Blood Glucose Homeostasis

Dr.
Baskaran Krishnan
Associate Professor
Anna Medical College
Mauritius
Specific learning objectives
 State normal blood glucose levels.
 Describe abnormality in blood glucose levels.
 Define blood glucose homeostasis.
 Describe regulation in fasting and post prandial.

 List out hormones that are involved in the regulation.
Blood glucose homeostasis
 Glucose is a major fuel for most tissues.
 Continuous supply of glucose is essential for

erythrocytes and central nervous system.
 Its level is finely regulated by number of factors.
 It is called blood glucose homeostasis or regulation

of blood glucose level (blood sugar regulation).
Blood glucose homeostasis…
 Insulin and glucagon are involved in the regulation.
 Liver plays a larger role in the homeostasis.
 Increase or decrease in blood glucose is a major issue.
 Sometimes, it is life threatening.
 Blood glucose homeostasis defined as a process of

maintaining blood glucose with in its normal levels.
 Normal blood glucose:
 Fasting (F): 70 – 110 mg/dl.
 Post-prandial(PP): 70-140 mg/dl.
 Random (R): up to 140 mg/dl.
 Fasting usually begins three hours after meal.#
 Post-prandial is usually two hours after food.

 #For blood glucose determination, 12-hour overnight fasting is recommended.
 Random is anytime and not specifying fasting or PP.
 Blood glucose with in normal limit is normoglycemia.
 Blood glucose below its normal is called hypoglycemia.
 Value below 40 mg/dl is fatal.
 Above normal value is called hyperglycemia.
 Value above 200 mg/dl is harmful.

 Maintained with in physiological limits by:
 Rate of glucose entry (source) into blood circulation.
 Rate of its removal / utilization from the blood stream.

 Rate of glucose entry in to the blood by:
 Absorption from intestine (dietary source).
 Hepatic glycogenolysis.
 Gluconeogenesis.
 Glucose obtained from fructose and galactose.

 Rate of its removal / utilization from the blood stream.
 Oxidation of glucose (glycolysis) by tissue to for energy.
 Glycogenesis in liver and muscle.
 Conversion of glucose to fats in adipose tissues.
 Formation of fructose in seminal vesicle and galactose in
mammary gland.
 Oxidation in alternative pathways-HMP and uronic acid.

 Absorptive state.
 Absorptive state starts from feeding and lasts around three
hours after meal.
 Dietary glucose carried from intestine to liver and then to
most tissues.
 Blood glucose tends to raise (hyperglycemic).
 This stimulates beta-cells of pancreas to secrete insulin in
to the blood stream.
 Absorptive state…
 Insulin signals to GLUT4 of muscle, adipose tissue to uptake
glucose in and to utilize it.
 This leads to fall in blood glucose level and come to fasting
state approximately in three hours.

 But glucose uptake by liver is independent of insulin.
 Post absorptive state (fasting state).
 The post absorptive starts three hours after meal and
lasts for about 16-18 hours.
 Blood glucose tends to fall (hypoglycemic) which
stimulates alpha-cells of pancreas to secrete glucagon.
 Glucagon acts on lever to cause glycogenolysis.
 Hepatic glycogenolysis becomes the major source of

glucose supply.
 Post absorptive state (fasting state)…
 Glycogenolysis (by epinephrine) in muscle is used for its
energy.
 Glycogenolysis starts declining after 16-18 hours.
 Gluconeogenesis (by the action of glucagon) starts gradually
and peaks about 24 hours after the last meal.
 After 24 hours, it is the only source of blood glucose.

Role of hormones in glucose homeostasis.
 Many hormones are involved in the regulation of blood glucose.
They are:
 Insulin.
 Glucagon.
 Cortisol.
 Epinephrine.
 Growth hormone.
 Thyroxine.
Role of hormones in glucose homeostasis…
 Insulin (is the only hormone) lowers blood glucose
(hypoglycemic/antihyperglycemic) while the rest of them
enhance it (hyperglycemic).
• Insulin (hypoglycemic hormone).

• Lowers blood glucose by:
 Causing glycogen synthesis.
 Promoting glycolysis.
 Inhibiting gluconeogenesis.
• Glucagon (hyperglycemic hormone).
• Enhances blood glucose by:
 Promoting glycogenolysis.
 Enhancing gluconeogenesis.
 Depressing glycogen synthesis.
 Inhibiting glycolysis
 Cortisol (hyperglycemic hormone).
 Increases blood glucose level by:
 Promoting gluconeogenesis.
 Releasing amino acids from the muscle
 Epinephrine or adrenaline (hyperglycemic

hormone).
 Promoting glycogenolysis.
 Favoring uptake of amino acids.
 Growth hormone (hyperglycemic hormone).
 Decreasing glycolysis.
 Mobilizing fatty acids from adipose tissue.
 Thyroxine.
Reflection
 Define the term fasting blood glucose?
 Define the term post prandial blood glucose?
 Define the term random blood glucose?
 How is blood glucose regulated in fasting state?
 How is blood glucose regulated in post prandial state?

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Dr.

 Describe abnormality in blood glucose levels.

 Define blood glucose homeostasis.

 Describe regulation in fasting and post prandial.

 Continuous supply of glucose is essential for

 Its level is finely regulated by number of factors.

 It is called blood glucose homeostasis or regulation

 Liver plays a larger role in the homeostasis.

 Increase or decrease in blood glucose is a major issue.

 Sometimes, it is life threatening.

 Blood glucose homeostasis defined as a process of

 Fasting (F): 70 – 110 mg/dl.

 Post-prandial(PP): 70-140 mg/dl.

 Random (R): up to 140 mg/dl.

 Fasting usually begins three hours after meal.#

 Post-prandial is usually two hours after food.

 Blood glucose with in normal limit is normoglycemia.

 Blood glucose below its normal is called hypoglycemia.

 Value below 40 mg/dl is fatal.

 Above normal value is called hyperglycemia.

 Value above 200 mg/dl is harmful.

 Rate of its removal / utilization from the blood stream.

 Glucose obtained from fructose and galactose.

 Oxidation of glucose (glycolysis) by tissue to for energy.

 Glycogenesis in liver and muscle.

 Conversion of glucose to fats in adipose tissues.

 Formation of fructose in seminal vesicle and galactose in

 Oxidation in alternative pathways-HMP and uronic acid.

glucose in and to utilize it.

 This leads to fall in blood glucose level and come to fasting

state approximately in three hours.

 Hepatic glycogenolysis becomes the major source of

 Glycogenolysis starts declining after 16-18 hours.

 Gluconeogenesis (by the action of glucagon) starts gradually

and peaks about 24 hours after the last meal.

 After 24 hours, it is the only source of blood glucose.

• Insulin (hypoglycemic hormone).

• Enhances blood glucose by:

 Depressing glycogen synthesis.

 Epinephrine or adrenaline (hyperglycemic

 Define the term post prandial blood glucose?

 Define the term random blood glucose?

 How is blood glucose regulated in fasting state?

 How is blood glucose regulated in post prandial state?

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