Glucose Homeostasis and Gluconeogenesis
BMI = Weight (kg) / height2 (m)
= kg/m2
*does not account for balance in muscle mass vs fat %
+ was developed on a specific population
• White European males
o Problematic given that genetics plays a role in obesity
§ Therefore WHO adjusted range for people with Asian ancestry due to
high risk for certain disease even at low BMI
§ Hormone levels also play a role in where and when women store fat
• BMI does not account for increased danger of fat storage around specific organs
compared to others
BMI >30 = obese
Overweight = 25 < x < 30
Why use BMI?
• Biomarker = allows for easy measurement and comparison of disease/risk
Problems with obesity?
• Hypertension
• Hyperlipidemia
• Type 2 diabetes
• Cardiovascular disease
DIABETES
• = Inability to maintain glucose homeostasis
o Hyperglycemia (normal = 5 mmoles/L)
• Homeostasis = tendency to resist change in order to maintain a stable, relatively
constant internal environment
• Hormone function = important role in homeostasis maintenance
Type 1 Diabetes Type 2 Diabetes
Autoimmune mediated destruction of Abnormal post-prandial B-cell action
pancreatic B-cells
Loss of insulin and amylin Loss of immediate insulin response to a
meal
• Hormones involved in glucose homeostasis
o Insulin
o Glucagon
§ Major stimulus of hepatic glucose production
§ Synthesized by a-cells of pancreas
§ Bi-hormonal model of diabetes
o Amylin
§ B-cell hormone
§ Suppresses glucagon secretion
§ Slows food intake and gastric emptying (CNS)
, o Glucagon-like peptide 1
§ insulin secretion ¯ glucagon secretion
§ GLP-1 analogues used to treat diabetes
REGULATION BY INSULIN AND GLUCAGON
• Consume meal with carbs à blood sugar rises
• Rise in blood sugar stimulates insulin increase
• Fasted state à takes 4-5 hours to digest a meal, thereafter, in fasted state
o Low blood sugar increases glucagon production
BMI = Weight (kg) / height2 (m)
= kg/m2
*does not account for balance in muscle mass vs fat %
+ was developed on a specific population
• White European males
o Problematic given that genetics plays a role in obesity
§ Therefore WHO adjusted range for people with Asian ancestry due to
high risk for certain disease even at low BMI
§ Hormone levels also play a role in where and when women store fat
• BMI does not account for increased danger of fat storage around specific organs
compared to others
BMI >30 = obese
Overweight = 25 < x < 30
Why use BMI?
• Biomarker = allows for easy measurement and comparison of disease/risk
Problems with obesity?
• Hypertension
• Hyperlipidemia
• Type 2 diabetes
• Cardiovascular disease
DIABETES
• = Inability to maintain glucose homeostasis
o Hyperglycemia (normal = 5 mmoles/L)
• Homeostasis = tendency to resist change in order to maintain a stable, relatively
constant internal environment
• Hormone function = important role in homeostasis maintenance
Type 1 Diabetes Type 2 Diabetes
Autoimmune mediated destruction of Abnormal post-prandial B-cell action
pancreatic B-cells
Loss of insulin and amylin Loss of immediate insulin response to a
meal
• Hormones involved in glucose homeostasis
o Insulin
o Glucagon
§ Major stimulus of hepatic glucose production
§ Synthesized by a-cells of pancreas
§ Bi-hormonal model of diabetes
o Amylin
§ B-cell hormone
§ Suppresses glucagon secretion
§ Slows food intake and gastric emptying (CNS)
, o Glucagon-like peptide 1
§ insulin secretion ¯ glucagon secretion
§ GLP-1 analogues used to treat diabetes
REGULATION BY INSULIN AND GLUCAGON
• Consume meal with carbs à blood sugar rises
• Rise in blood sugar stimulates insulin increase
• Fasted state à takes 4-5 hours to digest a meal, thereafter, in fasted state
o Low blood sugar increases glucagon production
