Clinical Applications of Carbohydrates

you all learnt how much important is carbohydrate for our body. The carbohydrates should be supplied.to body in a continuous manner. Both excess as well as lack of carbohydrates is detrimental for body. There are a number of diseases associated with carbohydrates such as hypoglycemia, ladtose intolerance, diabetes mellitus, galactosemia, glycogen storage disease etc. Diseases associated with carbohydrate are given below.

Hypoglycemia

Hypoglycemia means low sugar level in blood.

Symptoms: Nervousness, anxiety, hunger, palpitations and headache.

Causes: Clinicians have identified two types of hypoglycemia and their causes.

i) Reactive hypoglycemia: Reactive hypoglycemia occurs after a meal if persons had abdominal surgery or has diabetes.

ii) Fasting hypoglycemia: Fasting hypoglycemia occurs due to inadequate food or from poor eating habits: Several drugs may cause hypoglycemia e.g., alcohol which blocks glucose productiori in the liver.

Other clinical conditions which cause hypoglycemia are: 

(i) Tumors in pancreas stimulate excessive insulin secretion 

(ii) Adrenal insufficiency: Stress conditions increases metabolic demands of the body and contribute to hypoglycemia which is due to adrenal insufficiency.

Diagnosis: Normal blood glucose range is 70 - 110 mg/100ml. Below 70mgl 100ml of blood sugar level is the sign of hypoglycemia.

Treatment: A diet of frequent small meals, rich in complex carbohydrates and a good dietary fiber content with fewer carbohydrates and sugars.

Lactose Intolerance

One of the most common problems throughout the world is lactose intolerance. In this condition, the man is unable to digest product with lactose such as nonferhented milk.

Symptoms: Abdominal cramps, nausea, bloating or diarrheoa when milk is consumed.

Cause: The problem is due to deficiency of lactase, a digestive enzyme found in - the microvilli of small intestine that converts milk sugar and lactose (by hydrolysis) into its component monosaccharide, glucose and galactose for absorption. Children are born with high level of lactase to utilize high lactose level in mother's milk. In animals, lactase activity decreases shortly after birth

and in human after five years of age.

Diagnosis: Based on symptoms along with history of non-fermented milk consumption.

Treatment: Treatment consists simply cutting down of milk consumption. Most lactose intolerant patients digest fermented milk products (cheese, butter milk, yogurt) very well and they can consume these as their primary source of calcium instead of milk. Low lactose milk and sweet acidophilus milk have been

developed for lactose intolerant people.

Diabetes Mellitus

It is a metabolic disorder in which the ability to oxidize the primary fuel glucose is almost lost. It also affects the fat and protein metabolism.

Normal Pbysiological Functions of Pancreas

Symptoms: Glucose level increases in the blood and is lost in the urine, causing excessive urination, thirst and hunger and on prolonged disease develops multiple system complications.

Cause: Sugar and other simple carbohydrates can contribute to blood glucose level in persons with diabetes. Sugar does not cause diabetes but the cause is due to lack of available insulin, the pancreatic hormone.

Diagnosis: Diagnosis of diabetes can be done by different methods like:

i) Estimation of sugar in urine (Glycosuria): Presence of sugar in urine is dctected by colorimetric method.

ii) Elevation of blood sugar (Hyperglycemia): Normal level of blood sugar is 70 - 100 mg/100ml. In diabetes, blood sugar level increases from the normal level.

iii) Glucose tolerance test: In this test, 75 gram dose of glucose is given to patients. The patient is kept on fasting and two hour plasma was collected.

The glucose level is estimated. A two hour plasma glucose value of 200mgl lOOml or above indicates diabetes and 140 - 200mg/100ml indicates the impaired glucose tolerance.

iv) Glycosylated Hemoglobin Alc: It is a relatively stable molecuie within the red blood cells. Higher the level of circulating glucose over the life of the red blood cells, the higher the concentration of glycohemoglobin. It provides an effective tool for evaluating long-term management of diabetes and degree of control.

Treatment and control: Treatment of diabetes includes:

Well-planned food habits and exercise

Insulin therapy

Self-monitoring of blood glucose level

Nutrient balance: Ratio of carbohydrate, protein and fat in the diet is based on the recommendation of ideal glucose regulation. Majority of carbohydrate in the form of complex carbohydrate, starch should be used. About 50 - 55 per cent of total kilocalorie of the diet is of complex carbohydrates. It gives simple sugars slowly over a time. Fiber rich diet (polysaccharides) also has some effect on blood glucose level.

Other Conditions

Hyperactivity: Greater activity, ease of stimulation and other hyperactive signs suggesting an association of sugar intake and hyperactivity.

Dental caries: Dental caries is the only health problem caused by sugar. Better dental care can greatly reduce the incidence of caries.