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Chapter 20

Control of the
Blood Glucose

The level of blood glucose is


the amount of glucose in the
blood
The

level of blood glucose is


expressed as millimoles per liter
(mM).

The

concentration of blood glucose


is regulated within narrow limits:
3.89----6.11mM

Hypoglycemia:

the blood glucose


level blow 3.33.9 mM.

Hyperglycemia:

the blood glucose


level above 7.227.78mM.

Physiologic significance of
stable level of blood glucose
Glucose

is a major source of energy for


most cells of the body.

Some

tissues and cells (brain, red blood


cells) are almost totally dependent on
blood glucose as a source of energy.

Glucose

is the only fuel that will supply


energy to skeletal muscle under anaerobic
conditions.

Glucose

is also required in adipose tissue


as a source of glyceride-glycerol, and it
probably plays a role in maintaining the
level of intermediates of citric acid cycle
in many tissues.

continual supply of glucose is


necessary as a source of energy,
especially for the nervous system and
erythrocytes.

Blood glucose is derived from


the diet, gluconeogenesis, and
glycogenolysis

The inlet and outlet of blood sugar


Dietary supply

Digest
Absorb
A

glycogenolysis
Liver glycogen

c
u
l
g

g
o
e
on

is
s
e
en

ic
b
ero

id
x
o

CO2 + H2O

glycogenesis

Blood
sugar PPP etc

Non-carbohydrate

n
o
i
at

glycogen

other
saccharides

Lip
ids
&a
me
mi
tab
n
oli
sm o aci
ds

lipids , amino acids

Control of the blood glucose


by hormones
Main
hormones

Decrease blood glucose


insulin play a central role in
redulating blood glucose
Increase blood glucose
glucagon
glucocorticoids
epinephrine

Metabolism pathway of
glucose in red blood cells
Glycolysis

and 2,3-bisphosphoglycerate shunt

2,3-bisphosphoglycerate shunt result in the


production of 2,3-BPG but not ATP.
The

pentose phosphate pathway

glucose

1, 3-BPG

bisphosphsglycerate
mutase

Phosphoglycerate
kinase

3-phosphoglycerate

2, 3-BPG

2, 3-BPG
phosphatase

lactate

2,3-bisphosphoglycerate shunt

Pyruvate as a junction point

GLYCOGEN

Glycogenesis
The storage of glucose
in the form of glycogen
for later use.

UDPG

Glycogenolysis
Pi

G-1-P
G-6-P

GLUCOSE

Fructose 6-p

Anaerobic oxidation
(glycolysis)

non-carbohydrates
trioses phosphate
energy

pyruvate

lactate

Formation of acetyl CoA


Aerobic
oxidation

6-phosphogluconate

Pentose phosphate pathway

Pi

Glycolytic
pathway

The release of glucose


from its storage form
for use by cells

Gluconeogenesis

The formation of glucose


from non-carbohydrates

acetyl CoA

Tricarboxylic acid cycle


CO2 + H2O + energy

Oxidative phosphorylation

Overview of carbohydrate metabolism