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So to understand diabetes mellitus we must first understand the physiology oxblood glucose regulation now sometime sin this talk I might slip up and say sugar instead of glucose because in clinical practice very often we walkabout blood sugar levels it#39’s a bit sloppy really we should really walkabout blood glucose levels glucose is the monosaccharide sugar which is present in the blood, and it's the only type of sugar found in the blood so whence talk about blood sugar blood glucose is what we really mean now I know that other types of sugar are absorbed from the gastrointestinal tract galactose and fructose for example are alsomonosaccharides that IN#39’ll absorb from the gastrointestinal tract but than#39’t circulate in the systemic blood usually because the first time those sugars go through the liver will convert them to glucose so glucose is the sugar in the blood, and it's used by many cells virtually all the cells in the body are using glucose as their fuel supply they use it for energy so glucose needs to be present in the blood at all times to fuel all the physiological processes going on well doesn't#39’t fuel all the physiological process because other metabolic substrates are sometimes used such asphalts, but we always need some glucose in the blood, and we want just the right amount if their#39’s too much that's called hyperglycemia Hyper always means highs owe don't want hyperglycemia that would be too much the blood would be too sweet too sugary but there again we don't want hypoglycemia we don't want it to go too low, so we need to be homeostatic regulated not low hypoglycemia not high hypoglycemia both of these states are abnormal that#39’s why we have these clinical words for them that#39’re abnormalsituationwe want just the right amount of glucose in the blood it needs to be homeostatic controlled now if we're done#39’t give you anything to eat for about 12 hours anyone#39’re healthy we'll find that your blood sugar is going to be around about3.6 to 5.8 millimoles of glucose per liter, so that will be a normal fasting blood level 3.6 to 5.82 mini-mallsnow if had something to eat it can go bit higher, but that will be the normal fasting range and how is it maintained for example if you eat a lot of lots of sugar is going to go into your blood audit#39’s going to start to rise how do Weston it's rising too far and becoming hypoglycemic that's what this physiology is about, and you might have realized the place to start this story is the pancreas is a glandular organ it#39’s in the upper abdominal cavity at the back and the head is towards the right side and the tail is towards the left side so let#39’s draw pancreas and try and start the story from there now the pancreas is an endocrine gland and exocrine gland, and you might remember that an exocrine gland is a gland which excretes its product from the gland induct sit has ducts, so the pancreas has ducts so here we have the main pancreatic duct and there's going to be...