake by muscle, adipose tissue, leukocytes, and
mammary glands. However, 80% of glucose uptake in the
body is not dependent on insulin. Tissues that allow
glucose to enter include brain, kidney, retina, nerve, blood
vessels, and intestinal mucosa. Insulin indirectly promotes
glucose utilization in the liver.
• Effect on glucose utilization : Insulin boosts glycolysis in
muscle and liver by increasing the activation and quantity
of key enzymes like glucokinase, phosphofructokinase, and
pyruvate kinase, and enhancing glycogen production by
increasing glycogen synthetase activity.
 • Effect on glucose
Table Metabolic effects of Insulin—a Summary production : Insulin inhibits
gluconeogenesis by
suppressing pyruvate
carboxylase, phosphoenol
pyruvate carboxykinase, and
glucose 6-phosphatase
enzymes, while also
inactivating glycogen
phosphorylase enzyme.

2. Effects on lipid metabolism :

Insulin's effect on lipid metabolism is
to decrease the release of fatty
acids from stored fat and decrease
the production of ketone bodies,
with adipose tissue being the most
sensitive.

• Effect on lipogenesis : Insulin

enhances glucose synthesis by
increasing glycerol 3-phosphate
and NADPH levels, and enhances
the activity of acetyl CoA
carboxylase, a crucial enzyme in
fatty acid synthesis.
• Effect on lipolysis :Insulin
regulates circulating free fatty
acids by decreasing hormone-
sensitive lipase activity,
reducing fatty acid release
from adipose tissue and liver
mobilization, thus maintaining
a constant balance.

• Effect on ketogenesis : Insulin

decreases HMG CoA synthetase
activity, promoting acetyl CoA
utilization for oxidation and
lipogenesis, resulting in low
availability for ketogenesis in
normal conditions.

3. Effects on protein metabolism :

Insulin is an anabolic hormone that
promotes the entry of amino acids
into cells, enhances protein synthesis,
and decreases protein degradation.

*Insulin, along with its metabolic effects, also

promotes cell growth and replication through Hormonal regulation of blood glucose.
factors like EGF, PDGF, and prostaglandins.`
 CLASSIFICATI Non-insulin dependent
ON OF diabetes mellitus (NIDDM)
DIABETES NIDDM, or type II diabetes, is the most common type
Diabetes
MELLITUSmellitus is a metabolic disorder of diabetes, accounting for 80 to 90% of the diabetic
characterized by hyperglycemia leading to population. It occurs in adults over 35 years old and is
long-term complications. It is divided into less severe than type 1 diabetes. Factors contributing to
two groups: insulin-dependent diabetes NIDDM include genetic and environmental factors.
mellitus (IDDM) and non-insulin dependent Obesity is more common, as it leads to obesity and
diabetes mellitus (NIDDM), based on the decreased insulin receptors on target cells. NIDDM
need for insulin treatment. patients may have normal or increased insulin levels.
Weight reduction through diet control can often correct
Insulin-dependent NIDDM. Recent research suggests that increased levels
of TNF-α and resistin, as well as reduced adiponectin
diabetes mellitus (IDDM)
seretion by adipocytes, cause insulin resistance.
IDDM, also known as type I diabetes or juvenile
onset diabetes, is a childhood disease affecting
10-20% of diabetics. It results from the
destruction of beta-cells in the pancreas, which
can be caused by drugs, viruses, or
autoimmunity. Genetic variations can cause
these cells to be recognized as non-self and
destroyed by immune-mediated injury.
Symptoms usually appear when 80-90% of
beta-cells are destroyed, and the pancreas fails
to secrete insulin. IDDM patients require insulin
therapy.
Table : Comparison of 2 types of Diabetes Mellitus GLUCOSE
TOLERANCE TEST
(GTT)

Diabetes is diagnosed
based on an individual's
response to an oral
glucose load, known as
the oral glucose tolerance
test (OGTT).

Preparation of the
subject for GTT

The individual must have

been on a carbohydrate-rich
diet for at least 3 days
before the test, discontinue
all drugs affecting
carbohydrate metabolism for
2 days, avoid strenuous
exercise, be in a 10 hour
fasting state, be comfortably
seated during GTT, and
refrain from smoking and
exercise.
 Procedure for GTT

The glucose tolerance test involves a morning fasting blood sample

and urine collection, followed by oral glucose administration, blood
and urine samples, and glucose estimation, with samples
qualitatively tested for glucose.

Interpretation of GTT

Fig. shows normal fasting plasma glucose levels, peaking at 140

mg/dl in less than an hour, returning to normal by 2 hours, & no
glucose detected in urine samples.

Individuals with impaired glucose tolerance have elevated fasting and

2 hour plasma glucose levels, leading to a 2% annual rate of frank
diabetes. Treatment involves dietary restriction and exercise.
Diagnosis of diabetes is based on fasting and 2 hour plasma glucose
levels.

Oral glucose tolerance

test.
 Management of diabetes
Diabetes therapy consists of
food, exercise, medications,
and insulin. Diet can control
50% of new cases, oral
hypoglycemic medications
20%-30%, and insulin 20%-
30%.

Other relevant aspects of GTT

Glycated hemoglobin tests (GTT) are used to assess glucose levels in children and pregnant
women.
Children should be given oral glucose based on weight, while pregnant women should be given
100g of glucose.
Diagnosis criteria for diabetes during pregnancy should be stricter than WHO guidelines.
Mini GTTs use fasting and 2 hours of blood and urine samples instead of 1/2 hour intervals.
This test is unphysiological and is commonly used in established diabetic patients for monitoring
control.
Intravenous GTTs are used for individuals suspected of malabsorption, and corticosteroid-
stressed GTTs are used to detect latent diabetes.
Some clinical concepts

• Glucose is the most important energy source of carbohydrates to the mammals(except ruminants).
• The bulk of dietary carbohydrate (starch) is digested and finallyabsorbed as glucose into the body.
• Dextrose (glucose in solution in dextrorotatory form) is frequently used in medical practice.
• Fructose is abundantly found in the semen which is utilized by the sperms forenergy.
• Several diseases are associated with carbohydrate's e.g., diabetes mellitus,glycogen storage diseases
galactosemia.
• The non-digestible carbohydrate cellulose plays a significant role in humannutrition.
• These include decreasing the intestinal absorption of glucose and cholesterol, andincreasing bulk of feces
to avoid constipation.
• The mucopolysaccharide hyaluronic acid serves as lubricant and shock absorbent in joints.
• The mucopolysaccharide heparin is an anticoagulant(prevents blood clotting).
• The survival of Antarctic fish below -2°C is attributed to the antifreeze glycoproteins.
• streptomycin is a glycoside employed in the treatment of tuberculosis
• Diabetes mellitus is a chronic condition characterized by hyperglycemia, insulin deficiency, type 1
diabetes, type 2 diabetes, gestational diabetes, prediabetes, complications, treatment, prevention, and
living with diabetes.
• It is characterized by high blood sugar levels, damage to cells and organs, and complications like heart
disease, stroke, kidney disease, blindness, and nerve damage.
• Treatment involves lifestyle changes and medication, while prevention involves maintaining a healthy
weight and lifestyle.
 Conclusion

 Biochemistry is a field that studies the molecular underpinnings of life,

including carbohydrates.
 Carbohydrates, including polysaccharides, play crucial roles in energy storage,
structural support, and cellular communication.
 Understanding carbohydrates and their metabolism is essential for
understanding energy regulation.
 Carbohydrate metabolism is linked to diabetes mellitus, a prevalent
metabolic disorder with multiple types.
 Recognizing diabetes types helps guide treatment and management, and
biochemistry helps in understanding its molecular intricacies.
Further readings & Refrences
 Satyanarayana, U. (2007) Biochemistry, Books & Allied
(P) Ltd, Kolkata, India
 Notes of Biochemistry by Prof. Dr. Saurabh Dubey Sir
 Biochemistry by Prof. Dr Rajesh Jambhulkar
 Lehninger Principles of Biochemistry
 Helps from some AI & websites