Diabetes mellitus is a deficiency causes hormone insulin, which functions utilize glucose as a source of energy and fat sintesa. The result is the cumulative glucose in the blood (hiperglikemia) and finally through the urine without ekskresi used (glycosuria). Therefore, urine production is increased and the patient must urinate often, feeling very thirsty, decreased body weight and feel tired.
Blood glucose
Glukoneogenesis body will meet the interests of glucose at the time of carbohydrate is not available in sufficient amount of glucose in food. Supply continuously required as a source of energy, particularly for the nervous system and eritrosit. Failure on the glukoneogenesis usually fatal result. Blood glucose level below the critical value will cause disfungsi brain that can lead to coma and death. Glucose also needed in the network as adipose source gliseda- glyseril, and may have a role in maintaining the level of compound in the citric acid cycle in the body in many networks. Even in circumstances in which supply most of the fat calorie needs for the organism, the particular needs of basaltic will glucose there. Glucose is one - one of the baker's energy supply for the muscles in order anaerobe. This element is a precursor of milk sugar (lactose) in the breast gland and is actively taken by the fetus. In addition, the mechanism glukoneogenesis in use to clean the various products of metabolism other network in the blood, such as lactate produced by muscle and eritrosit, and glycerol that it continuously produced by the network adiposa. Propionat, namely acid fat glukogenik in the main produce in the process of carbohydrate digest by ruminant animals, is important for substrate glukoneogenesis body in this animal species.
Most of the carbohydrate in food that is most of the glucose will be formed. Carbohydrate foods are digested in the active residues containing glucose, and galaktosa will fruktosa in the offshore in intestinum. Elements in this nutrient transport into the vena porta hepar through hepar. Galaktosa and fruktosa immediately in a change in glucose hepar.
Glucose in the form of various compound glukogenik the glukoneogenesis. This compound can be in the grade in 2 categories:
(1) compound that includes the conversion into glucose net directly without re-cycle, which means, as some amino acids and propionate, and
(2) compound which is a partial result of glucose metabolism in certain network and the in transport in the kidney and hepar for synthesis back into glucose. Thus, the compound that laktat through glucose oxidation in muscle and order by eritrosit, will be taken in hepar and kidney for glucose re-made so that the element is available for circulation through oxidation in the network. This process is known as Cori cycle or cycles lactate acid. Glycerol 3-phosphate for synthesis triasilgriserol network adipose derived from blood glucose. Asilgliserol compound on the network adiposa continue to experience in the hydrolysis to form free gliserol that can not be in use by the network and thus adipose will be diffuse out and into the blood. This free Gliserol will converted into glucose through a mechanism glukoneogenesis in hepar and kidney.
Between acid-amino acid is transported from muscle to hepar in during the famine was the most dominant alanine. This then produces postulate cycle alanine the glucose-glucose recycling result of hepar to muscle with the piruvat, which was followed by transmitting a alanine, and transportation alanine to hepar, and then followed by glukoneogenesis back into glucose. Net transfer of amino nitrogen from muscle to hepar and free energy from the muscles to hepar thus can be done. Energy needed for glucose synthesis in the hepar of piruvat derived from acid-oxidation fatty acid. Also be formed from glucose glycogen hearts through glikogenolisis.
On deficiency insulin there is a heavy acceleration lipolisis. This resulted in the increase rate triasil-gliserol plasma (hiperlipidemia). Few asetil-KoA can metabolise through the citric acid cycle, so the rest must be converted into acid-keto acid (ketonemia) and some excrested(ketonuria). Because glikolisis blocked, enzyme glucose 6-phosphate that the acceleration of glikogenolisis will changed into glucose. This together with the acceleration glukoneogenesis result hiperglikemia (due to increased amino acid and which have increased the amount of enzyme PEPCK). Insulin is basically the reverse of all this. (Murray, 1999)
The process of maintaining a stable glucose level in the blood is one of the homeostasis mechanisms that set the fine and also the one where hepar, network ekstrahepatik and took some hormone. Cell heart cells appear to be passed with a glucose-free (through the GLUT transporter 2), while cells outside the network ekstrahepatik (outside the island of Langerhans pancreas) is relatively not permeable. As a result, crossing through the membrane into the cell phase-speed barrier in the process of glucose in the network ekstrahepatik, glucose and the process fosforilasi quickly by heksokinase at the time of entry in cells. Conversely, enzyme activity and concentration of some compound that may be important to provide a far more direct or to the expenditure of glucose in hepar. However, the concentration of glucose in the blood are important factors that control the speed of glucose in the hepar and ekstrahepatik network. Role of various glikosa the transporter protein found in the cell membrane and each have 12 pieces of transmembran.
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