- Glucose
 homeostasis requires interactions between key tissues and organs - liver, adipose tissue, skeletal muscle and pancreas. - Stress response involves major changes in fuel metabolism.
- Disruption of this homeostatic system results in potentially life-threatening conditions - hypoglycemia and diabetes mellitus.
- The organism alternates between the fasting and postabsorptive state. Metabolite concentrations in blood change during the fast-feed cycle, and are influenced by stress and disease.
- The measurement of plasma glucose concentration is part of a routine assessment of every patient admitted to hospital. In diabetic patients the measurements of glucose, ketones, HbA1c, and tests of renal function, including microalbuminuria, are performed.
|
- Describe how insulin causes an increase in cellular glucose uptake.
- What are anti-insulin hormones?
- Why a non-diabetic patient brought to emergency unit with extensive burns would have an inceased plasma glucose concentration? Describe her metabolic state.
- You have asked a patient to come to the outpatient clinic to have plasma triglycerides tested. The patient asks whether he needs to be fasting that day. Please provide an answer and explain your reasons.
- Do people with impaired glucose tolerance develop long-term vascular complications?
- What do obesity and diabetes mellitus have in common?
|
Diamond J. The double puzzle of diabetes. Nature 2003;423:599-602.
Full article
|
| Zimmet P, Alberti KGMM, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414:782-787.
Full article
|
| Vollenveider P. Insulin resistant states and insulin signaling. Clin Chem Lab Med CCLM 2003;41:1107-1119.
|
| Service FJ. Hypoglycemic disorders. New Engl J Med 1995;332:1144-1152.
Full article
|
| Schmidt MI, Duncan BB. Diabesity: an inflammatory metabolic condition. Clin Chem Lab Med 2003;41:1120-1130.
Full article
|
| The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2003;26:S4-S20.
|
| Alberti KG, Zimmet. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabetic Medicine 1998:15:539-553.
|
| The Diabetes Control and Complications Trial (DCCT) Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977-986.
|
| U.K. Prospective Diabetes Study (UKPDS) Group. Intensive Blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-853.
|
| Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report. JAMA 2003;289:2560-2572.
Full article
|
| page 296 |  | | page 297 |
| Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third report of the National Cholesterol education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-2497.
|
| Sacks DB, Bruns DE, Goldstein DE, Maclaren NK, MCDonald JM, Parrott M. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care 2003;25:750-786.
|
| Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature 2001;414:813-820.
Full article
|
| Dominiczak MH. Obesity, glucose intolerance and diabetes and their links to cardiovascular disease. Implications for laboratory medicine. CCLM 2003;41:1266-1278.
Full article
|
| page 297 | | | page 298 |
|
