Name: Date of Birth: Year Month Fasting Blood Sugar Phone: Lunch Dinner Blood Sugar Affter Meal Blood Sugar Before Meal Carb Insulin Dose Blood Sugar Affter Meal Breakfast Carbs Insulin Dose Blood
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So to understand diabetes mellitus wemust first understand the physiology ofblood glucose regulation now sometimesin this talk I might slip up and saysugar instead of glucose because inclinical practice very often we talkabout blood sugar levels it's a bitsloppy really we should really talkabout blood glucose levels glucose isthe monosaccharide sugar which ispresent in the blood and it's the onlytype of sugar found in the blood so whenwe talk about blood sugar blood glucoseis what we really mean now I know thatother types of sugar are absorbed fromthe gastrointestinal tract galactose andfructose for example are alsomonosaccharides that I'll absorb fromthe gastrointestinal tract but theydon't circulate in the systemic bloodusually because the first time thosesugars go through the liver the liverwill convert them to glucose so glucoseis the sugar in the blood and it's usedby many many cells virtually all thecells in the body are using glucose astheir fuel supply they use it for energyso glucose needs to be present in theblood at all times to fuel all thephysiological processes going on well itdoesn't fuel all of the physiologicalprocess because other metabolicsubstrates are sometimes used such asfats but we always need some glucose inthe blood and we want just the rightamount if there's too much that's calledhyperglycemia Hyper always means high sowe don't want hyperglycemia that wouldbe too much the blood would be too sweettoo sugary but there again we don't wanthypoglycemia we don't want it to go toolow so we need to be homeostatic lyregulated not low hypoglycemia not highhypoglycemia both of these states areabnormal that's why we have theseclinical words for them they're abnormalsituationwe want just the right amount of glucosein the blood it needs to be homeostaticly controlled now if we don't give youanything to eat for about 12 hours andyou're healthy we'll find that yourblood sugar is going to be around about3.6 to 5.8 millimoles of glucose perliter so that will be a normal fastingblood level 3.6 to 5.82 mini-mallsnow if had something to eat it can go abit higher but that will be the normalfasting range and how is it maintainedfor example if you eat a lot lots ofsugar is going to go into your blood andit's going to start to rise how do westop it rising too far and becominghypoglycemic that's what this physiologyis about and you might have realized theplace to start this story is thepancreas the pancreas is a glandularorgan it's in the upper abdominal cavityat the back and the head is towards theright side and the tail is towards theleft side so let's draw pancreas and tryand start the story from there now thepancreas is an endocrine gland and anexocrine gland and you might rememberthat an exocrine gland is a gland whichexcretes its product from the gland inductsit has ducts so the...