CARDOHYDRATE METABOLISM

Carbohydrate is a major part of out food, which, is derived from potatoes, sugar and sugar-based food items, like sugar-cane juice, crystal sugar, jaggery and unrefined sugar, fruits like grapes, mangoes etc. in fact, even oranges, limes, peaches, lichies, loquats, berries etc. also have enough portion of sugar contents. Among cereals, wheat flour contains maximum amount of carbohydrates, as also its bi-products.

The starch, generated by the food we take, when intermingles with various enzymes, present in out intestines and end-product of this chemical process is glucose. Glucose remains stored in our liver and is released only when our body needs it. Glucose, after being absorbed into intestines, travels to liver and remains stored there in the form of glycogen which remains stored therein until and unless body-cells need it to provide energy to body. When body-cells need it, it gets converted into glucose and its unutilized portion enters the blood stream for onward travel to body-cells. Fats and protein also generate glucose.
Entire quantity of glucose generated by food does not convert into glycogen due to various metabolic factors. Liver has limited storage capacity and entire quantity of glucose, when it fails to convert it into glycogen and the liver also fails to store it, then the excess quantity of glucose (140mg per 100 It.) passes on to urine, and thus there is presence of sugar in the urine. Further, various enzymes and secretions, including insulin, also mix up with the blood stream and try to control absorption of sugar in the blood. But, due to lack or insufficient secretion of insulin, the sugar (glucose) release is passed to blood steam which also causes rise in blood sugar level. Presence of sugar in urine and blood will suffice to confirm diabetic status of a person. Due to metabolic disturbance in sugar absorption, certain functions of the body are affected, giving rise to various symptoms, which have already been pointed out earlier. A gram of carbohydrates generates about 4 calories.

Due to above carbohydrate factor, consumption of much sugar is considered to be the chief cause of diabetes, Excess of sugar is not a true and definite indication of DM, for the simple reason, that if a person consumes abnormal amount of sugar producing foodstuff, the excessive amount (after the body has already utilized its required quantity to meet its purpose) of sugar will pass on to urine but when the person returns to normal intake of carbohydrates, his urine will not show any presence of sugar. But, if the blood also shows higher glucose presence, then only it is a true case of DM, when blood sugar level crosses is normal (optimum) range, then the extra unconsumed sugar appears in urine. As for blood sugar tests and their details, we will take up its details, later on, so as to give one and all a clear pathological picture on clinical tests etc.

It is not that the carbohydrate factor is the only factor in diabetes. As maintained earlier, insufficient amount of insulin release by the pancreas, further complicates and precipitates sugar-absorption process. For instance, if one takes sugar in excess but his pancreas release sufficient amount of insulin to help quick absorption of glucose (sugar), then there won’t be any amount of extra unabsorbed sugar which could ever pass on to blood stream. Conversely, if a patient’s body generates sufficient amount of glucose but his body requirement is not in proportion, to the amount of glucose(or glycogen, stored in the liver) generated and, above all, the secretion of insulin is in larger quantity, then the patient is bound to have hypoglycemia (low sugar content in the body). The following comparison will clarify out view point.
a) More intakes of carbohydrates generate larger quantity of glucose. Liver stores glucose according to its retentive capacity. Excess generation but non-retention of glucose passes on to blood stream and there is lack of insulin to absorb it. Hence sugar passes on to urine and blood, causing a state of hypoglycemia.
b) Even if there is higher quantity of sugar, due to excessive intake of carbohydrates and liver also stores glucose as per its retentive capacity. The excess quantity of glucose is released in the body via blood steam. Now, even if the glucose requirement of body is high along with higher secretion of insulin, the glucose released by liver and also the excessive quantity is absorbed by higher quantity of insulin-release. In such a situation, the body cells do not get sufficient glucose to feed various body-organs and as a result of which sugar/glucose level falls down below normal limits which, in turn, result in hypoglycemia. Both the aforesaid, hyper and hypoglycemia states do not augur well for a person’s health condition. Hence, both extremes should be avoided or at best, an honest effort must be directed towards avoidance of such high and low sugar levels.

It does not mean that energy-generating carbohydrates are not useful for the body because our body does not and cannot function without energy which is provided by food, rich in carbohydrates. Energy, generated by food, is the end-product of glucose. For the diabetics, a tapered quantity of glucose can be can be determined by present state of blood sugar level. Persons with low sugar content in their blood will require higher intake of sugar-rich carbohydrates to compensate for the low sugar levels.

It may be noted that the sugar obtained from fruits is called ‘Fructose’. From the milk it is called lactose and that which is obtained from sugar etc. is called ‘Glucose’. As for the sugar content, glucose, fructose and lactose in descending order should be termed as highest, high and low. Certain fruit sugars, like grapes and mangoes, have high percentage of sugar content.

Generally 60% of the foodstuff eaten should consist of carbohydrates, 40% of protein and 20% of fats, providing also sufficient extra quantity for vitamins and minerals. But above mentioned percentage will require to be tapered according to condition of the patient. Thus, obese and hyperglycemias will require less carbohydrates and hypoglycemia, and weak persons will require higher percentage of carbohydrates. Calories required by a person, during 24 hours, will actually determine ratio of said essential food constituents and nutrients.