Blood glucose Watch

Pbough
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how can blood glucose in a diabetic and non-diabetic person be controlled?
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Jpw1097
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(Original post by Pbough)
how can blood glucose in a diabetic and non-diabetic person be controlled?
Well in a non-diabetic person, blood glucose levels are tightly controlled by insulin (which lower blood glucose levels) and glucagon (which increase blood glucose levels) - both of these hormones are secreted by the pancreas.

In type 1 diabetes, they don’t produce insulin and so blood glucose levels can reach very high levels (causing diabetic ketoacidosis). In type 1 diabetes, they must inject insulin to keep blood glucose levels low.

In type 2 diabetes, cells become less sensitive to insulin and so insulin cannot lower blood glucose levels in the way it normally would. Type 2 diabetes is usually caused by things like obesity, poor diet, lack of exercise, etc. Therefore blood glucose levels can be controlled by a good diet, losing weight and increasing physical activity.
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macpatgh-Sheldon
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Very good answer by Jpw1097 as always!

Just to add that in Type 2 diabetes (NIDDM - non insulin dependent diabetes mellitus), if the measures outlined above are not successful OR the patient is not disciplined enough to lose weight, etc. then drugs may be needed e.g. the sulphonylureas like chlorpropamide OR biguanides like metformin (older drugs) OR newer ones like the thiazolidinediones e.g. pioglitazone OR even newer ones.
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Jpw1097
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(Original post by macpatgh-Sheldon)
Very good answer by Jpw1097 as always!

Just to add that in Type 2 diabetes (NIDDM - non insulin dependent diabetes mellitus), if the measures outlined above are not successful OR the patient is not disciplined enough to lose weight, etc. then drugs may be needed e.g. the sulphonylureas like chlorpropamide OR biguanides like metformin (older drugs) OR newer ones like the thiazolidinediones e.g. pioglitazone OR even newer ones.
Absolutely. Just as macpatgh-Sheldon has said, there are LOTS of drugs used in type 2 diabetes if blood glucose is not controlled using dietary and lifestyle modifications - metformin is the most common and works by increasing the sensitivity of target cells to insulin.
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nexttime
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(Original post by Jpw1097)
In type 1 diabetes, they don’t produce insulin and so blood glucose levels can reach very high levels (causing diabetic ketoacidosis).
Don't know how technical we want to get, but its more the lack of intracellular glucose that causes this. Pure high glucose will (eventually) cause more of a HHS type picture.

In type 2 diabetes, cells become less sensitive to insulin and so insulin cannot lower blood glucose levels in the way it normally would. Type 2 diabetes is usually caused by things like obesity, poor diet, lack of exercise, etc. Therefore blood glucose levels can be controlled by a good diet, losing weight and increasing physical activity.
Or by insulin of course. I think I'm right in saying that most people on insulin in the UK have type 2 diabetes, not type 1.
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Jpw1097
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(Original post by nexttime)
Don't know how technical we want to get, but its more the lack of intracellular glucose that causes this. Pure high glucose will (eventually) cause more of a HHS type picture.



Or by insulin of course. I think I'm right in saying that most people on insulin in the UK have type 2 diabetes, not type 1.
Or perhaps we want to get even more technical and say that insulin inhibits hormone sensitive lipase (HSL), therefore low insulin leads to activation of HSL leading to the release of free fatty acids (FFAs) which are then converted into acetyl CoA via beta oxidation. Low levels of insulin leads to gluconeogenesis and since many of the Krebs cycle intermediates are substrates for gluconeogensis, this depletes these intermediates and so the Krebs cycle is inhibited. Therefore acetyl CoA cannot enter the Krebs cycle and is instead converted to ketone bodies.

Yes of course, people with T2DM who have poor glycaemic control despite optimal lifestyle/dietary changes (probably rare) and pharmacological intervention will need insulin. I’m not too sure about the statistics, but that would make sense; there are far more people with T2DM compared to T1DM. However, all people with T1DM need insulin whereas not all people with T2DM do.
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nexttime
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(Original post by Jpw1097)
Or perhaps we want to get even more technical and say that insulin inhibits hormone sensitive lipase (HSL), therefore low insulin leads to activation of HSL leading to the release of free fatty acids (FFAs) which are then converted into acetyl CoA via beta oxidation. Low levels of insulin leads to gluconeogenesis and since many of the Krebs cycle intermediates are substrates for gluconeogensis, this depletes these intermediates and so the Krebs cycle is inhibited. Therefore acetyl CoA cannot enter the Krebs cycle and is instead converted to ketone bodies.

Yes of course, people with T2DM who have poor glycaemic control despite optimal lifestyle/dietary changes (probably rare) and pharmacological intervention will need insulin. I’m not too sure about the statistics, but that would make sense; there are far more people with T2DM compared to T1DM. However, all people with T1DM need insulin whereas not all people with T2DM do.
Haha, just correcting a technical inaccuracy and a large omission for those reading. I know you know your stuff Jpw don't worry
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Kallisto
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(Original post by Jpw1097)
Well in a non-diabetic person, blood glucose levels are tightly controlled by insulin (which lower blood glucose levels) and glucagon (which increase blood glucose levels) - both of these hormones are secreted by the pancreas.

In type 1 diabetes, they don’t produce insulin and so blood glucose levels can reach very high levels (causing diabetic ketoacidosis). In type 1 diabetes, they must inject insulin to keep blood glucose levels low.

In type 2 diabetes, cells become less sensitive to insulin and so insulin cannot lower blood glucose levels in the way it normally would. Type 2 diabetes is usually caused by things like obesity, poor diet, lack of exercise, etc. Therefore blood glucose levels can be controlled by a good diet, losing weight and increasing physical activity.
Best answer. Everything what is relevant to know is explained, a green thumb is deserved.
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Last edited by Kallisto; 1 month ago
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Reality Check
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I think the OP has probably been scared off from the increasingly overly-detailed posts which don't mean anything to him. This is a GCSE question :lol:

Pbough - try to pick through it to see what you can get. If this is GCSE or Level 3 (BTEC), then think primarily about the roles of insulin and glucagon, and then maybe some pharmacological (drugs) based ways that blood glucose levels might be changed. Apologies if you're actually in your third year of a biochemistry/pharmacology or medical degree, in which case you'll find the detail useful.
Last edited by Reality Check; 1 month ago
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