Clinical Importance of Carbohydrates

Providing energy to the body and the brain is possibly considered as the main function of
carbohydrates. But before we discuss the clinical importance of carbohydrates, let us first
understand what carbohydrates are [9].

Carbohydrates
Carbohydrates literally mean “hydrated carbon”. Chemically it can be defined as the complex
substances which upon hydrolysis yields
polyhydroxy aldehydes or ketones. Basically
compose of carbon, hydrogen and oxygen
and have molecular formula as Cx(H2O)y [1].
Basic source of carbohydrates are the green
plants. Carbohydrates play both structural
and functional roles. They also help in the
metabolism of fat.

Sources of Carbohydrates Figure 1

As carbs play structural roles for membranes along with the proteins and the lipids, some
common sources of carbohydrates are given as under [7, 8].
Milk
Corn
Cherry
Beans
Cookies
Bread
Potatoes
Cookies
Figure 2
Maze

Classification of Carbohydrates
Carbohydrates are classified into three groups on the basis of their behavior on hydrolysis;
monosaccharide, disaccharide and polysaccharide [19].

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 Figure 3

Nutritional Significance of Carbohydrates

As everyone knows that glucose is the main energy source and also a good source of vitamins
and minerals. For brain high energy demand, carbohydrates serve as the primary fuel source. So
in nutrition, carbohydrates are fruits, grains and vegetable products [11, 12].
So if all these products are needed for the proper mechanism of the body, then their deficiency or
exceeding may cause disease. So now we are going to signify the clinical importance of
carbohydrates. In the carbohydrates the main energy source is the glucose, a simple sugar that is
a component of starch [15, 8].

Derivatives of Carbohydrates
In case of the carbohydrates, derivatives are those modifications happen in the sugar molecules
by the addition of other substituents other than the
hydroxyl group. In fact carbohydrate derivatives
are also very much important for the body and
have structural and functional roles. Examples are
as follows [7].
Amino sugars
Acidic sugars
Deoxy sugars
Sugar alcohols
Figure 4
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Glycosylamines
Sugar phosphates
Dextrin

Clinical Applications of Carbohydrates

In a continuous manner, the carbohydrates should be provided to the body. Owing to the
significance of carbohydrates and its derivatives, there is a dire need to maintain them. If we fail
to maintain them, we have to face the serious consequences. There are a number of diseases that
are related with the imbalance of carbohydrates. Some of them are as follows [18, 15].
Hypoglycemia
Lactose intolerance
Diabetes mellitus
Glycogen storage diseases

Hypoglycemia
It simply means the blood with the low sugar level [5].
Symptoms
Nervousness
Anxiety
Hunger
Palpitations
Headache Figure 5

Causes
Two types of hypoglycemia have been
identified by the clinicians and their
causes have been given as follows.
Reacting Hypoglycemia – If the
person has abdominal surgery or has
diabetes this type of glycemia may
occur. However, it is usually reported
after a meal [20].
Fasting Glycemia – Eating inadequate
food or with the poor habits, this type
of glycemia generally results [13].
Figure 6

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However, hypoglycemia is also caused by means of several drugs including blockage of glucose
production in the liver by the alcohol. Also, the adrenal insufficiency and tumors in pancreas also
cause it [17].
Diagnosis
The range of normal glucose level is 70 – 100mg/100ml. The sign of hypoglycemia observes if
the blood sugar level is below of it [2, 9].
Treatment
With fewer carbohydrates and the sugar content in the good dietary fiber food and that which is
rich in complex carbohydrates or with small meals have minimized the hypoglycemia. So the use
of proper carbohydrates in the food is essential [11].

Lactose Intolerance
In this condition the product with the lactose is unable to digest by the man. Probably,
throughout the world, this is the most common problem [6, 10].
Symptoms
The symptoms usually appear after the intake of
dairy products. Some general symptoms are as
follows [4].
Bloating
Diarrheoa
Nausea
Figure 7
Abdominal cramps
Causes
Humans are born naturally with the digestive enzyme lactase that is found in the microvilli of the
small intestine. By means of
hydrolysis, the enzyme coverts the
milk sugar and the lactose into its
respective monosaccharide that is
glucose and galactose for absorption. Figure 8
But sometimes there is a deficiency
of lactase in the human body and
this condition results. Normally, the
level of lactose usually decreases
after five years of age [12, 20].
Diagnosis
The diagnosis is generally recommended by means of the history of non-fermented milk
composition based on the above symptoms [9].

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Treatment
Simply cut down the consumption of the milk involves in the treatment of it. Mostly fermented
milk is used by these patients. For lactose intolerant people, low lactose milk and sweet
acidophilus milk have been developed [18].

Diabetes Mellitus
The capability to oxidize the primary fuel glucose is lost in this metabolic disorder. The
metabolism of the fat and protein is also affected in it [1, 5].
Symptoms
Glucose level decreases in the muscles and is increased in the blood. Therefore excessive
urination, thirst and hunger are caused by it. However some multiple system complications are
also resulted by these prolonged
diseases [17].
Causes
When the blood glucose level
increase, lack of insulin, the
pancreatic hormone, results and
consequently it causes the sugar
and simple carbohydrates
increase its level in blood [3, 5].
Diagnosis
The diagnosis can be done by
different methods as follows.
Figure 9
Evaluation of Sugar in Urine
(Glycosuria) – colorimetric
method is used to detect the presence of sugar in urine [12, 18].
Increasing of Blood Sugar (Hyperglycemia) – 70-100mg/100ml is the normal level of blood
sugar. But in this condition, the blood sugar level increases [6].
Glucose Tolerance Test- This test has a complete procedure. 75g of glucose is injected to the
patient in this test and plasma is collected after two hours. The valuation of level of glucose is
observed. If the value comes to the 200mg/100ml or above, it shows the diabetes and if the value
comes out to 140-200mg/100ml, it shows the glucose tolerance in an impaired way [14, 15]
Glycosylated hemoglobin Alc – Within the red blood cells, there is a molecule that is relatively
stable. Its concentration is directly proportional to the red blood cells. For evaluating the long
term management of diabetes and the degree of control, it gives us an effective tool that is higher
the level of glucose circulation over the life of red blood cells, higher the glycohemoglobin
circulation [13, 14].
Treatment
Treatment of diabetes mellitus is as follows
Well-organized Food Habits

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Exercise
Insulin therapy
Self - Check of Blood Glucose Level
Nutrient Balance – The basis of ideal glucose regulation is upon the ratio of carbohydrate, fat
and protein in the diet. Our food mostly contains the proportion of carbohydrates. So the
equilibrium should be attained in the food [18, 19].

Hyperactivity
Greater the ease of the stimulus and other energetic cyphers proposing a connotation of sugar
intake and hyperactivity, greater is the activity [20].

Dental Caries
Dental caries is the only health problem that is caused by sugar. The incidence of caries can be
reduced by means of better dental care [2, 5].
These are the storage diseases.
However there are other disorders in which the carbohydrates and its derivatives paly its
different role.

Rheumatoid Arthritis
Carbohydrates are an important part of structural and functional components of the body
particularly of the following components [18, 19].
Connective Tissue Matrix
Nucleic Acids
Galactolipids of Brain and Many Proteins
The serum, for example, consists of more hexose as part of macromolecules than in the free –
state and contains as much hexosamine. In the wide range of diseases, the changes in the
concentration of these substances occur. The Carbohydrates, hyaluronic acid, is the main
component of synovial – fluid mucin, which usually destroys inactive rheumatoid arthritis and
provides an important clue to the diagnosis of this disease [12, 13].
Cause
When the immune system is not working well, then this disorder usually result in.
Treatment
Generally, this disease is treated with regular medication. However, in some case surgery is also
required to nip the disease in the bud [11].
Also, we also observe the carbohydrate metabolism during the acute period of ischemic stroke.
The most important test in emergency stroke valuation is glucose test (or blood sugar test)
because levels of blood glucose which are much high or too low can cause symptoms which may

6
be mistaken for stroke. Fasting blood glucose is used to help in the diagnosis of diabetes which is
a risk factor for stroke [11, 18].
So, the Glycobiology (the study of study amounts in the human body) helps us to identify a
number of diseases.

Hypovolemia
It can be referred as the depletion of volume of the circulating blood plasma or we can also say
the state of decreased intravascular volume. However, this term should not be confused with
dehydration but can be said as most serious complications of it because it is due to the loss of
extracellular fluid. It is also known as oligemia. Loss of sugars (glucose) also contributes
towards it [19, 20]/
Causes
 Lack of salt and water can consequently cause hypovolemia.
 It can be resulted mistakenly from the surgery or trauma.
 Severe burns can damage blood vessels and bleeding (by various issues) also contributes
toward the hypovolemia.
 Ulcers may also cause the hypovolemia
[ 14].

Symptoms
 Nausea
 Quick, Shallow Breathing
 Low Blood Pressure
 Confusion or Wooziness
 Cool, Clammy Skin
Figure 10
Diagnosis
A person can normally lose 15% of the blood. But if it reaches to the level of 30% or 40%, it can
be fatal and blood pressure will lost and the person start breathing fast and feeling flustered.
In the hospitals, different tests such as ultrasound or CT scan are performed to check out the
level of blood [9, 19].
Treatment
So in the treatment to circulate the red blood cells, that provide oxygen to the body, plasma is
needed. For this purpose dextran is used [4, 15].
Figure 11
Dextran, that is a complex branched glucan
(polysaccharide derived from the condensation of
glucose). It can be defined as "Branched poly-α-d-
glucosides of microbial origin having glycosidic bonds
predominantly C-1 → C-6". Its chains are of different
lengths that ranges from 3 to 2000k Daltons. So it is
understood that the carbohydrates are clinically

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significant and their deficiencies cause various diseases. Dextrans are applied to the bodies of
these patients in the form of drips [8,20].

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