BIOCHEMISTRY

Competency 208.5.3: Myoglobin and Hemoglobin - The graduate constructs models of various states of hemoglobin, demonstrates how changes in the usual configuration of hemoglobin can lead to molecular disease, and distinguishes between the chemical structure and function of hemoglobin and myoglobin.

Competency 208.5.5: Carbohydrate Metabolism, Adenosine Triphosphate (ATP) - The graduate constructs models of carbohydrates and demonstrates metabolism of carbohydrates; and demonstrates how adenosine triphosphate (ATP) is essential to energy transfer in the cell and how irregularities in ATP synthesis in the cell can cause cytopathologies.

Competency 208.5.6: Lipids - The graduate constructs models of fatty acids and demonstrates why lipids are essential to the functioning of cells.

Introduction:

You are the lead nurse on a medical team caring for a patient who has been recently diagnosed with type 2 diabetes. One of the new nurses on the team is curious about the early prescription for metformin given by the attending physician and has asked for clarification to better understand the benefits and risks of this medication. Because you have a working knowledge of biochemical concepts as well as a good relationship with the new nurse, the physician has asked you to help the nurse understand the effects of metformin and why it is used as a treatment for type 2 diabetes.

Requirements:

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

Note: Download the attached " ZZP1 Tasks Spreadsheet" to your computer, then open the file. When the file opens, enter your name and student ID as they appear in Taskstream into the appropriate boxes so the assigned fatty acid for part B1 will populate in the worksheet. If the attached template does not open or is missing information, please contact Ecare ecare@wgu.edu for assistance with opening the file. WGU has partnered with Microsoft to offer Office for free for our students. Please click on this link and enter your WGU student email (use your @my.wgu.edu account) to find out eligibility: http://office.microsoft.com/en-us/office-in-education-FX104367920.aspx.

A. Demonstrate how the cell membrane is involved in type 2 diabetes by doing the following:

1. Create an original and clearly labeled illustration that compares a normal cell membrane to the cell membrane of a person with type 2 diabetes.

2. Explain how the difference between the cell membranes illustrated in part A1 contribute to the high blood sugar levels associated with type 2 diabetes.

B. Demonstrate the importance of both carbohydrate and fat metabolism in the development of potential complications in type 2 diabetes by doing the following:

1. Create an original diagram, with clear labels, that shows the full structure of the assigned fatty acid and which bond will be broken in the first round of beta oxidation.

2. Compare lactic acidosis and ketoacidosis by doing the following:

a. Describe how lactic acidosis and ketoacidosis affect blood pH levels and oxygen transport in the blood.

b. Beginning with glucose and a fatty acid, explain how the pathways involved in lactic acidosis and ketoacidosis lead to ATP synthesis, and the role of oxygen, if any, in each pathway.

c. Explain why metformin can impact the propensity for the development of lactic acidosis and ketoacidosis in type 2 diabetics, and how that relates to its effectiveness as a diabetic treatment.

C. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.