Prepared by

Fargeen. E. Abdullah
Lecturer in Clinical Biochemistry/Medicine College/
1st Stage 2022-2023
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✓ What are Carbohydrates?
✓ Explain general structures of
Carbohydrates?

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➢ Carbohydrates are the most abundant organic
molecules in nature.
➢ Structurally defined as aldehydes or ketones
with multiple hydroxyl groups or “hydrate” of
carbon (– C-H2O).
➢ The term Carbohydrate is the most common in
biochemistry, where it is a synonym of
saccharide.

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✓ What are Functions of Carbohydrates?

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General Functions of Carbohydrates:
➢Fuel for cells
➢Storage of energy
➢Cell structure
➢Metabolic intermediates
➢Cell-Cell recognition

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✓ How Carbohydrates classified?
✓ What are classes of Carbohydrates?

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Classification of Carbohydrates:
1- Monosaccharides
2- Disaccharides
3- Oligosaccharides
4- Polysaccharides

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✓ Define monosaccharides?
✓ What are kinds of monosaccharides?
✓ Give examples of monosaccharides?

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1- Monosaccharides:
➢ Are the simplest carbohydrates in that they
cannot be hydrolyzed to smaller carbohydrates.
➢ Monosaccharides consist of:
• 3-6 carbon atoms.
otrioses
otetroses
opentoses
ohexoses
• A carbonyl group aldehyde(aldose) or
ketone(ketose).
• Several hydroxyl groups.

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Monosaccharides, cont.
➢ Examples of monosaccharides:

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✓ What are α and β sugars?
✓ What are D and L sugars?
✓ Define Pyranose and Furanose?
✓ What are Epimers?

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 Differences between α and β sugars
The cyclic forms of carbohydrates can exist in α and β forms,
based on the position of the (–OH) or (–CH2OH) group at the
anomeric carbon.

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 Differences between D and L sugars
These two forms are enantiomers, their molecular structures are
mirror images of each other. In D-(Dextro) form the (–OH) of the
penultimate carbon atom on the right side whearese, in L-(Levo)
form the (-OH) in the left side.

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 What are Pyranose and Furanose
Pyranose is a term for saccharides that have a six-membered
ring structure consisting of five carbon atoms and one oxygen
atom, while
Furanose have a five-membered ring structure consisting of
four carbon atoms and one oxygen atom.

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What are Epimers? Isomers that differ in configuration
around only one specific carbon atom are defined as
epimers of each other.

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✓ Define disaccharides?
✓ What is glycosidic bond?
✓ Give examples of disaccharides?

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2- Disaccharides:
➢ Are formed as a result of combination of 2
monosaccharide units by glycosidic bond.
➢ A glycosidic bond forms by a condensation
reaction.
➢They can yield two monosaccharides on
hydrolysis.

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➢ Glycosidic bonds formed from reaction of
monosaccharide with alcohol or with amine
as follows:

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Disaccharides, cont.
➢ Examples of disaccharides:
Sucrose (“table sugar”)
glucose + fructose

Lactose (“milk sugar”)

galactose + glucose

Maltose (“malt sugar”)

glucose + glucose

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✓ Define oligosaccharides?
✓ Give examples of oligosaccharides?

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3- Oligosaccharides:
➢ Short carbohydrate chains of 3 - 10
monosaccharides.
➢ Found in legumes and human milk.
➢ Their function in living organisms is usually
either structure or storage.
➢ Examples of oligosaccharides:
oraffinose cannot be broken down by human enzymes,
oStachyose though can be digested by colonic bacteria.

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✓ Define polysaccharides?
✓ Give examples of polysaccharides?

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4- Polysaccharides:
➢ Polysaccharides contain greater than 10
mono saccharide units.
➢ They represent an important class of
biological polymers.
➢ Examples of polysaccharides:
o Starch
o Glycogen
o Cellulose

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✓ What are the main differences between
Glycogen, Starch, and Cellulose in:
- Sources
- Structures
- Digestion
- Functions

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Differences between polysaccharides:
Polysaccharide Sources Structures Digestions Functions
s
Starch Plants Polymers of Digested by Major storage
(amylopectin, glucose(α1- human form in plants,
& amylose) 4,and α1-6) enzymes and has
nutritional
function.
Glycogen Animals Polymers of Digested by Major storage
glucose(α1- human form in animals
4,and α1-6), enzymes
highly
branched chain
Cellulose Plants Polymers of Can’t be Structural
glucose(β1-4) digested by function
human
enzymes
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✓ What are Glycosaminoglycans?
✓ Explain chemical structure of
glycosaminoglycan?

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Polysaccharides, cont.
➢ Glycosaminoglycans, also known as
mucopolysaccharides, made of repeating
units of disaccharides containing a
derivative of an amino sugar.
➢ One of the sugars in unit has negatively
charged carboxylate or sulfate group.
➢ Usually attached to proteins
oproteoglycans

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✓ What is reducing sugar?
✓ Give examples about reducing sugars?

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Reducing Sugars & Non Reducing Sugars:
➢ A reducing sugar is any sugar that is capable
of acting as a reducing agent.
➢ It has a free aldehyde group or a free ketone
group.
➢ All monosaccharides are reducing sugars,
along with some disaccharides,
oligosaccharides, and polysaccharides.
➢ Examples of a reducing sugar that react with
an oxidizing agent:

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Oxidation Reduction Reaction

Glucose Gluconic Acid

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✓ What is the difference between Complex
and Simple carbohydrates?
✓ Mention food sources for Complex and
Simple carbohydrates?

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Complex & Simple Carbohydrates:
➢ Complex carbohydrates are often referred to as
starch and starchy foods.
➢ They are found naturally in foods and also
refined in processed foods.
➢ Complex carbohydrates as natural starches are
found in:
o Bananas, beans, brown rice, lentils, nuts,
potatoes, root vegetables, whole grain cereals,
etc.
➢ Complex carbohydrates as refined starches are
found in :
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o Biscuits, pastries, cakes, pizzas, white rice;
bread; and flour.
➢ Simple carbohydrates are also known as sugars.
➢ They also exist in either a natural or refined
form.
➢ Natural sugars are found in fruits and vegetables.
➢ Refined sugars are found in:
o Biscuits, pastries, cakes, chocolates, honey, pizzas,
sweets, prepared foods, etc.

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✓ Mention names of dietary carbohydrates?
✓ Explain main sites for carbohydrates digestion
in human body?
✓ What are Enzymes involved in carbohydrates
digestion?
✓ What is the result of complete digestion of
carbohydrates?

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Digestion of Carbohydrates:
➢ Digestion of
carbohydrates begins in
the mouth.
➢ The major dietary
polysaccharides are of
plant (starch) origin.

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➢ Salivary α- amylase hydrolyze α1-4 bonds of dietary
polysaccharides, resulting dextrins.
➢ Carbohydrate digestion halts temporarily in the
stomach, because the high acidity inactivates the
salivary α- amylase.
➢ In the small intestine, the acidic stomach neutralized
by bicarbonate secreted by the pancrease, and
pancreatic α- amylase continues the process of
starch digestion.

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➢ The final digestive processes occur at the mucosal
lining of the upper jejunum, which includes the
action of several disaccharidases and
oligosaccharidases.
o isomaltose isomaltase glucose
o maltose maltase glucose

o sucrose sucrase glucose ₊ fructose

o lactose lactase galactose ₊ glucose

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✓ How monosaccharides absorbed by the small
intestine?

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Absorptipon of Carbohydrates:
➢ Glucose, and galactose are transported into
the mucosal cells by an active transport
system (SGLT-1).
➢ Fructose transported by passive transport
system(GLUT-5).
➢ All three monosaccharides are transported
from the intestinal mucosal cell into the portal
circulation by (GLUT-2).

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✓ What are causes of disturbances in carbohydrates
absorption?

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Disturbances in Carbohydrate
Resorption:
1. Disaccharidase deficiency syndrome:
i- saccharase, lactase, maltase; when activity
of disaccharidase ↓ hydrolysis of
disaccharide ↓ resorption of substrate ↓
concentration of disaccharide in small intestine
lumen ↑ osmotic activity of the lumen
fluid ↑ diarrhea

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 ii- activity of disaccharidase ↓ concentration
of disaccharide in small intestine lumen↑
concentration of disaccharide in large intestine
↑ disaccharide fermentation by bacteria
concentration of lactic acid and fatty acids ↑
stimulation of intestine wall abdominal
cramps, bloating, diarrhea, acidic stools,
explosive diarrhea.

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2- Lactase deficiency syndrome:
Causes of lactase deficiency:
➢ genetic defect (primary)
➢ secondary to a wide variety of gastrointestinal diseases
that damage the mucosa of the small intestine .
➢ Disaccharide lactose is the principal carbohydrate in milk.
➢ Many persons showing milk intolerance prove to be

lactase – deficient

➢ Milk intolerance may not become clinically apparent until

adolescence.

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3- Monosaccharides malabsorption:

➢ Small intestine ability to resorb glucose and galactose

is decreased.

o Cause: Specific transport system for galactose and

glucose absorption in cells of small intestine is
insufficient.

o Results: Symptoms and signs similar to disaccharidase

deficiency syndrome.

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✓ What is the importance of Glucose?
✓ What are sources of Glucose?

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➢ Glucose is a major circulatory carbohydrate
and energy source for human body.
➢ It is derived primarily from dietary
carbohydrates, body stored glycogen
(glycogenolysis), and from non carbohydrate
substances like a. acids, glycerol, and lactic
acid (gluconeogenesis) which occur in liver.

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✓ What is Glycemic Index?

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Glycemic Index:
➢ Glycemic Index (GI) is a relative ranking of
carbohydrate in foods according to how they
affect blood glucose levels .
➢ Carbohydrates with a low GI value (55 or less)
are more slowly digested, absorbed and
metabolised,
➢ and cause a lower and slower rise in blood
glucose and, therefore insulin levels.

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Glycemic Index

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✓ How blood glucose regulated?

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How Blood Glucose Regulated:
➢ Liver
o Extracting glucose from blood
o Synthesizing glycogen
o Performing glycogenolysis
o Performing gluconeogenesis
➢ Peripheral tissues Muscle and Adipocytes
o They use glucose for their energy needs

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How Blood Glucose Regulated, cont.
- The liver’s uptake and output of glucose and
the use of glucose by peripheral tissues depend
on the physiological balance of several
hormones that:
1- Lower blood glucose level (insulin).
2- Rise blood glucose level (glucagon,
epinephrine, GH, glucocorticoids,…).

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✓ What is DM?
✓ How many types of DM are there?
✓ What are differences between types of DM?

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➢ DM is the commonest endocrine disorder,
➢ Defined as a syndrome characterized by
hyperglycemia due to an insulin resistance and
an absolute or relative lack of insulin.
➢ DM is the leading cause of adult blindness,
renal failure, heart attacks, and strokes.
➢ DM is generally classified into two classes:
1- Type I (Insulin dependent DM).
2- Type II (Non insulin dependent DM).

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 Differences between Type I & Type II
DM
Type I DM Type II DM
1- Age < 30 years 1- > 40 years
2- Cause: auto immune 2- Insulin Resistance
destruction of pancreatic islet
cell
3- Insulin: low or absent 3- normal or high
4- Weight: normal or 4- overweight or obese
underweight
5- Treatment: Insulin is 5- changing life
necessary style, medications.
6- Epidemiology: 10-20% 6- 80-90%
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✓ What are main symptoms of DM?

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Symptoms of DM:
➢ frequent urination
➢ feeling very thirsty and drinking a lot
➢ feeling very hungry
➢ feeling very fatigued
➢ blurry vision
➢ cuts or sores that don’t heal properly

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Main symptoms and signs of DM and
mechanisms of their onset:
➢ Hyperglycemia:
o relative or absolute deficiency of insulin effect →
 transport of glucose to muscle and fat cells →
 glycemia
o  insulin effect → gluconeogenesis in liver →
 blood level of glucose
o  glycogenolysis

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➢ Polyuria:
o high blood level of glucose → ↑amount of glucose
filtered by the glomeruli of the kidney →
↑absorption capacity of renal tubules for glucose
→glycosuria results, accompanied by large amounts
of water lost in the urine (osmotic effect of
glucose).
➢ Polydipsia :
o high blood level of glucose → hyperosmolality of
plasma →water moves from cells to ECF →
intracellular dehydratation → creation of thirst
feeling (in hypothalamus) → intake of fluids 59
➢ Polyphagia:
o depletion of cellular stores of carbohydrates, fats,
and proteins → cellular starvation and a

corresponding increase in hunger.

➢ Weight loss :
o fluid loss in osmotic diuresis, loss of body tissue
as fats and proteins are used for energy creation.
➢ Fatigue :
o metabolic changes result in poor use of food
products → lethargy and fatigue
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✓ What are the main biochemical changes that
results in uncontrolled DM?

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Important biochemical changes that
occur in uncontrolled DM:
➢ Increased blood glucose level
➢ Hyper cholesterolaemia
➢ Glucoseuria
➢ Ketonaemia
➢ Incresed urea and non protein nitrogen compound
➢ Dehydration
➢ Acidosis (decreased PH and hyperventilation ) and
kussmaul breathing.
➢ Lowered sodium and disturbance in fluid and
electrolyte balance.
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