Glucose and Insulin .. continued...
Diabetes

Insulin Treatment for Diabetes

People with type 1 diabetes cannot make insulin because the beta cells in their pancreas are damaged or destroyed. Therefore, these people will need insulin injections to allow their body to process glucose and avoid complications from hyperglycemia.
People with type 2 diabetes do not respond well or are resistant to insulin. They may need insulin shots to help them better process sugar and to prevent long-term complications from this disease. Persons with type 2 diabetes may first be treated with oral medications, along with diet and exercise. Since type 2 diabetes is a progressive condition, the longer someone has it, the more likely they will require insulin to maintain blood sugar levels.

Various types of insulin are used to treat diabetes and include:
Rapid-acting insulin: It starts working approximately 15 minutes after injection and peaks at approximately 1 hour but continues to work for two to four hours. This is usually taken before a meal and in addition to a long-acting insulin.
Short-acting insulin: It starts working approximately 30 minutes after injection and peaks at approximately 2 to 3 hours but will continue to work for three to six hours. It is usually given before a meal and in addition to a long-acting insulin.
Intermediate-acting insulin: It starts working approximately 2 to 4 hours after injection and peaks approximately 4 to 12 hours later and continues to work for 12-18 hours. It is usually taken twice a day and in addition to a rapid- or short-acting insulin. 
Long-acting insulin: It starts working after several hours after injection and works for approximately 24 hours. If necessary, it is often used in combination with rapid- or short-acting insulin.
Insulin can be given by a syringe, injection pen, or an insulin pump that delivers a continuous flow of insulin.
Your doctor will work with you to figure out which type of insulin is best for you depending on whether you have type 1 or type 2 diabetes, your blood sugar levels,and your lifestyle.

Facts about Sugar :
We encounter sugar in two different ways in our food: sugars that exist in unprocessed foods such as fruits, vegetables, and dairy products, and sugars that are added to packaged foods to boost flavor or allow food to be more shelf-stable.
Added sugars are not chemically different from naturally occurring sugars. Both are broken down in the body using the same enzymatic processes. However, the amount and form in which we consume the sugars—in fruits and vegetables, in sodas, or in other processed foods—affects how quickly the body absorbs them, and how the body signals and experiences satiety, or feelings of fullness.
Simple and Complex Sugars
All digestible carbohydrates enter the bloodstream as individual sugar units.
Digestible carbohydrates, including “complex” starches and “simple” sugars, are all nutritionally similar in that they each provide 4 calories per gram. They are also chemically similar: more-complex carbohydrates have to be broken into simple sugars before they can be absorbed, transported by the bloodstream, and used for energy.
Carbohydrate breakdown takes place high in the digestive tract, and with high efficiency. Starch is broken into glucose units and absorbed at about the same rate as pure glucose. Likewise, sucrose (a disaccharide made up of glucose paired with fructose) is clipped apart and absorbed about as quickly as high fructose corn syrup (a mixture of individual glucose and fructose units).
Simple and Complex Sugars
Glucose and fructose have the same chemical formula: C6H12O6. But the atoms are arranged differently, giving the two sugars different chemical properties. The chemical structures of fructose and glucose influence their sweetness and how they are processed in the body.
Sweetness
Fructose tastes twice as sweet as glucose, and sucrose (composed of fructose and glucose linked together) is somewhere in between. The proportion of these sugars in foods—both natural and processed—affects how sweet different kinds of sugars taste alone and when added to processed foods. 
Location
Glucose travels through the bloodstream to all of our tissues, and every cell in the body readily burns it for energy. In contrast, fructose is almost exclusively taken up and metabolized by the liver.
Excess glucose and fructose are both converted to fat and stored. 
Whatever sugar we choose, the key is moderation: any sugar consumed in excess contributes to fat build-up.
Multiple Tanks: Blood Sugar, Glycogen, and Fat
The amount of glucose circulating in the blood of an average healthy adult is equal to only one or two packets' worth (about 5 grams). Yet, in a day, the brain alone uses about 25 packets’ worth.
Our blood glucose concentration must be kept very stable. When blood sugar levels are too low, the brain can starve. When levels are too high, sensitive tissues in nerves, eyes, and organs can be damaged. To keep blood glucose steady, the body alternates between storing excess glucose after meals and supplying glucose to the blood between meals. Some glucose is stored in liver and muscle cells as glycogen, and some is converted to fat for storage in adipose tissue.
Glycogen and glycerol (a component of fat) are easily converted back to glucose. However, we cannot make glucose from fatty acids. When the body’s supply of glycogen is depleted, as in the case of someone running a marathon, muscle proteins are broken down and used by the liver to regenerate blood glucose.
The body stores extra fuel as glycogen or fat. Most of our energy reserves are found in fat. While glycogen can be used to replenish blood sugar, fatty acids cannot. Only the small glycerol portion of fat can be converted to glucose, but glycogen is released very slowly only as fatty acids are being burned for fuel.
Unprocessed fruits, vegetables, and whole grains supply moderate amounts of sugar, and they contain other nutrients that make them an important part of a healthy diet. But sugar itself is not an essential nutrient, and when consumed in excess it is a source of completely unnecessary calories.
Consuming large amounts of added sugars, particularly from sugar-sweetened beverages, increases the risk of developing obesity, Type 2 diabetes, or cardiovascular disease. 
Simple and Complex Sugars
Added sugars can be tricky to spot on food labels. They are often "disguised" under less-sweet or natural sounding names. Some of the more common sugary ingredients are listed below.
Ingredient : Beet sugar / Cane sugar / Cane juice
What's in it : Mainly sucrose (same as table sugar: glucose plus fructose)
Ingredient : Dextrose, Fructose, Lactose, Maltose, Sucrose
What's in it : These are the chemical names of specific types of sugar
Ingredient : Rice syrup / Brown rice syrup
What's in it : Mainly maltose and maltotriose (2 or 3 glucose units)
Ingredient : Corn syrup / Corn syrup solids
What's in it : Mainly glucose
Ingredient : High fructose corn syrup
What's in it : Glucose and fructose (high in fructose compared to corn syrup, but same amount of fructose as table sugar)
Ingredient :  Malt syrup / Barley malt
What's in it : Mainly maltose
Ingredient : Fruit juice / Fruit juice concentrate
What's in it : Fructose, glucose, and sucrose (proportions vary by fruit)
Ingredient : Honey
What's in it : Fructose and glucose
Ingredient : Molasses
What's in it : Mainly sucrose
Apples, Oranges, and Soda
Consuming 1.2 large apples, 1.6 large oranges, or a 12-ounce can of soda delivers the same number of calories to your body, but the fruit will keep your body feeling satisfied for longer. Why?
1.Because it requires biting and chewing, fruit will arrive at the stomach more slowly.
2.Solid food spends more time in the stomach than liquid does. The stomach needs time to break food particles down before they are allowed to enter the small intestine.
3.The fruits contain 6 to 7 grams of fiber. As some of this fiber is broken down, the cells of the small intestine release hormones that signal feelings of fullness to the brain.
4.The sugar in the fruit takes a longer time to reach the small intestine, slowing its absorption into the bloodstream. In contrast, the sugar in the soda is absorbed very quickly, and often leads to a brief period of high blood sugar immediately followed by a blood sugar “crash” when the body’s hormones overcorrect in attempt to keep blood sugar steady.
The fruit also has vitamins and other nutrients that the soda lacks, such as vitamin C, calcium, and magnesium.
For Reference: ( Knowledge purpose )
Carbohydrates
Structures and Function
Composed of carbon, hydrogen, and oxygen
Simple sugars: monosaccharides, disaccharides, oligosaccharides)
Complex sugar: polysaccharides (starch and fiber)
Simple carbohydrates
Monosaccharides (glucose, fructose, and galactose – isomers of each other)
Glucose (also called dextrose and blood sugar) has a six carbon (hexose) ring structure
Fructose (also called levulose) has a six carbon ring structure
Found in fruit, honey, and corn syrup used in soft drink and food production
8 to 10% of our energy intake
Metabolized into glucose in the liver
Converted into glycogen, lactic acid, or fat if consumption is high
Galactose has a six carbon ring structure
Not usually found in nature but exists mostly as a unit of the disaccharide lactose which is found in nature
Converted to glucose in the liver or stored as glycogen
Ribose has a five carbon ring structure and used in genetic material (why is ribose not a dietary consideration?)
Disaccharides
Maltose (glucose + glucose) - commonly used in the production of alcohols
Sucrose (glucose + fructose) - table sugar and plants are the major source
Lactose (glucose + galactose) - primary sugar found in milk and milk products
Oligosaccharides
Raffinose (trisaccharide - made up of glucose, fructose, and galactose)
Stachyose (tetrasaccharide - made up of a glucose, fructose, and two galactose)
Found in beans, cabbage, brussel sprouts, broccoli, etc...
Digestive enzymes cant break them apart
Bacteria in the large intestines break apart these oligosaccharides, producing gas and other byproducts
Complex Cabohydrates (Digestible starch and glycogen and indigestible fiber)
Starch
Long chains of glucose
Amylose is a straight chain polymer
Amylopectin is a branched chain polymer
Food sources include potatoes, breads, pasta, and rice
Amylopectin raises blood sugar levels quicker because of the branched configuration which enables more digestive capabilities
Glycogen
Storage form of glucose in the human body
Long branched chains of glucose
Highly digestible because of the branched structure
Fiber
Dietary fibers chemically composed of non-starch polysaccharides:
Cellulose and hemicellulose – found in wheat, rye, rice, vegetables
Pectins, gums, and mucilage – citrus fruits, oat products, beans
Dietary fibers also composed of the non-carbohydrate called lignin
All dietary fibers come from plants and are not digested in the stomach
But fibers can be soluble and insoluble in water
Those that are soluble include pectins, gums, and mucilages and are metabolized by bacteria in the intestines
Carbohydrate Digestion and Absorption
Begins in the mouth (salivary amylase) during mastication
Some starches are broken down to maltose
Acid environment of stomach inactivates salivary enzymes
Pancreatic amylases release from pancreas into small intestine further breaks down starches into mono and disaccharides
Brush border cells (small intestine cells) release various other enzymes (e.g., maltase, sucrase, and lactase)
Glucose and galactose are actively absorbed in the small intestine
Fructose is absorbed through passive facilitated diffusion
Functions of Glucose and Other Sugars
Yields energy (4 kcal/g)
Sparing protein from use as an energy source (sparing the body from having to undergo gluconeogenesis)
Preventing Ketosis
Adequate intake of carbohydrates is necessary for the complete metabolism of fats to carbon dioxide and water 
Low carbohydrate intake leads to incomplete breakdown of fatty acids and formation of ketone bodies
Imparting flavor and sweetness to foods – order of sweetness (high to low): fructose, sucrose, glucose, maltose, lactose
Functions of Dietary Fiber
Dietary fiber
Adds mass and water
Feces then are larger and softer
Less pressure needed to expel stool
RDA for fiber: Men 14-50 (38 grams) and Women 14-50 (26 grams)
Little or no fiber in diet can cause constipation and thus more pressure in intestine is needed
May cause diverticula and hemorrhoids
Diverticulosis versus diverticulitis
Additional health benefits:
Aids in weight control
Link between fiber consumption and decrease in colon cancer
Higher intakes of fiber correlated to inhibition of cholesterol and bile acid absorption
Recommended Carbohydrate Intakes
NET CARBS? (define)
130 grams of carbohydrates daily
Problems with high intakes:
May not contribute the right proportion of energy to diet
High fiber diet can produce phytobezors
May lower nutritional value of a diet by contributing to the lack of consuming other energy-yielding nutrients
May cause dental caries
Diets may contain too many carbohydrates with high glycemic indexes
Glycemic index - the blood glucose response of a given food, compared to a standard (glucose or white bread); Influenced by starch structure, fiber content, food processing, physical structure, and macronutrients in the meal, such as fat
Lactose intolerance may occur
Food Sweeteners (Nutritive and alternative sweeteners)
Nutritive Sweeteners
Sugars (mono and disaccharides)
50+ pounds are consumed per year per person
Fructose in the form of fructose corn syrup is predominately used
Others: brown sugar, turbinado sugar, honey, and maple syrup
Stevia (Truvia)?
Sugar alcohols (sorbitol, mannitol, xylitol)
Contribute energy (1.5 to 3 kcal/gram)
Broken down more slowly than simple sugars
Sorbitol and xylitol are used in sugarless gum, breath mints, and candy – these sugar alcohols aren’t readily metabolized by bacteria so prevent the development of dental caries
Non-Nutritive or Alternative Sweeteners (saccharin, aspartame, acesulfame potassium, sucralose)
Saccharine
Discovered in 1879
300 times sweeter than sugar
May cause bladder cancer (?)
Aspartame
Discovered in 1969, and in 1981 was approved by the FDA for use in foods
Produced from two amino acids—aspartic acid and phenylalanine
Trade name “Nutrasweet” and “Equal”
Health controversy
Yields 4 kcal/gram and is 180-200 times sweeter than sucrose
Because it is so sweet so little is used in foods thereby lowering energy content
Sucralose (Splenda)
Discovered in 1976
600 times sweeter than sugar
Approved in 1998 for use in baked goods, nonalcoholic beverages, chewing gum, frozen dairy desserts, fruit juices, and gelatins
Today approved as general purpose sweetener for foods
Acesulfame Potassium (Sunett)
200 times sweeter than sugar and calorie free
Discovered in 1967 in Germany - approved in 1988 by the FDA as a tabletop sweetener
Cyclamate (Sucaryl)
Cyclamate is 30 times sweeter than sucrose
Discovered in 1937
Had been used in foods since the 1950s
Used in Sugar Twin
It was removed from food products in the USA and Canada by the 1970s because several animal studies suggested it posed an increased cancer risk
It is completely banned in the USA, BUT it is available today in Canada as a tabletop sweetener.
The U.S. scientific community is reviewing more current data that may support cyclamate approval again.
The maximum daily limit suggested is 1.5 grams per day.
Are carbohydrates addictive?
Scientific studies have revealed that people who have higher BMI's have decreased "pleasure" receptors in the brain and require more stimuli such as sugar (and alcohol, certain ilicit drugs, etc...) to cause dopamine/seratonin release and produce pleasure. Furtermore, most carbohydrates have only been in the diet in the last couple hundred years and absent in the diet more than 10,000 years ago. Therefore, increased exposure to carbohydrates have shifted our production and consumption of foods as well as increased incidence of certain disorders such as obesity.
Blood Glucose levels
Blood glucose is regulated by two principle hormones: insulin and glucagon
Low blood glucose initiates the pancreas to produce and secrete insulin which causes glycogen (long chains of glucose) to release glucose
High blood glucose initiates the pancreas to produce and secrete glucagon which causes muscle and liver to store glucose in the form of glycogen
Hyperglycemia (high blood glucose) versus hypoglycemia (low blood glucose)
Diabetes Mellitus: (Type 1, insulin dependent) versus (Type 2, non-insulin dependent)