glucose transporters organ glucose transporter hk computer classification brain glut1 hk-i glucose...
TRANSCRIPT
![Page 1: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/1.jpg)
![Page 2: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/2.jpg)
Glucose transporters
Organ Glucose transporter
HK computer Classification
Brain GLUT1 HK-I Glucose dependent
Erythrocyte GLUT1 HK-I Glucose dependent
Adipocyte GLUT4 HK-II Insulin dependent
Muscle GLUT4 HK-II Insulin dependent
Liver GLUT2 HK-IVL Glucose sensor
GK ß-cell GLUT2 HK-IVB (glucokinase)
Glucose sensor
Gut GLUT3-symporter
- Sodium dependent
Kidney GLUT3-symporter
- Sodium dependent
DeFronzo, Diabetes Rev 5:177-269, 1997
![Page 3: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/3.jpg)
![Page 4: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/4.jpg)
![Page 5: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/5.jpg)
![Page 6: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/6.jpg)
![Page 7: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/7.jpg)
![Page 8: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/8.jpg)
![Page 9: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/9.jpg)
![Page 10: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/10.jpg)
![Page 11: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/11.jpg)
![Page 12: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/12.jpg)
![Page 13: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/13.jpg)
![Page 14: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/14.jpg)
![Page 15: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/15.jpg)
![Page 16: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/16.jpg)
![Page 17: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/17.jpg)
![Page 18: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/18.jpg)
![Page 19: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/19.jpg)
Secre
ció
m in
su
lín
ica
Concentración de insulina basal
Fase temprana de secreción insulínica
Segunda fase de secreción insulínica
Secreción insulínica bifásica normal
![Page 20: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/20.jpg)
Fase temprana de secreción de insulina (FTSI)
FTSI
Captación de glucosa en el hígado y tejidos
periféricos
Inhibición de gluconeogénesis hepática
GPA
Resistencia a la insulinaGlucotoxicidad
![Page 21: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/21.jpg)
Burger HG, et al. 2001. Diabetes Mellitus, Carbohydrate Metabolism, and Lipid Disorders. In Endocrinology. 4th ed. Ed.
by LJ DeGroot and JL Jameson. Philadelphia: W.B. Saunders Co., 2001.Originalmente en Diabetes tipo 2 BASICS. International Diabetes Center, Minneapolis, 2000.
Obesidad IG DiabetesHiperglucemiadescontrolada
Historia natural de la resistencia a la insulina y disfunción de célula beta
Glucosa(mg/dl)
90–
270 –
360 –
0 –
50 –
100 –
150 –
200 –
250 –
-10 -5 0 5 10 15 20 25 30Años de diabetes
Función relativa
(%)
Glucosade ayuno
Resistencia a Insulina
Glucosapostprandial
Secreción InsulinaDiagnóstico
clínico
180 –
![Page 22: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/22.jpg)
900
0
300
500
600
700
800
GN- FDMn=85
IGT+/- FDM
N=98
GN+ FDMn=100P
rim
era
fase s
ecre
ció
n d
e in
su
lin
a p
mol/l
Primera fase de secreción de insulina en sujetos normales e
intolerantes a la glucosa con y sin familiares diabéticos
Van Haeften T .Metabolism. 2000;49:1318–1325.
GN. Glucosa normalIGT intolerancia a glucosaFD: Familiares diabéticos
![Page 23: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/23.jpg)
Patofisiología de la DM tipo 2
Resistencia a Insulina Defectos en secreciónResistencia a Insulina Defectos en secreción de insulinade insulina
Utilización glucosa Utilización glucosa Producción glucosa Producción glucosa Basal y Basal y estimuladaestimulada
![Page 24: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/24.jpg)
Historia Natural de la Diabetes tipo 2
DM2
Intolerancia a la glucosa
Alteración en el metabolismo de la
glucosaTolerancia a la glucosa
normal
10%
50%
70%
100%
30%
70-%
150%
100%
Sensibilidad a insulina
Secreción de insulina
Groop L. Diabetes Obes Metab 1999;1(1):S1.
![Page 25: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/25.jpg)
Definiciones de AGA, ICHO’s y DM
Categoría Glucosamg/dl
(ayuno)
Glucosa 0’CTGO
Glucosa 120’CTGO
GA normal < 100
GA alterada
100-125
ICHO’s 140-199
DM > 126 > 200
![Page 26: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/26.jpg)
Metas de control glucémicoen diabetes
Parámetro ADA IDF ACE
HBA1c % < 7 < 6.5 < 6.5
Glucosa Plasmática:
PreprandialPosprandial
90-130<180
< 100<135
< 110<140
ADA Diab Care enero 2006.IDF Diab Med 1999: 16; 719-30.ACE Conference of Diabetes Mellitus. August 2001.
![Page 27: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/27.jpg)
![Page 28: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/28.jpg)
Indicacion de insulina desde el principio en pacientes con DM tipo 2Indicacion de insulina desde el principio en pacientes con DM tipo 2
Descontrol severo, catabolismo marcado
estrés intenso: infecciones, trauma, etc.
INSULINOTERAPIA
Sin respuesta
Hiperglucemia(sin catabolismo)
HO
![Page 29: Glucose transporters Organ Glucose transporter HK computer Classification Brain GLUT1 HK-I Glucose dependent Erythrocyte GLUT1 HK-I Glucose dependent](https://reader035.vdocuments.site/reader035/viewer/2022062309/5665b45d1a28abb57c90e656/html5/thumbnails/29.jpg)
Glu
cosa
pla
smát
ica
(mg
/dl)
Glu
cosa
pla
smát
ica
(mg
/dl) 300-300-
200-200-
100-100-
0-0-06000600 12001200 18001800 24002400 06000600
Tiempo (horas)Tiempo (horas)
Picos prandiales de Picos prandiales de la glucosala glucosa
Hiperglucemia en Hiperglucemia en ayunasayunas
NormalNormal
VARIACIONES DEL CONTROL GLUCÉMICO EN VARIACIONES DEL CONTROL GLUCÉMICO EN 24 HORAS RELATIVOS A GA Y GPP *24 HORAS RELATIVOS A GA Y GPP *
Riddle MC. Diabetes Care 1990; 13: 676-86Riddle MC. Diabetes Care 1990; 13: 676-86
* GA = Glucosa en ayunas* GA = Glucosa en ayunas GPP = Glucosa Post-prandialGPP = Glucosa Post-prandial