lc@thrivewithdiabetes.com
 

Notes to Part II

1 Adapted from the online wikipedia article “Digestion” at

http://en.wikipedia.org/wiki/Digestion. Retrieved on 3/2/08.

2 In the discussion of digestion of carbohydrates; nouns ending in the suffix -ose usually

indicate a sugar, such as lactose. Nouns ending in the suffix -ase indicates the enzyme that

will break down the sugar, such as lactase. Enzymes usually begin with the substrate

(substance) they are breaking down. For example: maltose, a disaccharide, is broken down

by the enzyme maltase (by the process of hydrolysis), resulting in a two glucose molecules,

a monosaccharide.

3 Swallowing, known scientifically as deglutition, is the reflex in the human body that makes

something pass from the mouth, to the pharynx, into the esophagus, with the shutting of

the epiglottis. If this fails and the object goes through the trachea, then choking or

pulmonary aspiration can occur. For a more detailed representation of swallowing, see

http://www.voiceandswallowing.com/swall_norm.htm. Retrieved on 3/2/08.

4 Adapted from http://en.wikipedia.org/wiki/Peristalsis. Retrieved 3/2/08.

5 Denaturation is the major change in protein or nucleic acid structure by application of

some external stress for example, treatment of proteins with strong acids or bases, high

concentrations of inorganic salts or organic solvents (e.g., alcohol or chloroform), heat,

which results in improper functioning of cell activity. Denatured proteins can exhibit a

wide range of characteristics, from loss of solubility to communal aggregation. Proteins are

very long strands of amino acids linked together in specific sequences.

6 An emulsion is a mixture of two immiscible (unblendable) substances. One substance (the

dispersed phase) is dispersed in the other (the continuous phase). Examples of emulsions

include butter and margarine, milk and cream, espresso, mayonnaise, the photo-sensitive

side of photographic film, and cutting fluid for metal working. In butter and margarine, a

continuous liquid phase surrounds droplets of water (a water-in-oil emulsion). In milk and

cream, oil is dispersed within a continuous water phase (an oil-in-water emulsion).

Emulsification is the process by which emulsions are prepared. See

http://en.wikipedia.org/wiki/Emulsion. Retrieved on 3/2/08.

7 Gaudichon C, Bos C, Morens C, Petzke KJ, Mariotti F, Everwand J, Benamouzig R, Dare S,

Tome D, Metges CC. (2002). Ileal losses of nitrogen and amino acids in humans and their

importance to the assessment of amino acid requirements. Gastroenterology 123(1):50-9.

8 Mahe S, Roos N, Benamouzig R, Davin L, Luengo C, Gagnon L, Gausserges N, Rautureau

J, Tome D. (1996). Gastrojejunal kinetics and the digestion of [15N]beta-lactoglobulin and

casein in humans: the influence of the nature and quantity of the protein. Am J Clin Nutr

63(4):546-52.

9 Mahe S, Marteau P, Huneau JF, Thuillier F, Tome D. (1994). Intestinal nitrogen and

electrolyte movements following fermented milk ingestion in man. Br J Nutr 71(2):169-80.

10 See

http://arbl.cvmbs.colostate.edu/hbooks/pathphys/digestion/basics/overview.html.

Retrieved on 3/1/08.

11 Adapted from Wikipedia article at http://en.wikipedia.org/wiki/Liver. Retrieved

2/24/08.

12 Robbins and Cotran Pathologic Basis of Disease, 7th Edition, p. 878.

13 You are also encouraged to review the following standard medical textbooks: Eugene R.

Schiff, Michael F. Sorrell, Willis C. Maddrey, eds. Schiff's diseases of the liver, 9th ed.

Philadelphia: Lippincott, Williams & Wilkins, 2003. ISBN 0-7817-3007-4; Sheila Sherlock,

James Dooley. Diseases of the liver and biliary system, 11th ed. Oxford, UK; Malden, MA:

Blackwell Science. 2002. ISBN 0-632-05582-0; David Zakim, Thomas D. Boyer. eds.

Hepatology: a textbook of liver disease, 4th ed. Philadelphia: Saunders. 2003. ISBN 0-7216-9051-

3

14 Adapted from Wikipedia online at http://en.wikipedia.org/wiki/Pancreas. Retrieved

2/24/08.

15 See Boston University Histology Learning System online at

http://www.bu.edu/histology/m/i_main00.htm. Retrieved on 2/24/08.

16 Hellman B, Gylfe E, Grapengiesser E, Dansk H, Salehi A (2007). "[Insulin oscillations--

clinically important rhythm. Antidiabetics should increase the pulsative component of the

insulin release]" (in Swedish). Lakartidningen 104 (32-33): 2236–9. Accessible online at

http://www.ncbi.nlm.nih.gov/pubmed/17822201. Retrieved on 2/24/08.

17 BRS physiology 4th edition ,page 255-256, Linda S. Constanzo, Lippincott publishing.

18 The Body, by Alan E. Nourse, in the Time-Life Science Library Series.

19 Harper, Douglas. Pancreas. Online Etymology Dictionary.

20 Adapted from http://en.wikipedia.org/wiki/Insulin. Retrieved on 3/2/08.

21 Ian Murray (1971). "Paulesco and the Isolation of Insulin" (PDF). Journal of the History of

Medicine and Allied Sciences 26 (2): 150–157. Accessible online

at http://jhmas.oxfordjournals.org/cgi/reprint/XXVI/2/150.pdf (subscription required).

Retrieved on 3/2/08.

22 To learn more about Glucose Transporters visit

http://www.medbio.info/Horn/Time%203-4/glucose_transport_proteins.htm. Retrieved

on 3/2/08.

23 William C. Duckworth, Robert G. Bennett and Frederick G. Hamel (1998). "Insulin

Degradation: Progress and Potential". Endocrine Reviews 19 (5): 608–624. Accessible online

at http://edrv.endojournals.org/cgi/content/full/19/5/608#F1. Retrieved on 3/2/08.

24 FDA approval of Exubera inhaled insulin;

http://www.fda.gov/bbs/topics/news/2006/NEW01304.html. Retrieved on 3/2/08.

25 See “Diabetes (Type 1 and 2), Inhaled Insulin - Appraisal Consultation Document

(second).” Available online at

http://www.nice.org.uk/guidance/index.jsp?action=article&r=true&o=33783. Retrieved

on 3/2/08.

26 Cefalu W, Skyler J, Kourides I, Landschulz W, Balagtas C, Cheng S, Gelfand R (2001).

"Inhaled human insulin treatment in patients with Type 2 diabetes mellitus". Ann Intern

Med 134 (3): 203–7. PMID 11177333. Accessible online at

http://www.ncbi.nlm.nih.gov/pubmed/11177333?dopt=Abstract. Retrieved on 3/2/08.

27 See “Diabetes (Type 1 and 2), Inhaled Insulin - Appraisal Consultation Document

(second).” Accessible online at

http://www.nice.org.uk/guidance/index.jsp?action=article&r=true&o=33783. Retrieved

on 3/2/08.

28 Arora A, Hakim I, Baxter J, et al (2007). "Needle-free delivery of macromolecules across

the skin by nanoliter-volume pulsed microjets". Proc. Natl. Acad. Sci. U.S.A. 104 (11): 4255–

60. doi:10.1073/pnas.0700182104. PMID 17360511. Accessible online at

http://www.ncbi.nlm.nih.gov/pubmed/17360511?dopt=Abstract. Retrieved on 3/2/08.

29 Dixit N, Bali V, Baboota S, Ahuja A, Ali J (2007). "Iontophoresis - an approach for

controlled drug delivery: a review". Current drug delivery 4 (1): 1–10. PMID 17269912.

Accessible online at http://www.ncbi.nlm.nih.gov/pubmed/17269912?dopt=Abstract.

Retrieved on 3/2/08.

30 Lalej-Bennis D, Boillot J, Bardin C, et al (2001). "Efficacy and tolerance of intranasal

insulin administered during 4 months in severely hyperglycaemic Type 2 diabetic patients

with oral drug failure: a cross-over study". Diabet. Med. 18 (8): 614–8. PMID 11553197.

Accessible online at http://www.ncbi.nlm.nih.gov/pubmed/11553197?dopt=Abstract.

Retrieved on 3/2/08.

31 Oral Insulin - Fact or Fiction? - Resonance - May 2003. Accessible online at

http://www.ias.ac.in/resonance/May2003/May2003p38-46.html. Retrieved on 3/2/08.

32 Yong Lian Zhu et al. (2003). "Aggregation and Lack of Secretion of Most Newly

Synthesized Proinsulin in Non-β-Cell Lines". Endocrinology 145 (8): 3840–3849. Accessible

online at http://endo.endojournals.org/cgi/content/abstract/145/8/3840. Retrieved on

3/2/08.

33 Glycemic index (also glycaemic index, GI) is a ranking system for carbohydrates based

on their effect on blood glucose levels. It compares available carbohydrates gram for gram

in individual foods, providing a numerical, evidence-based index of postprandial (postmeal)

glycemia. The concept was invented by Dr. David J. Jenkins and colleagues in 1981

at the University of Toronto. Carbohydrates that break down rapidly during digestion

have the highest glycemic indices. Carbohydrates that break down slowly, releasing

glucose gradually into the blood stream, have a low glycemic index. A lower glycemic

index suggests slower rates of digestion and absorption of the sugars and starches in the

foods and may also indicate greater extraction from the liver and periphery of the products

of carbohydrate digestion. A lower glycemic response is often thought to equate to a lower

insulin demand, better long-term blood glucose control and a reduction in blood lipids.

See Glycemic Index, by Michel Montignac at

http://www.montignac.com/en/ig_pionnier.php. Retrieved on 3/21/08. See also

Glycemic Index and GI Database University of Sydney at

http://www.glycemicindex.com/. Retrieved on 3/21/08. See also Gl News University of

Sydney at http://ginews.blogspot.com/. Retrieved on 3/21/08. See also "International

table of glycemic index and glycemic load values: 2002," at the American Journal of Clinical

Nutrition’s website at http://www.ajcn.org/cgi/content/full/76/1/5. Retrieved on

3/21/08. See also GI of International Foods available onine at

http://www.cylive.com/viewContent.do?id=125. Retrieved on 3/21/08. See also

Alphabetic GI List available onine at http://www.gilisting.com/. Retrieved on 3/21/08.

Sources and summary courtesy of Wikipedia at

http://en.wikipedia.org/wiki/Glycemic_index. Retrieved on 3/21/08.

34 Adapted from http://en.wikipedia.org/wiki/Insulin_glargine. Retrieved on 3/21/08.

35 From “Anti-Aging Teleclinic,” with Dr. Ron Rosedale and Dr. Joseph Mercola, page 32-

34. Accessible online at the Mercola.com website at

http://www.mercola.com/forms/downloads/antiagingteleclinic.htm. Retrieved on

1/31/08.

36 Retrieved from http://en.wikipedia.org/wiki/Leptin. Retrieved on 3/2/08.

37 See http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=164160&rn=1. Retrieved on

3/2/08.

38 Kus I, Sarsilmaz M, Colakoglu N, et al (2004). "Pinealectomy increases and exogenous

melatonin decreases leptin production in rat anterior pituitary cells: an

immunohistochemical study". Physiological research / Academia Scientiarum Bohemoslovaca 53

(4): 403–8. Accessible online at

http://www.ncbi.nlm.nih.gov/pubmed/15311999?dopt=Abstract. Retrieved on 3/2/08.

39 Alonso-Vale, Maria Isabel Cardoso; Sandra Andreotti, Sidney Barnabe Peres, Gabriel

Forato Anhe, Cristina das Neves Borges-Silva, Jose Cipolla Neto, Fabio Bessa Lima

(November 2004). "Melatonin Enhances Leptin Expression by Rat Adipocytes in the

Presence of Insulin (abstract)". Am J Physiol Endocrinol Metab. Accessible online at

http://ajpendo.physiology.org/cgi/content/short/00478.2004v1. Retrieved on 3/2/08.

40 Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR,

Ohannesian JP, Marco CC, McKee LJ & Bauer TL (1996). "Serum Immunoreactive-Leptin

Concentrations in Normal-Weight and Obese Humans". N Engl J Med 334 (5): 292-295.

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41 Zhao J, Townsend KL, Schulz LC, Kunz TH, Li C, Widmaier EP (2004). "Leptin receptor

expression increases in placenta, but not hypothalamus, during gestation in Mus musculus

and Myotis lucifugus". Placenta 25 (8-9): 712–22. PMID 15450389. Accessible online at

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42 Moynihan AT, Hehir MP, Glavey SV, Smith TJ, Morrison JJ (2006). "Inhibitory effect of

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16647683. Accessible online at

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43 Studies include: Dubuc G, Phinney S, Stern J, Havel P (1998). "Changes of serum leptin

and endocrine and metabolic parameters after 7 days of energy restriction in men and

women". Metab. Clin. Exp. 47 (4): 429-34. PMID 9550541. Accessible online at

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Weigle D, Duell P, Connor W, Steiner R, Soules M, Kuijper J (1997). "Effect of fasting,

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44 Chin-Chance C, Polonsky K, Schoeller D (2000). "Twenty-four-hour leptin levels respond

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45 Keim N, Stern J, Havel P (1998). "Relation between circulating leptin concentrations and

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obesity (Lond) 30 (1): 122-8. Accessible online at

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46 Margetic S, Gazzola C, Pegg GG, Hill RA (2002). "Leptin: a review of its peripheral

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47 John S. Torday, Virender K. Rehan (2006). "Up-regulation of fetal rat lung parathyroid

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48 Margetic S, Gazzola C, Pegg GG, Hill RA (2002). "Leptin: a review of its peripheral

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49 Aka N, Atalay S, Sayharman S, Kiliç D, Köse G, Küçüközkan T (2006). "Leptin and leptin

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50 Cervero A, Domínguez F, Horcajadas JA, Quiñonero A, Pellicer A, Simón C (2006). "The

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51 Iwaniec UT, Boghossian S, Lapke PD, Turner RT, Kalra SP (2007). "Central leptin gene

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52 From comments by Dr. Ron Rosedale, see

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53 Accessible online at http://en.wikipedia.org/wiki/Ghrelin. Retrieved on 3/2/08.

54 Inui A, Asakawa A, Bowers CY, et al (2004). "Ghrelin, appetite, and gastric motility: the

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55 “Hunger hormone tied to learning,” at The Scientist. Accessible online at

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56 Lall S, Tung LY, Ohlsson C, Jansson JO, Dickson SL (2001). "Growth hormone (GH)-

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57 Hewson AK, Dickson SL. (2000). "Systemic administration of ghrelin induces Fos and

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58 Dickson SL, Luckman SM. (1997). "Induction of c-fos messenger ribonucleic acid in

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59 Hewson AK, Tung LY, Connell DW, Tookman L, Dickson SL.. "The rat arcuate nucleus

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60 Jerlhag E, Egecioglu, E, Dickson SL, Andersson M, Svensson L, Engel JA. (2004). "Ghrelin

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extracellular concentration of dopamine in the nucleus accumbens.". Addiction Biology 12: 6-

16. Accessible online at http://www.ncbi.nlm.nih.gov/pubmed/17407492?dopt=Abstract.

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SL. (2002). "The rat arcuate nucleus integrates peripheral signals provided by leptin,

insulin, and a ghrelin mimetic.". Diabetes. 51 (12): 3412-3419. Available online at

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61 Yildiz B, Suchard M, Wong M, McCann S, Licinio J (2004). "Alterations in the dynamics of

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62 Cummings D, Weigle D, Frayo R, Breen P, Ma M, Dellinger E, Purnell J (2002). "Plasma

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63 See

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10083.html. Retrieved on 3/2/08.

64 Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K (1999). "Ghrelin is a

growth-hormone-releasing acylated peptide from stomach". Nature 402 (6762): 656-60.

PMID 10604470. Accessible online at

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65 Scripps.edu - 'Scripps Research Scientists Successfully Test New Anti-Obesity Vaccine' at

The Scripps Research Institute. Accessible online at

http://www.scripps.edu/newsandviews/e_20060814/ghrelin.html. Retrieved on 3/2/08.