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1
00:00:02,870 --> 00:00:07,210
Categories of increased risk for diabetes ุจูŠู‚ู†ู‘ุง

2
00:00:07,210 --> 00:00:12,410
ุงู„ูุฆุงุช ุงู„ู„ูŠ ุงุญุชู…ุงู„ูŠุฉ ุงู„ุฅุตุงุจุฉ ุจูŠู‡ ุงู„ู€ diabetes

3
00:00:12,410 --> 00:00:18,710
ุนู†ุฏู‡ู… ุฃุนู„ู‰ ุฃูˆู„ ุดูŠุก ุจูŠู‚ู†ู‘ุง impaired glucose

4
00:00:18,710 --> 00:00:22,330
tolerance people who have blood glucose

5
00:00:22,330 --> 00:00:26,490
concentrations above normal but less than those

6
00:00:26,490 --> 00:00:33,290
required for diagnosis of diabetes malitusูˆู‡ุฐุง

7
00:00:33,290 --> 00:00:43,410
ุงู„ู„ูŠ .. ุงู„ู„ูŠ ู‡ูˆ ู…ุฑุชุจุท ุจู‚ูŠุงุณ ู„ู„ุฌู„ูˆูƒูˆุฒ ุนู† ุทุฑูŠู‚ ุงู„ู„ูŠ

8
00:00:43,410 --> 00:00:48,890
ู‡ูˆ ุงู„ู€ Oral Glucose Tolerance Test ูˆุนู†ุง

9
00:00:48,890 --> 00:00:55,650
ุงู„ู‚ูŠุงุณ ู„ุฌู„ูˆูƒูˆุฒ ุจุนุฏ ุณุงุนุชูŠู† ู…ู† ุฅุนุทุงุก ุงู„ู„ูŠ ู‡ูˆ ุงู„ุฌุฑุนุฉ

10
00:00:55,650 --> 00:01:01,580
ู„ุฌู„ูˆูƒูˆุฒ ุจูŠูƒูˆู† ุจูŠู† ู…ูŠุฉ ูˆุฃุฑุจุนูŠู† ุฅู„ู‰ ู…ูŠุฉ ุชุณุนุฉูˆ

11
00:01:01,580 --> 00:01:06,260
ุงู„ุชุณุนูŠู† ุทุจุนุง ุจู‡ุฐุง ุงู„ุญุงู„ุฉ ูŠุนู†ูŠ ู…ุง ู†ู‚ุฏุฑุด ู†ู‚ูˆู„ ุฃู† ู‡ุฐุง

12
00:01:06,260 --> 00:01:11,420
ุนู†ุฏู‡ diabetes mellitus ู„ุฃู† ุนุดุงู† ู†ู‚ูˆู„ ุฃู†ู‡ ุนู†ุฏู‡

13
00:01:11,420 --> 00:01:14,480
diabetes mellitus ุงู„ู…ูุฑูˆุถ ูŠูƒูˆู† ุงู„ glucose

14
00:01:14,480 --> 00:01:22,260
concentration ุฃูƒุชุฑ ู…ู† 200 ูˆ ุงู„ normal ุฃู‚ู„ ู…ู† 140

15
00:01:22,260 --> 00:01:28,990
ู„ุฃ ู‡ูˆ ู…ุน ุงู„ normal ูˆู„ุง ู‡ูˆู…ุน ุงู„ุฃุดุฎุงุต ุงู„ู„ูŠ ู…ุตุงุจูŠู†

16
00:01:28,990 --> 00:01:34,650
ุจุงู„ุณูƒุฑูŠุŒ ููŠ 140 ู„ 199 ู‡ุฐุง ุงู„ุดุฎุต ุจูŠูƒูˆู† ุนู†ุฏู‡ ู…ุง ูŠุณู…ู‰

17
00:01:34,650 --> 00:01:41,270
ุจุงู„ู€ Impaired Glucose Tolerance ุฃูˆ ุงู„ู„ูŠ ุจู†ุณู…ูŠู‡ู… ุฃูˆ

18
00:01:41,270 --> 00:01:46,010
ุจู†ุณู…ูŠ ุงู„ู…ุฑุญู„ุฉ ู‡ุฐู‡ ูŠุนู†ูŠ Pre-diabetes ุงู„ู„ูŠ ู‡ูŠ ู…ุฑุญู„ุฉ

19
00:01:46,010 --> 00:01:48,490
ู…ุง ู‚ุจู„ ุงู„ุณูƒุฑูŠ

20
00:01:53,340 --> 00:01:55,620
ู„ุชุฎู„ุต ู…ู† ุฌู„ูˆูƒูˆุฒ ุตุญูŠุญ ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ

21
00:01:55,620 --> 00:01:56,320
ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ

22
00:01:56,320 --> 00:02:02,000
ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ

23
00:02:02,000 --> 00:02:02,780
ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ

24
00:02:02,780 --> 00:02:07,560
ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ

25
00:02:07,560 --> 00:02:08,040
ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ

26
00:02:08,040 --> 00:02:08,300
ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ

27
00:02:08,300 --> 00:02:13,500
ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญ ุงู„ุตุญูŠุญุจุนุฏ ู‡ูŠูƒ

28
00:02:13,500 --> 00:02:16,160
ูŠุนู†ูŠ ุนุดุงู† ูŠุชุฌู†ุจูˆุง ุงุณุชุฎุฏุงู… ุงู„ู€ oral glucose

29
00:02:16,160 --> 00:02:21,260
tolerance test ุตุงุฑ ููŠ ุนู†ุฏู†ุง ุงู„ู„ูŠ ู‡ูˆ ุงู„ู„ูŠ ู‡ูŠ

30
00:02:21,260 --> 00:02:24,780
category ุฃูˆ ู…ุตุทู„ุญ ุขุฎุฑ ุงู„ู„ูŠ ูŠุณู…ู‰ impaired fasting

31
00:02:24,780 --> 00:02:29,540
glucose ูˆ

32
00:02:29,540 --> 00:02:35,540
ู‡ุฐู‡ ุชู… ุฅุถุงูุชู‡ุง ุทุจุนุง ุนู† ุทุฑูŠู‚ ุงู„ ADA ุงู„ American

33
00:02:35,540 --> 00:02:42,270
Wadiabeta Associationูˆู„ุงุญู‚ุงู‹ ุจุฑุถู‡ ุชู… ุฅุถุงูุชู‡ุง ู…ู†

34
00:02:42,270 --> 00:02:49,510
ุฎู„ุงู„ ุงู„ู€ WHO ููŠ ุงู„ุนุงู… ุชุณุนุฉ ูˆุชุณุนูŠู† ุงู„ู€

35
00:02:49,510 --> 00:02:52,310
impaired fasting glucose diagnosed by fasting

36
00:02:52,310 --> 00:02:55,590
glucose value between those of normal and diabetic

37
00:02:55,590 --> 00:03:01,330
individuals ูˆู‡ุง ุจุฑุถู‡ ู†ูุณ ุงู„ issueุงู„ู…ูุฑูˆุถ ุงู„ุดุฎุต

38
00:03:01,330 --> 00:03:05,110
ุทุจูŠุนูŠ ุฅุฐุง ูƒุงู† ุงู„ glucose ุนู†ุฏู‡ ุทุจุนุง ุงุญู†ุง ุจู†ุญูƒูŠ ุนู„ู‰

39
00:03:05,110 --> 00:03:10,910
glucose ู„ุดุฎุต ุตุงูŠู… ุงู„ glucose ุจุฏูŠ ูŠูƒูˆู† ุทุจูŠุนูŠ ุฅุฐุง

40
00:03:10,910 --> 00:03:16,410
ูƒุงู† ุฃู‚ู„ ู…ู† ู…ูŠุฉ ูˆ ุจุฏูŠ ูŠูƒูˆู† ุนู†ุฏู‡ diabetes ุฅุฐุง ูƒุงู† ุงู„

41
00:03:16,410 --> 00:03:21,030
concentration ุฃูƒุชุฑ ู…ู† 126 ูŠุจู‚ู‰ ุงู„ concentration

42
00:03:21,030 --> 00:03:27,800
ู‡ุงู† ุจูŠู† ู…ูŠุฉูˆุงู„ู€ 125 ู…ูŠู„ูŠ ุฌุฑุงู… per ุฏูŠุณู„ูŠุชุฑ ูˆุจุงู„ุชุงู„ูŠ

43
00:03:27,800 --> 00:03:32,580
ู„ุง ู‡ูˆ normal ูˆู„ุง ู‡ูˆ diabetic ุจุฑุถู‡ ู‡ุฐู‡ ุงู„ู…ุฑุญู„ุฉ ุงู„ู„ูŠ

44
00:03:32,580 --> 00:03:36,280
ู‡ูˆ ุจู†ุณู…ูŠู‡ุง pre-diabetes ุจู…ุฑุญู„ุฉ ุงู„ู€ pre-diabetes

45
00:03:36,280 --> 00:03:41,420
ู…ู…ูƒู† ุงู†ุดุฎุตู‡ุง ู…ู† ุฎู„ุงู„ ุงุณุชุฎุฏุงู… ุงู„ู€ Oral Glucose

46
00:03:41,420 --> 00:03:45,840
Tolerance Test ูˆุฒูŠ ู…ุง ู‚ู„ู†ุง ุงู„ู„ูŠ ู‡ูˆ ุจุนุฏ ุณุงุนุชูŠู†

47
00:03:45,840 --> 00:03:52,030
ุจุฏูŠูƒูˆู† ุนู†ุฏู†ุง ุงู„ concentration ุจูŠู† 140 ู„ 199ุฃูˆ ู…ู†

48
00:03:52,030 --> 00:03:58,590
ุฎู„ุงู„ ูุญุต ุงู„ุฌู„ูˆูƒูˆุฒ ู„ุดุฎุต ุตุงูŠู… ูˆุจุชูƒูˆู† ุงู„ู€

49
00:03:58,590 --> 00:04:05,910
concentration ุจูŠู† 100 ุฅู„ู‰ 125 ุทุจุนุง

50
00:04:05,910 --> 00:04:08,930
ู‡ุฐู‡ ุงู„ .. ุงู„ concentration ุงู„ู„ูŠ ู‡ูˆ 100 ุฅู„ู‰ 125

51
00:04:08,930 --> 00:04:14,770
ุจู†ุงุก ุนู„ู‰ ุงู„ American Diabetes Association ู„ูƒู†

52
00:04:14,770 --> 00:04:22,450
ุจุงู„ู†ุณุจุฉ ู„ู„ู€ WHO ุงู„ุฃุฑู‚ุงู… ู…ุฎุชู„ูุฉูˆุงู„ู€ WHO ุจุชุนุชุจุฑ ุฃู†ู‡

53
00:04:22,450 --> 00:04:30,710
ุงู„ cut-off value ู„ุงู„ .. ุงู„ู„ูŠ ู‡ูˆ ุงู„ normal 110 ูˆู…ุด

54
00:04:30,710 --> 00:04:36,810
100 ูˆุจุงู„ุชุงู„ูŠ ุฅุฐุง ูƒุงู† ุฃู† ุงู„ุดุฎุต ุงู„ concentration ู„ุงู„

55
00:04:36,810 --> 00:04:41,270
glucose ุงู„ fasting ุงู„ู„ูŠ ู‡ูˆ ุงู„ glucose ู…ู† 110 ู„125

56
00:04:42,940 --> 00:04:47,440
ุจู†ุงุก ุทุจุนุง ุนู„ู‰ ุงู„ู„ูŠ ู‡ูˆ ุงู„ WHO ูŠุจู‚ู‰ ุจู†ู‚ูˆู„ ุฃู† ู‡ุฐุง

57
00:04:47,440 --> 00:04:58,420
ุงู„ุดุฎุต ุนู†ุฏู‡ pre diabetes ููŠ

58
00:04:58,420 --> 00:05:04,880
2009 ุชู… ุฅุถุงูุฉ ุงู„ู„ูŠ ู‡ูˆ ูุญุต ุขุฎุฑ ุงู„ู„ูŠ

59
00:05:04,880 --> 00:05:09,280
ุงู„ู„ูŠ ู‡ูˆ ุจุฑุถู‡ ุงู„ detection of pre diabetes status

60
00:05:09,280 --> 00:05:11,660
ุงู„ู„ูŠ ู‡ูˆ ุงู„ hemoglobin A1C

61
00:05:14,730 --> 00:05:19,910
ุงู„ู†ุงุณ ู…ุน ู‚ูŠู…ุฉ Hemoglobin A1C ุชุญุช ู‚ุทุน 4 ุฏูŠุงุจุชุง ุงู„ู‰

62
00:05:19,910 --> 00:05:24,890
6.5 ูˆู„ูƒู† ุฃุนู„ู‰ ู…ู‚ุงุฑู†ุฉ ุงู„ุงู†ุชุฑุงู„ ู‡ู… ููŠ ุญุฑุต ุนุงู„ูŠ

63
00:05:24,890 --> 00:05:32,270
ู„ู„ุชุทูˆุฑ ู…ู† ุฏูŠุงุจุชุง ุฅุฐุง ูƒุงู† ุงู„ Hemoglobin A1C ุฃุนู„ู‰ ู…ู†

64
00:05:32,270 --> 00:05:38,070
6.5 ู…ุนู†ุงุชู‡ ู‡ุฐุง ุงู„ุดุฎุต ุฏูŠุงุจุงุชูŠูƒ

65
00:05:39,420 --> 00:05:45,840
ูˆุฅุฐุง ุฃู‚ู„ ู…ู† 5.7 normal ูŠุจู‚ู‰ ุฅุฐุง ูƒุงู† ูุญุตู†ุง ุงู„ู€

66
00:05:45,840 --> 00:05:50,860
hemoglobin A1C ูˆู„ุงุฌูŠู†ุงู‡ุง ุจูŠู† 5.7 ุนู„ู‰ 6.4 ูŠุจู‚ู‰ ุจุฑุถู‡

67
00:05:50,860 --> 00:05:56,020
ู‡ุฐุง ุงู„ู„ูŠ ู‡ูˆ ุงู„ุดุฎุต ุงู„ู„ูŠ ููŠ ู…ุฑุญู„ุฉ ุงู„ู€ pre-diabetes

68
00:05:56,020 --> 00:06:03,480
ูˆุนู†ุฏู‡ ุงู„ risk ุนุงู„ูŠ ู„ู„ุฅุตุงุจุฉ ุจุงู„ู€ diabetes ูŠุจู‚ู‰

69
00:06:03,480 --> 00:06:09,390
ุนู†ุฏู†ุง ุฃูƒุชุฑ ู…ู† ูุญุต ู…ู…ูƒู† ูŠุชู… ุงุณุชุฎุฏุงู…ู‡ู…ูˆ ู…ู…ูƒู† ู…ู†

70
00:06:09,390 --> 00:06:16,010
ุฎู„ุงู„ู‡ู… ู†ุญุฏุฏ ุงู„ู†ุงุณ ุงู„ู„ูŠ ูŠุนู†ูŠ ุฃูƒุชุฑ ุนุฑุถุฉ ุฃูˆ at higher

71
00:06:16,010 --> 00:06:22,250
risk ู„ู„ุฅุตุงุจุฉ ุจุงู„ู€ diabetes ุจุงู„ู†ุณุจุงู„ูŠ

72
00:06:22,250 --> 00:06:28,870
ุงู„ู‡ุฑู…ูˆู†ุงุช ุงู„ู„ูŠ ุจุชู†ุธู… ู…ุณุชูˆู‰ ุงู„ blood glucose ููŠ

73
00:06:28,870 --> 00:06:34,680
ุนู†ุฏู†ุง ู†ูˆุนูŠู† ู…ู† ุงู„ู‡ุฑู…ูˆู†ุงุช ููŠ ุนู†ุฏู†ุงุงู„ู€ Hypoglycemic

74
00:06:34,680 --> 00:06:41,360
Hormones ูˆููŠู†ุง ุงู„ู€ Hyperglycemic Hormones ุงู„ู€

75
00:06:41,360 --> 00:06:45,680
Hypoglycemic Hormones ุทุจุนุง ุฅู†ู‡ุง ู‡ุฑู…ูˆู† ูˆุญูŠุฏ ู‡ูˆ ุงู„ู€

76
00:06:45,680 --> 00:06:50,620
Insulin ุจู‡ุฐุง ุงู„ู‡ุฑู…ูˆู† ุงู„ูˆุญูŠุฏ ุงู„ู„ูŠ ุจูŠุนู…ู„ ุนู„ู‰ ุชุฎููŠุฏ

77
00:06:50,620 --> 00:06:55,740
ู…ุณุชูˆู‰ ุงู„ุฌู„ูˆูƒูˆุฒ ููŠ ุงู„ุฏู… ุจูŠู†ู…ุง ุงู„ู€ Hyperglycemic

78
00:06:55,740 --> 00:07:02,610
Hormones ุฅู†ู‡ุง ู‡ุฑู…ูˆู†ุงุช ุนุฏูŠุฏุฉ ุจุชุนู…ู„ ุนู„ู‰ ุฑูุนู…ุณุชูˆู‰

79
00:07:02,610 --> 00:07:08,410
ุงู„ุฌู„ูˆูƒูˆุฒ ููŠ ุงู„ุฏู… ุฒูŠ ุนู†ุฏู†ุง ุทุจุนุง ุงู„ glucagon ุงู„

80
00:07:08,410 --> 00:07:13,990
epinephrine ุนู†ุฏู†ุง ุงู„ growth hormone ุงู„ cortisol

81
00:07:13,990 --> 00:07:19,550
ุจูŠุงุฏุฉ ูƒู„ู‡ุง ู‡ุฑู…ูˆู†ุงุช ุจุชุนู…ู„ ุนู„ู‰ ุฒูŠุงุฏุฉ ู…ุณุชูˆู‰ ุงู„ุฌู„ูˆูƒูˆุฒ

82
00:07:19,550 --> 00:07:21,190
ููŠ ุงู„ุฏู…

83
00:07:30,410 --> 00:07:37,970
Normal glucose disposal depends on ูŠุจู‚ู‰ ุนุดุงู† ุงู„ ..

84
00:07:37,970 --> 00:07:44,890
ุงู„ glucose ุงู„ู„ูŠ ุจูŠุฏุฎู„ู‡ ุงู„ุฏู… ุนุดุงู† ู†ู‚ุฏุฑ ู†ุฎูุถู‡ ูŠุจู‚ู‰

85
00:07:44,890 --> 00:07:51,090
ู„ุงุจุฏ ุงู†ู‡ ูŠูƒูˆู† ุนู†ุฏู†ุง ุงู„ุฃู…ูˆุฑ ุงู„ุชุงู„ูŠุฉ ุงู„ุฃู…ุฑ ุงู„ุฃูˆู„ the

86
00:07:51,090 --> 00:07:55,250
ability of the pancreas to secrete insulin ูŠุจู‚ู‰

87
00:07:55,250 --> 00:07:58,090
ู„ุงุฒู… ูŠูƒูˆู† ููŠู‡ ู‚ุฏุฑุฉ ู„ู‚ู‰ ุงู„ pancreas ุทุจุนุง ุนู„ู‰ ุฅูุฑุงุฒ

88
00:07:58,090 --> 00:08:02,540
ุงู„ insulinูˆุงู„ู†ู‚ุทุฉ ุงู„ุชุงู†ูŠุฉ ability of insulin to

89
00:08:02,540 --> 00:08:06,100
promote uptake of glucose into peripheral tissue

90
00:08:06,100 --> 00:08:11,000
ูŠุจู‚ู‰ ุงู„ู†ู‚ุทุฉ ุงู„ุชุงู†ูŠุฉ ุงู„ู„ูŠ ู‡ูˆ ุงู†ู‡ ุงู„ insulin action

91
00:08:11,000 --> 00:08:17,260
ูŠุฑุชุจุท ุงู„ insulin ู…ุน ุงู„ุฎู„ุงูŠุง ูˆูุนู„ูŠุง ูŠุนู…ู„ ุนู„ู‰ ุฏุฎูˆู„

92
00:08:17,260 --> 00:08:23,320
ุงู„ glucose ู„ู„ุฎู„ุงูŠุง ุงู„ู…ุฎุชู„ูุฉ ูˆุงู„ู†ู‚ุทุฉ ุงู„ุชุงู„ุชุฉ the

93
00:08:23,320 --> 00:08:26,060
ability of insulin to suppress hepatic glucose

94
00:08:26,060 --> 00:08:32,080
production ูŠุจู‚ู‰ ุจุฑุถู‡ุจุฏู†ุงุด ูŠุนู†ูŠ ุฒูŠ ู„ุฃู† ุงู„ุฌู„ูˆูƒูˆุฒ

95
00:08:32,080 --> 00:08:37,440
ุนุงู„ูŠ ุจูŠุจุฏู†ุงู‡ ูŠุชูˆู‚ู ุงู„ูƒุจุฏ ุนู† ุฅู†ุชุงุฌ ุงู„ุฌู„ูˆูƒูˆุฒ ุจูŠุจู‚ู‰

96
00:08:37,440 --> 00:08:41,780
ุจุฑุถู‡ ู‡ุฐุง ุจูŠุชู… ุงู„ู„ูŠ ู‡ูˆ ุชุญุช ุชุฃุซูŠุฑ ุงู„ุงู†ุณูˆู„ูŠู† ุงู„ู„ูŠ

97
00:08:41,780 --> 00:08:49,440
ุจูŠุนู…ู„ suppression ู„ุฎุฑูˆุฌ ุงู„ุฌู„ูˆูƒูˆุฒ ู…ู† ุงู„ูƒุจุฏ the

98
00:08:49,440 --> 00:08:52,200
major insulin target organs are liver, skeletal

99
00:08:52,200 --> 00:08:55,500
muscle and adipose tissue ุจูŠู‡ุฏูŠ ุงู„ tissues

100
00:08:55,500 --> 00:09:01,100
ุงู„ู…ุฎุชู„ูุฉ ุงู„ู„ูŠ ุจูŠุดุชุบู„ ุนู„ูŠู‡ุงmainly ุงู„ insulin these

101
00:09:01,100 --> 00:09:03,680
organs is exhibit some differences in their

102
00:09:03,680 --> 00:09:08,500
response to insulin ูŠุจู‚ู‰ ุงู„ุชู„ุงุชุฉ ุจูŠุณุชุฌูŠุจูˆุง ู„ุงู„

103
00:09:08,500 --> 00:09:14,760
insulin ู„ูƒู† ุงู„ุงุณุชุฌุงุจุฉ ู…ุด ู…ุชุดุงุจู‡ุฉ ูŠุจู‚ู‰ ููŠู‡ ุงู†ู‡ ุจุนุถ

104
00:09:14,760 --> 00:09:19,780
ุงู„ุงุฎุชู„ุงู ููŠ ุงู„ุงุณุชุฌุงุจุฉ ู„ุงู„ tissuesุงู„ู…ุฎุชู„ูุฉ for

105
00:09:19,780 --> 00:09:23,120
example the hormone stimulates glucose uptake

106
00:09:23,120 --> 00:09:26,160
through a specific glucose transporter ุงู„ู„ูŠ ู‡ูˆ

107
00:09:26,160 --> 00:09:32,040
glut4 into muscle and fat cells but not into liver

108
00:09:32,040 --> 00:09:37,640
cells ูŠุจู‚ู‰ ุงู„ glucose transporters ู…ู…ูƒู† ูŠุฎุชู„ู ู…ู†

109
00:09:37,640 --> 00:09:43,480
tissue ุฅู„ู‰ ุขุฎุฑ ุจูŠู†ู…ุง

110
00:09:43,480 --> 00:09:46,540
ููŠ ุงู„ liver ุชุญุชุงุฌ ุฅู„ู‰ transporter ุขุฎุฑ ุงู„ู„ูŠ ู‡ูˆ

111
00:09:46,540 --> 00:09:47,800
glut2

112
00:09:49,830 --> 00:09:55,790
ุทูŠุจ ู†ุญูƒูŠ ุดูˆูŠุฉ ุนู† ุงู„ hormone ุงู„ุงู†ุณูˆู„ูŠู† ูˆ ุนู† ุงู„

113
00:09:55,790 --> 00:10:02,130
synthesis ูˆ ุงู„ degradation ู„ู‡ุฐุง ุงู„ hormone ุนุจุงุฑุฉ

114
00:10:02,130 --> 00:10:08,090
ุนู† ุฎู…ุณ ุชู„ุงู ูˆ ุชู…ุงู†ูŠุฉ ูˆ ุชู…ุงู†ูŠุฉ ุฏุงู„ุชูˆู† ุจุฑูˆุชูŠู† ุจุชูƒูˆู†

115
00:10:08,090 --> 00:10:13,530
ู…ู† ูˆุงุญุฏ ูˆ ุฎู…ุณูŠู† amino acid ูˆ ุจุชูƒูˆู† ู…ู† two chains

116
00:10:13,530 --> 00:10:21,960
ุงู† ุงู„ chain Aุจุงู„ุฃุญู…ุฑ ูˆู‡ูŠ ุนู†ุฏู†ุง ุงู„ chain B ูˆู‡ุฏูˆู„ ุงู„

117
00:10:21,960 --> 00:10:25,960
two chains ู…ุฑุชุจุทูŠู† ู…ุน ุจุนุถู‡ู… ุงู„ุจุนุถ ุงู„ู„ูŠ ู‡ูˆ ุนู† ุทุฑูŠู‚

118
00:10:25,960 --> 00:10:33,800
disulfide bridge ุจุงู„ู†ุณุจุงู„ูŠ

119
00:10:33,800 --> 00:10:40,010
ุงู„ insulin ุงู„ู„ูŠ ู…ูˆุฌูˆุฏ ุนู†ุฏ ุงู„ุฅู†ุณุงู†ุงู„ู€ amino acid

120
00:10:40,010 --> 00:10:43,910
sequence ู„ุงู„ู€ human insulin differs slightly from

121
00:10:43,910 --> 00:10:50,270
insulin of other species ููŠู†ุง ุงุฎุชู„ุงู ููŠ ู„ูˆุจุงุท ุงู„

122
00:10:50,270 --> 00:10:58,270
amino acids ู„ูƒู† ููŠู†ุง ู…ู†ุงุทู‚ ู…ุชุดุงุจู‡ุฉ ุจุงู„ุงู†ุณูˆู„ูŠู† ุณูˆุงุก

123
00:10:58,270 --> 00:11:03,340
ุงู„ู…ูˆุฌูˆุฏ ุจุงู„ุฅู†ุณุงู† ุฃูˆ ุงู„ู…ูˆุฌูˆุฏ ููŠุงู„ู„ูŠ ู‡ูˆ other

124
00:11:03,340 --> 00:11:07,600
species the carboxyl terminal region of the B

125
00:11:07,600 --> 00:11:16,200
chain ุงู„ู„ูŠ ู‡ูŠ ุงู„ู…ู†ุทู‚ุฉ ู…ู† B23 ู„ B26 ู‡ุฐู‡ appears

126
00:11:16,200 --> 00:11:20,420
crucial for the biological action of insulin ูˆู…ู‡ู…ุฉ

127
00:11:20,420 --> 00:11:24,120
ุงู„ุนู…ู„ ู„ู„ุฅู†ุณู„ูŠู† ูˆุจุงู„ุชุงู„ูŠ ู‡ุฐู‡ ุงู„ู…ู†ุทู‚ุฉ highly

128
00:11:24,120 --> 00:11:29,960
conserved among species ูŠุจู‚ู‰ ูŠุนู†ูŠ ุชู… ุงู„ู„ูŠ ู‡ูˆ

129
00:11:29,960 --> 00:11:35,390
ุงู„ู…ุญุงูุธุฉ ุนู„ูŠู‡ุง ูˆู…ุชุดุงุจู‡ุฉููŠ ุงู„ุงู†ุณู„ูŠู† ุงู„ู…ูˆุฌูˆุฏ ููŠ ุงู„

130
00:11:35,390 --> 00:11:40,990
different species ุจู†ุณุจุงู„ู‡ุง

131
00:11:40,990 --> 00:11:44,950
ุงู„ุงู†ุณู„ูŠู† senses ุงู†ุณู„ูŠู† from most animals is

132
00:11:44,950 --> 00:11:49,610
immunologically and biologically similar to human

133
00:11:49,610 --> 00:11:53,970
insulin and in the past patients were treated with

134
00:11:53,970 --> 00:12:00,270
insulin purified from beef or pig cancersู„ุฃู† ุฒูŠ ู…ุง

135
00:12:00,270 --> 00:12:05,770
ู‚ู„ู†ุง ุฅู† ููŠ ู…ู†ุทู‚ุฉ ุงู„ู„ูŠ ู‡ูŠ conserved ูˆูŠุนู†ูŠ

136
00:12:05,770 --> 00:12:09,910
ุจุงู„ุชุงู„ูŠ ุงู„ู…ู†ุทู‚ุฉ ู‡ุฐู‡ ู…ูˆุฌูˆุฏุฉ ุจุงู„ different species

137
00:12:09,910 --> 00:12:14,550
ูˆุจุงู„ุชุงู„ูŠ ุชู… ุงุณุชุฎุฏุงู… insulin ุจูŠู†ุชุฌ ู…ู† ุญูŠูˆุงู†ุงุช ุฒูŠ

138
00:12:14,550 --> 00:12:18,490
ุงู„ู„ูŠ ู‡ูˆ ุงู„ุฃุจู‚ุงุฑ ุฃูˆ ุงู„ู„ูŠ ู‡ูˆ ุงู„ุนุฌูˆู„ ุฃูˆ ุงู„ุฎู†ุฒูŠุฑ

139
00:12:18,490 --> 00:12:24,570
ู„ู…ุนุงู„ุฌุฉ ุฃูˆ ู„ู„ุญุตูˆู„ ุนู„ู‰ insulin ู„ู…ุนุงู„ุฌุฉ ุงู„ู…ุฑุถู‰ ู„ูƒู†

140
00:12:24,570 --> 00:12:29,120
ุงู„ุขู† ุทุจุนุง ุจูŠุชู… ุงู„ู„ูŠ ู‡ูˆ ุฅู†ุชุงุฌุงู„ุงู†ุณูˆู„ูŠู† ุงู„ู„ูŠ ู‡ูˆ ู…ู†

141
00:12:29,120 --> 00:12:34,600
ุฎู„ุงู„ ุงู„ .. ุงู„ู„ูŠ ู‡ูˆ ุงู„ .. ุงู„ recomponent ุงู„ู„ูŠ ู‡ูˆ

142
00:12:34,600 --> 00:12:38,880
DNA techniques ู‡ูŠุจู‚ู‰ ุนู†ุฏู†ุง ุงู„ู„ูŠ .. ุงู„ู„ูŠ ู…ูˆุฌูˆุฏ ุงู„ู„ูŠ

143
00:12:38,880 --> 00:12:46,540
ู‡ูˆ recomponent human insulin ุฃูˆู„

144
00:12:46,540 --> 00:12:54,580
ู…ู†ุชุฌ ุจูŠุชู… ุงู„ุญุตูˆู„ ุนู„ูŠู‡ ุฃูˆ ุฃูˆู„ protein ุจูŠุชู… ุงู„ุญุตูˆู„

145
00:12:54,580 --> 00:13:00,770
ุนู„ูŠู‡ ู‡ูˆ ุงู„ pre pro insulinุฅุจุงุฑุฉ ุนู† ุจุฑูˆุชูŠู† ุจุชูƒูˆู† ู…ู†

146
00:13:00,770 --> 00:13:05,250
meat amino acid formed by ribosomes in the rough

147
00:13:05,250 --> 00:13:09,730
endoplasmic reticulum of the pancreatic beta cells

148
00:13:09,730 --> 00:13:12,870
pre

149
00:13:12,870 --> 00:13:16,570
-proinsulin is not detectable in the circulation

150
00:13:16,570 --> 00:13:23,390
ู„ูˆ ุจุญุซุช ุนู† ุงู„ pre-proinsulin ู…ุด ู‡ู†ู„ุงู‚ูŠู‡ ู…ูˆุฌูˆุฏ

151
00:13:23,390 --> 00:13:30,080
ุจุงู„circulation ุจุธุฑูˆู ุงู„ุทุจูŠุนูŠุฉ ู„ุฃู†ู‡ู…ุจุงุดุฑุฉ ูˆุจุดูƒู„

152
00:13:30,080 --> 00:13:37,560
ุณุฑูŠุน ุจูŠุตูŠุฑู„ู‡ Eclivage ูˆุจูŠุชุญูˆู„ ุฅู„ู‰ Proinsulin ุงู„ู„ูŠ

153
00:13:37,560 --> 00:13:43,560
ุนุจุงุฑุฉ ุนู† ุจุฑูˆุชูŠู† ุจุชูƒูˆู† ู…ู† ุณุชุฉ ูˆ ุชู…ุงู†ูŠู† amino acid

154
00:13:43,560 --> 00:13:47,740
ูŠุนู†ูŠ ุฃูˆู„ ุจุฑูˆุชูŠู† ุจูŠู†ุชุฌ ู…ู† ุงู„ pre-proinsulin ู…ูŠุช

155
00:13:47,740 --> 00:13:56,690
amino acidู…ุจุงุดุฑุฉ ููŠ ุณู„ู‘ู‡ cleavage ุงู„ู„ูŠ ู‡ูˆ ุจูŠุชู… ู‚ุทุน

156
00:13:56,690 --> 00:14:00,570
ุฃุฑุจุนุฉ ุนุดุฑ amino acid ูˆุจูŠุนุทูŠู†ูŠ ุจุฑูˆุงู†ุณูˆู„ูŠู† ุงู„ู„ูŠ ู‡ูˆ

157
00:14:00,570 --> 00:14:04,850
ุนุจุงุฑุฉ ุนู† ุณุชุฉ ูˆ ุชู…ุงู†ูŠู† amino acid ุจุงู„ุฑูˆุชูŠู†

158
00:14:08,440 --> 00:14:13,600
ู‡ุฐุง ู…ู‚ูู„ ููŠ ู…ุฌุฒุฑุงุช ู…ุฎุตุตุฉ ููŠ ู…ุฌู„ุณ ุงู„ุฌูŠูˆู„ูˆุฌูŠุง ู„ู€

159
00:14:13,600 --> 00:14:17,980
Beta-cells ุญูŠุซ ูŠุญุฏุซ ุชู†ู‚ู„ ุงู„ุจุฑูˆุชุฑุงุชูŠูƒูŠ ู„ุงู„ุฅู†ุณู„ูŠู†

160
00:14:17,980 --> 00:14:24,290
ูˆู…ุดุงุฑูƒุฉ ุจูŠุจุชุงูŠุฏุทุจุนุง ุฃูŠ ุดูŠุก ุจุฏู‡ ูŠุชู… .. ุจุฏู‡ ูŠุตู„ู„ู‡

161
00:14:24,290 --> 00:14:32,510
secretion ู…ู† ุงู„ุฎู„ุงูŠุง ูŠุจู‚ู‰ ุงู„ู…ูุฑูˆุถ ุฃู†ู‡ ุทุจุนุง ุจุจุฏุฃ ..

162
00:14:32,510 --> 00:14:36,450
ุจุฏุงูŠุฉ ุจูŠุตู„ู‡ translation ู…ู† ุฎู„ุงู„ ุงู„ .. ุงู„ rough

163
00:14:36,450 --> 00:14:43,230
endoplasmic reticulum ูˆ ู‡ุฐุง ุงู„ protein ุจูŠูƒูˆู† ู…ูˆุฌูˆุฏ

164
00:14:43,230 --> 00:14:46,950
ููŠ ุฏุงุฎู„ physical ูˆ ุงู„ physical ุฐุงุชูŠ ุจุชุชุฌู‡ ู„ ุงู„

165
00:14:46,950 --> 00:14:52,320
geology ุงู„ู„ูŠ ู‡ูˆ complex ูˆู‡ู†ุงูƒ ุงู„ู„ูŠ ู‡ูˆ ุจูŠุตูŠุฑ ููŠ ุนู†ุง

166
00:14:52,320 --> 00:14:57,080
modification ู„ู‡ุฐู‡ ุงู„ุจุฑูˆุชูŠู†ุงุช ูˆุจุนุฏูŠู† ุจูŠุตูŠุฑ release

167
00:14:57,080 --> 00:15:03,660
ู„ู‡ุฐู‡ ุงู„ proteins ููŠ ุฏุงุฎู„ vesicles ุนุดุงู† ุจุนุฏ ู‡ูŠูƒ

168
00:15:03,660 --> 00:15:08,540
ูŠุตู„ู‡ุง ุงู„ู„ูŠ ู‡ูˆ execution ุฅู„ู‰ ุฎุงุฑุฌ ุงู„ุฎู„ูŠุฉ

169
00:15:11,740 --> 00:15:16,060
ูŠุจู‚ู‰ ุนุดุงู† ู†ุญุตู„ ุนู„ู‰ ุงู„ู€ Insulin ู„ุงุจุฏ ุฃู† ู†ุตูŠุฑ ุนู†ุฏู†ุง

170
00:15:16,060 --> 00:15:24,260
Eclavage ู„ู€ C-Peptide ูˆู‡ุฐุง ุงู„ู€ Eclavage ุจูŠุชู… ู…ู†

171
00:15:24,260 --> 00:15:30,900
ุฎู„ุงู„ enzymes ุงู„ู„ูŠ ูŠุชุณู…ู‰ Pro-Hormone Convertases I

172
00:15:30,900 --> 00:15:37,880
and IIุนุจุงุฑุฉ ุนู† Endopeptidases ูŠุจู‚ู‰ ุจูŠู‚ุทุนูˆุง ููŠ ุงู„ู„ูŠ

173
00:15:37,880 --> 00:15:45,160
ู‡ูˆ ุฏุงุฎู„ ุงู„ุจุฑูˆุชูŠู† ูˆุจูŠุนู…ู„ูˆุง ู‚ุทุน ู„ู€ C-peptide ุนุดุงู†

174
00:15:45,160 --> 00:15:53,160
ู†ุญุตู„ ุนู„ู‰ ุงู„ุงู†ุณู„ูŠู† ูŠุจู‚ู‰ ุฃู† ุงู„ enzyme pro hormone

175
00:15:53,160 --> 00:16:00,420
convertase I ุจูŠุฌูŠ ูˆุจูŠุฑุชุจุท ุนู„ู‰ ุงู„ู€ C-terminal end

176
00:16:00,420 --> 00:16:12,040
ุงู„ุงู†ุฏ ุงู„ู„ูŠ ู‡ูˆ RGN 31 ูˆRGN 32ูˆุจูŠุนู…ู„ ู‚ุทุน ุจูŠู†

177
00:16:12,040 --> 00:16:20,380
ุงู„ู€ amino acid ุฑู‚ู… 32 ูˆ33 ูˆุจูŠุนุทูŠู†ุง

178
00:16:20,380 --> 00:16:28,680
ู„ู‡ split 32 33 Pro-insulin ุนู†ุฏู†ุง

179
00:16:28,680 --> 00:16:30,880
ุงู„ู€ enzyme ุงู„ุฃุฎุฑ ุงู„ู„ูŠ ู‡ูˆ ุงู„ู€ Pro-hormone

180
00:16:30,880 --> 00:16:35,510
converterase-2ุจูŠุนู…ู„ cleavage ููŠ ู…ูƒุงู† ุขุฎุฑ Cleaves

181
00:16:35,510 --> 00:16:39,210
Pro Insulin on the c-terminal side of the basic

182
00:16:39,210 --> 00:16:45,810
residues Lysine 64 ูˆArginine 65 to generate split

183
00:16:45,810 --> 00:16:52,230
65 and 66 Pro Insulin ูŠุฌุจ ูŠู‚ุทุน ุจูŠู† ุงู„ amino acid

184
00:16:52,230 --> 00:16:55,790
65 ูˆ ุงู„ amino acid 66

185
00:16:59,890 --> 00:17:07,630
ุจุนุฏ ู…ุง ุจุชุชู… ุนู…ู„ูŠุฉ ุงู„ู‚ุทุน ุจูŠุตูŠุฑ ููŠู‡ removal ู„ู€ two

186
00:17:07,630 --> 00:17:15,330
exposed amino acids removal of two newly exposed C

187
00:17:15,330 --> 00:17:21,410
-terminal basic amino acids ูˆุงู„ู„ูŠ ุจูŠุนู…ู„ ุงู„ removal

188
00:17:21,410 --> 00:17:26,270
ู„ู‡ุฐู‡ ุงู„ amino acids ุงู†ุฒุงูŠู… ูŠุณู…ู‰ Carboxypeptidase-H

189
00:17:28,560 --> 00:17:34,240
ูˆุจุนุฏู…ุง ุชุชู… ุนู…ู„ูŠุฉ ุงู„ู‚ุทุน ูˆุนู…ู„ูŠุฉ ุงู„ู€ removal ู„ู€ ุงู„ู€

190
00:17:34,240 --> 00:17:39,920
two amino acids ู‡ุฐู‡ ุจูŠู†ุชุฌ ุนู†ุฏู†ุง ุงู„ู€ Insulin ูˆ ุงู„ู€

191
00:17:39,920 --> 00:17:46,300
C-peptide ูŠุจู‚ู‰

192
00:17:46,300 --> 00:17:50,380
ุฒูŠ ู…ุง ู‡ูˆ ูˆุงุถุญ ุนู†ุฏู†ุง ุจุงู„ figure ู‡ุงู† ู‡ุงู† ุงู„ู„ูŠ ู‡ูˆ ุงู„ู€

193
00:17:50,380 --> 00:17:54,720
Pro-insulin ู‡ุงู† ุนู†ุฏู†ุง ุงู„ู„ูŠ ู‡ูˆ ุงู„ู€ A-chain ูˆ ุงู„ู€ B

194
00:17:54,720 --> 00:17:56,500
-chain ูˆ ู‡ุงู† ุงู„ู€ C-peptide

195
00:18:02,900 --> 00:18:08,600
ูˆ ุนุดุงู† ู†ุญุตู„ ุนู„ู‰ ุงู„ insulin ู„ุงุจุฏ ู…ู† ู‚ุทุน ุงู„ C

196
00:18:08,600 --> 00:18:14,720
-peptide ุฒู‰ ู…ุง ู‚ูˆู„ู†ุง ุฃู†ู‡ ููŠ ุนู†ุฏู†ุง two enzymes ููŠ

197
00:18:14,720 --> 00:18:21,640
ุนู†ุฏู†ุง ุงู„ P-C-I ู‡ุฐุง ุจูŠู‚ุทุน ุจูŠู† ุงู„ุนู…ูŠู†ุง ุฃุณู„ 32 ูˆ 33

198
00:18:21,640 --> 00:18:28,160
ุฒู‰ ู…ุง ู‡ูˆ ูˆุงุถุญ ู‡ุงู† ุชู…ุงู… ุจูŠุจู‚ู‰ ุจูŠุตูŠุฑ ุนู†ุฏู†ุง ู‚ุทุน ู‡ุงู†

199
00:18:29,070 --> 00:18:34,310
ูˆุนู†ุง ุงู„ุงู†ุฒูŠู… ุงู„ุฃุฎุฑ ุงู„ู„ูŠ ู‡ูˆ ุงู„ PC2 ุจูŠู‚ุทุน ุจูŠู† ุงู„ู„ูŠ

200
00:18:34,310 --> 00:18:45,850
ู‡ูˆ ุฎู…ุณุฉ ูˆุณุชูŠู† ูˆุณุชุฉ ูˆุณุชูŠู† ุชู…ุงู…

201
00:18:45,850 --> 00:18:52,950
ูŠุจู‚ู‰ PC1 ุจูŠู‚ุทุน ุจูŠู† 32 ูˆ33 ูˆุจู†ุญุตู„

202
00:18:52,950 --> 00:18:57,780
ุนู„ู‰ ุงู„ู„ูŠ ู‡ูˆ split 32 ูˆ33 Proinsulinุจุนุฏ ู‡ูŠูƒ ุนู†ุฏู†ุง

203
00:18:57,780 --> 00:19:02,900
ุงู„ enzyme ุงู„ CBH ุฒู…ูˆู„ู†ุง ุจูŠุนู…ู„ removal ู„ ุงู„ two

204
00:19:02,900 --> 00:19:10,620
amino acids ูˆ ุจู†ุญุตู„ ุนู„ู‰ this 3130-t-pro-insulin ูˆ

205
00:19:10,620 --> 00:19:18,560
ุนู†ุฏู†ุง ุจุนุฏ ู‡ูŠูƒ ุงู„ enzyme ุงู„ุงุฎุฑ ุงู„ู„ูŠ ุจูŠุนู…ู„ ู‚ุทุน ู„ ุงู„

206
00:19:18,560 --> 00:19:22,560
.. ุงู„ู„ูŠ ู‡ูˆ ุงู„ .. ุงู„ c-peptide ู…ู† ุงู„ู†ุงุญูŠุฉ ุงู„ุฃุฎุฑู‰

207
00:19:22,560 --> 00:19:28,570
ุงู„ู„ูŠ ุจูŠู‚ุทุน ุจูŠู† ุงุฑุจุนุฉ ูˆ ุณุชุฉ .. ุจูŠู†ุจูŠู† 64 ูˆ 65 ูˆ

208
00:19:28,570 --> 00:19:32,030
ุจุนุฏูŠู† ุจูŠุตูŠุฑ ุจุฑุถู‡ ุนู†ุฏู†ุง ุนู† ุทุฑูŠู‚ ุงู„ ูˆ CpH ุจูŠุตูŠุฑ

209
00:19:32,030 --> 00:19:39,800
removal ู„ ุงู„ู„ูŠ ู‡ูˆ ุงู„ two amino acidsููŠ ุนู†ุฏู†ุง two

210
00:19:39,800 --> 00:19:44,220
pathways ู„ู‡ุฐู‡ ุงู„ุนู…ู„ูŠุฉ ุนู†ุฏู†ุง ุงู„ู€ major pathway ุงู„ู„ูŠ

211
00:19:44,220 --> 00:19:52,180
ุจุชุชู… ุงู„ู„ูŠ ู‡ูˆ ุจุฏุงูŠุฉ ุงู„ู„ูŠ ู‚ุทุน ุงู„ู€ PC1 ุจูŠู† ุงู„ู€ amino

212
00:19:52,180 --> 00:19:57,700
acids 32 ูˆ33 ุฃูˆ 30 ูˆ ุจุชุชูƒู…ู„ ุงู„ุนู…ู„ูŠุฉ ูˆููŠ ุนู†ุฏู†ุง ุงู„

213
00:19:57,700 --> 00:20:05,140
minor pathway ุงู„ู„ูŠ ู‡ูˆ ุจูŠุจุฏุฃ ุงู„ู‚ุทุน ุจุงู„ู€ PC2 ูˆ ุจูŠุตูŠุฑ

214
00:20:05,140 --> 00:20:09,470
ุจุนุฏ ุฐู„ูƒ removal ู„ู„ู€ twoุฃู…ูŠู†ูˆ ุฃุณูŠุฏ ูˆ ุจุนุฏูŠู† ุจูŠุตูŠุฑ

215
00:20:09,470 --> 00:20:14,410
ุนู†ุฏู†ุง ู‚ุทุน ู…ุฑุฉ ุฃุฎุฑู‰ ุจ ุงู„ PC-1 ูˆ removal ุงู„ two

216
00:20:14,410 --> 00:20:20,410
amino acids ุนู† ุทุฑูŠู‚ ุงู„ ูˆุงุณูŠ pH ูˆ ุจู†ุญุตู„ ุจุงู„ู†ู‡ุงูŠุฉ

217
00:20:20,410 --> 00:20:29,050
ุนู„ู‰ ุงู†ุณูˆู„ูŠู† ูˆ ุนู„ู‰ ุงู„ C-peptide ู…ู†

218
00:20:29,050 --> 00:20:37,080
ุฎู„ุงู„ ุงู„ุฃุจุญุงุซู„ุฌูˆุง ุงู†ู‡ ู„ูˆ ุตุงุฑ ููŠ incubation ู„ู€

219
00:20:37,080 --> 00:20:43,960
Proinsulin ู…ุน ุงู„ BC-1 ูู‚ุท ู„ุฌูˆุง ุงู†ู‡ ุงู„ BC-1 ูุนู„ูŠุง

220
00:20:43,960 --> 00:20:49,620
ุจูŠุนู…ู„ ุงู„ู‚ุทุนูŠู† ุงู„ู…ุทู„ูˆุจูŠู† ุชู…ุงู… ุจูŠุนู…ู„ ุงู„ู‚ุทุน ุงู„ู„ูŠ ู‡ูˆ

221
00:20:49,620 --> 00:20:58,290
ุจูŠู†32 ูˆ ุจูŠู† 33 ูˆ ุจูŠู† ุงู„ู€ 65 ูˆ ุจูŠู† ุงู„ู„ูŠ ู‡ูˆ ุงู„ู€ 66

222
00:20:58,290 --> 00:21:03,790
ูŠุจู‚ู‰ ุงู„ู€ BC1 ู‚ุงุฏุฑ ุนู„ู‰ ุฃู†ู‡ ูŠู‚ุทุน ููŠ ู‡ุฏูˆู„ ุงู„ู…ู†ุทู‚ุชูŠู†

223
00:21:03,790 --> 00:21:15,490
ุจูŠู†ู…ุง ุงู„ู€ BC2 ู„ุฌูˆุง ุฃู†ู‡ ุจูŠู‚ุทุน ูู‚ุท ููŠ ู‡ุฐู‡ ุงู„ู…ู†ุทู‚ุฉ ุฒูŠ

224
00:21:15,490 --> 00:21:18,450
ู…ุง ุฐูƒุฑู†ุง ููŠ ุงู„ู€ slider ุงู„ุณุงุจู‚ุฉ ุฃู†ู‡ ููŠ ุนู†ุฏู†ุง ุงู„ู„ูŠ

225
00:21:18,450 --> 00:21:19,590
ู‡ูˆ ุงู„ู€ minor pathway

226
00:21:22,170 --> 00:21:26,510
ูˆุฅู†ู‡ less than 10% of pro-insulin is metabolized

227
00:21:26,510 --> 00:21:32,590
via this 6465 pro-insulin which is present in

228
00:21:32,590 --> 00:21:37,250
negligible amounts in humans ุงู„ู…ู‡ู… ูŠุง ุฏูŠ ุงู„ู„ูŠ ู‡ูˆ

229
00:21:37,250 --> 00:21:41,930
ุงู„ minor part ูˆ ุจูŠู†ู…ุง ุฅู† this 3132 pro-insulin is

230
00:21:41,930 --> 00:21:46,510
the major pro-insulin conversion intermediate

231
00:21:48,760 --> 00:21:53,560
ุงู„ุฌู„ูˆูƒูˆุฒ ู‡ูˆ ุงู„ู„ูŠ ุจูŠุชุญูƒู… ุจูŠู‡ ุงู„ู€ Synthesis ู„ู€ ุงู„ู€

232
00:21:53,560 --> 00:21:58,460
Proinsulin ูˆ ุฃูŠุถู‹ุง ู„ู„ุฅู†ุฒุงูŠู… ุงู„ู„ูŠ ู‡ูˆ ุงู„ู€ PC-1 ุงู„ู„ูŠ

233
00:21:58,460 --> 00:22:04,180
ุจูŠุนู…ู„ ุงู„ู‚ุทุน ูˆ ุชุญูˆูŠู‡ ุงู„ู„ูŠ ุจูŠุญูˆู„ ุงู„ู€ Proinsulin ุฅู„ู‰

234
00:22:04,180 --> 00:22:08,540
InsulinูŠุจู‚ู‰ ุงู„ู€ Glucose regulates biosynthesis of

235
00:22:08,540 --> 00:22:14,000
both Proinsulin and BC-1 ู„ูƒู† ู…ุงู„ู‡ูˆุด ุฃูŠ ุชุฃุซูŠุฑ ุนู„ู‰

236
00:22:14,000 --> 00:22:21,520
ุงู„ู€ BC-2 ุฃูˆ ุนู„ู‰ ุงู„ู€ Carboxypeptidase H ูŠุจู‚ู‰ ุจุนุฏ ู…ุง

237
00:22:21,520 --> 00:22:24,460
ุงู„ู„ูŠ ู‡ูˆ ุงุชู… ุงู†ู‡ ุนู…ู„ูŠุฉ ุงู„ู‚ุทุน ุจุนุฏ ุฐู„ูƒ ุจูŠุตูŠุฑ ููŠู‡ ุงู†ู‡

238
00:22:24,460 --> 00:22:29,800
Exocytosis ูˆ ุจูŠุตูŠุฑ ููŠู‡ Release ู„ู„ุฅู†ุณู„ูŠู† ูˆ ู„ู„ู€ C

239
00:22:29,800 --> 00:22:30,640
-Peptide

240
00:22:33,200 --> 00:22:40,440
ูˆุจูŠุฏุฎู„ูˆุง ู„ู„ูƒุจุฏ ุนู† ุทุฑูŠู‚ ุงู„ portal circulation ูŠุจู‚ู‰

241
00:22:40,440 --> 00:22:44,980
ุจูŠุตูŠุฑ ููŠู‡ inner release ูˆุจูŠุฏุฎู„ูˆุง ู„ู„ูˆ ุงู„ุฏู… ูˆุจูŠุฏุฎู„ูˆุง

242
00:22:44,980 --> 00:22:49,300
ู„ู„ูƒุจุฏ ุนู† ุทุฑูŠู‚ ุงู„ portal circulation ูˆ ุจุนุฏูŠู† ุทุจุนุง

243
00:22:49,300 --> 00:22:54,760
ุจูŠุตู„ูˆุง ุฅู„ู‰ ุฌู…ูŠุน ุฃุฌุฒุงุก ุงู„ุฌุณู…

244
00:22:56,750 --> 00:23:01,410
ุจุงู„ุฅุถุงูุฉ ู„ู„ุฅู†ุณูˆู„ูŠู† ูˆุงู„ู€ C-peptide ุจุฑุถู‡ ุจู†ู„ุงู‚ูŠ

245
00:23:01,410 --> 00:23:06,110
small amounts of pro-insulin ูˆู…ู† ุงู„ intermediate

246
00:23:06,110 --> 00:23:12,970
cleavage forms ู‡ุฏูˆู„ ุจู†ู„ุงู‚ูŠู‡ู… ุจุฑุถู‡ ู…ูˆุฌูˆุฏูŠู† ููŠ ุงู„

247
00:23:12,970 --> 00:23:17,250
circulation ุทูŠุจุŒ

248
00:23:17,250 --> 00:23:21,470
ุฅูŠุด ุงู„ stimulus ุฃูˆ ุงู„ signal ุงู„ู„ูŠ ุจุชุคุฏูŠ ุฅู„ู‰ ุงู„

249
00:23:21,470 --> 00:23:26,700
release of insulinุŸุงู„ุฌู„ูˆูƒูˆุฒ is the most important

250
00:23:26,700 --> 00:23:32,800
physiological secretagogue for

251
00:23:32,800 --> 00:23:37,700
insulin ูŠุจู‚ู‰ ู‡ูˆ ุงู„ substance that promotes

252
00:23:37,700 --> 00:23:41,060
secretion of insulin ุงู„ุฌู„ูˆูƒูˆุฒ substance that

253
00:23:41,060 --> 00:23:45,600
promotes the secretion of insulin ูŠุจู‚ู‰ ุงู„ุฒูŠุงุฏุฉ

254
00:23:45,600 --> 00:23:52,140
ู„ุจู„ุฏ ููŠ ุงู„ุจู„ุฏ ุงู„ุฌู„ูˆูƒูˆุฒ ุจูŠุนู…ู„ stimulationู„ู„ู€ beta

255
00:23:52,140 --> 00:23:57,680
cells ุนุดุงู† ุชุนู…ู„ ุงู„ู„ูŠ ู‡ูˆ secretion ู„ู„ุฅู†ุณู„ูŠู† ูˆู‡ุฐุง

256
00:23:57,680 --> 00:24:01,140
ุจูŠุตูŠุฑ within minutes insulin release is

257
00:24:01,140 --> 00:24:06,420
potentiated by substances such as the encretin

258
00:24:06,420 --> 00:24:13,680
hormones ูŠุนู†ูŠ ุงู† ููŠ ุดุบู„ุงุช ุจุฑุถู‡ ู‡ุฐู‡ ุจุชุฒูŠุฏ ู…ู† ุฅูุฑุงุฒ

259
00:24:14,120 --> 00:24:17,560
ุงู„ุงู†ุณูˆู„ูŠู† ุฒูŠ ุนู†ุฏู†ุง ุงู„ุงู†ูƒุฑูŠุชูŠู† hormones ุนุจุงุฑุฉ ุนู†

260
00:24:17,560 --> 00:24:23,980
ู…ุฌู…ูˆุนุฉ ู…ู† ุงู„ู‡ุฑู…ูˆู†ุงุช ุงู„ู„ูŠ ุจูŠุตู„ู‡ุง release ุจุนุฏ ุงู„ุฃูƒู„

261
00:24:23,980 --> 00:24:29,200
ุจุฌู‡ุฉ ุงู„ู‡ุฑู…ูˆู†ุงุช ู„ู…ุง ุงู„ุฅู†ุณุงู† ุจูŠุชู†ุงูˆู„ ุงู„ู„ูŠ ู‡ูˆ ุงู„ุทุนุงู…

262
00:24:29,200 --> 00:24:34,220
ุจูŠุตูŠุฑ ููŠู‡ ุนู†ุฏู†ุง release ู„ ุงู„ุงู†ูƒุฑูŠุชูŠู† hormones ุฒูŠ

263
00:24:34,220 --> 00:24:37,440
ุงู„ู„ูŠ ู‡ูˆ ุงู„ glucagon-like peptide ูˆ ุงู„ glucose

264
00:24:37,440 --> 00:24:41,320
-dependent insulinotropic polypeptide

265
00:24:42,100 --> 00:24:49,440
ูˆยซูƒูˆู„ูŠุณุงูŠุชูˆูƒุงูŠู†ูŠู† ุจูŠุจุชุงูŠุฏ YYยป ูˆยซุฅูƒุฒูŠู†ุชูˆู…ูˆุฏูŠูˆู„ูŠู†ยป

266
00:24:49,440 --> 00:24:53,100
ูƒู„ู‡ุง ู‡ุฐูŠ ู‡ุฑู…ูˆู†ุงุช ุจุณ ุงู„ู„ูŠ ู‡ุง release ุจุนุฏ ุชู†ุงูˆู„

267
00:24:53,100 --> 00:25:00,380
ุงู„ุทุนุงู… ูˆู‡ุฐู‡ ุงู„ู‡ุฑู…ูˆู†ุงุช ูƒู„ู‡ุง ุจุชุฒูŠุฏ ู…ู† ุงู„ release

268
00:25:00,380 --> 00:25:02,300
ู„ู„ุฅู†ุณูŠู„ูŠู†

269
00:25:04,000 --> 00:25:07,940
ููŠ ุงู„ู…ู‚ุงุจู„ ุฅู†ู‡ ุงู„ุนุฏูŠุฏ ู…ู† ุงู„ุนูˆุงู…ู„ ุงู„ู„ูŠ ุจุชุนู…ู„

270
00:25:07,940 --> 00:25:12,220
Inhibition ู„ู€ Insulin Release ูˆู…ู†ู‡ุง ุงู„ู€

271
00:25:12,220 --> 00:25:17,000
Hypoglycemia ูŠุนู†ูŠ ุงู†ุฎูุงุถ ููŠ ู…ุณุชูˆู‰ ุงู„ู€ Glucose ุฅู†ู‡

272
00:25:17,000 --> 00:25:21,760
ุงู„ู€ Somatostatin ุงู„ู„ูŠ ุจูŠูุฑุฒ ุจุฑุถู‡ ููŠ ุงู„ู€ Pancreas

273
00:25:21,760 --> 00:25:26,440
ู…ู† ุฎู„ุงู„ ุงู„ู€ Delta Cells ุงู„ู…ูˆุฌูˆุฏุฉ ููŠ ุงู„ู€ Pancreas

274
00:25:26,710 --> 00:25:32,010
ู‡ุฐุง ุงู„ู€ hormone ุจูŠุนู…ู„ ุงู„ู„ูŠ ู‡ูˆ inhibition ุนู„ู‰ ุงู„ู€

275
00:25:32,010 --> 00:25:36,030
beta cells ูˆุจุงู„ุชุงู„ูŠ ุจูŠู‚ู„ู„ ุฃูˆ ุจูŠุนู…ู„ inhibition ู„ู„ู€

276
00:25:36,030 --> 00:25:42,650
release ู„ู„ุฅู†ุณูˆู„ูŠู† ุจุงู„ุฅุถุงูุฉ ู„ู„ุนุฏูŠุฏ ู…ู† ุงู„ drugs ุงู„ู„ูŠ

277
00:25:42,650 --> 00:25:47,770
ู…ู…ูƒู† ุจุชุนู…ู„ inhibition ู„ู„ู€ release ู„ู„ุฅู†ุณูˆู„ูŠู† ู…ู†

278
00:25:47,770 --> 00:25:52,030
ุฎู„ุงู„ ุชุฃุซูŠุฑู‡ุง ุนู„ู‰ ุงู„ beta cells

279
00:25:58,690 --> 00:26:01,690
in health individuals insulin is released in a

280
00:26:01,690 --> 00:26:05,610
pulsatile fashion ูŠุจู‚ู‰ ุจูŠูƒูˆู† ุงู„ู„ูŠ ู‡ูˆ ุนู† ุทุฑูŠู‚ ุงู„ู„ูŠ

281
00:26:05,610 --> 00:26:11,050
ู‡ูˆ pulses ุฃู‡ ูŠุจู‚ู‰ ุนู†ุฏู†ุง ูƒู„ ูุชุฑุฉ ุจูŠุตูŠุฑ ููŠ release

282
00:26:11,050 --> 00:26:15,210
ู„ูƒู…ูŠุฉ ู…ู† ุงู„ insulin ูŠุจู‚ู‰ ููŠ ุนู†ุฏู†ุง pulsatile

283
00:26:15,210 --> 00:26:20,620
releaseุŒ pulseswith glucose and insulin the main

284
00:26:20,620 --> 00:26:25,140
signals in the feedback loop ูŠุจู‚ู‰ ู‡ู… ุงู„ู„ูŠ .. ูˆ

285
00:26:25,140 --> 00:26:28,780
ุงู„ู„ูŠ ุจุชุญูƒู…ู‡ ูˆ ุงู„ู„ูŠ ุจูŠุนู…ู„ูˆุง ุงู„ู„ูŠ ู‡ูˆ feedback ุฃูˆ

286
00:26:28,780 --> 00:26:31,240
negative feedback ุนู„ู‰ ุงู„ .. ุงู„ release ุงู„ู„ูŠ

287
00:26:31,240 --> 00:26:35,500
glucose ูˆ ุงู„ insulin ุงู„ glucose ุงู„ู„ูŠ sets the

288
00:26:35,500 --> 00:26:39,000
release of insulin from the pancreas into phases

289
00:26:39,000 --> 00:26:46,220
ูŠุจู‚ู‰ ู„ู…ุง ุจูŠุฏุฎู„ ุงู„ glucose ู„ ุงู„ุฏู… ุจูŠุตูŠุฑ ููŠู‡ ุงู†ุง

290
00:26:46,220 --> 00:26:52,210
release ู„ุงู„ insulinุจุงู„ู‡ูˆ ู…ุฑุญู„ุชูŠู† ุฃูˆ ุนู„ู‰ ู…ุฑุญู„ุชูŠู†

291
00:26:52,210 --> 00:27:01,410
ุงู„ู…ุฑุญู„ุฉ ุงู„ุฃูˆู„ู‰ ุจุชุจุฏุฃ ุจุนุฏ ุฏู‚ูŠู‚ุฉ ุฅู„ู‰ ุฏู‚ูŠู‚ุชูŠู† ู…ู† ุฏุฎูˆู„

292
00:27:01,410 --> 00:27:09,310
ุงู„ู€ glucose ู„ู„ุฏู… ูˆ ุจุชู†ุชู‡ูŠ ุนู†ุฏ ุนุดุฑ ุฏู‚ุงุฆู‚ ุงู„ู…ุฑุญู„ุฉ

293
00:27:09,310 --> 00:27:13,330
ุงู„ุฃูˆู„ู‰ ุจุชุจุฏุฃ ูŠุนู†ูŠ ุจุดูƒู„ ุณุฑูŠุน ุจุนุฏ ุฏู‚ูŠู‚ุฉ ุฃูˆ ุฏู‚ูŠู‚ุชูŠู†

294
00:27:13,890 --> 00:27:18,590
ูˆุจุชู†ุชู‡ูŠ ุนู†ุฏ ุนุดุฑ ุฏู‚ุงุฆู‚ ูˆุจู‡ุฐู‡ ุงู„ู…ุฑุญู„ุฉ ุจูŠูƒูˆู† ููŠ ุนู†ุฏู†ุง

295
00:27:18,590 --> 00:27:23,190
release ู„ูƒู…ูŠุฉ ูƒุจูŠุฑุฉ ู…ู† ุงู„ุงู†ุณูˆู„ูŠู† ูŠุจู‚ู‰ sharp spike

296
00:27:23,190 --> 00:27:29,130
represent the rapid release of stored insulin ูŠุจู‚ู‰

297
00:27:29,130 --> 00:27:34,290
ุจูŠุตูŠุฑ release ู„ูƒู…ูŠุฉ ูƒุจูŠุฑุฉ ู…ู† ุงู„ุงู†ุณูˆู„ูŠู† ุจุนุฏ ู‡ูŠูƒ

298
00:27:34,290 --> 00:27:38,070
ุจุชุฏุฎู„ ุงู„ู…ุฑุญู„ุฉ ุงู„ุชุงู†ูŠุฉ beginning at the point where

299
00:27:38,070 --> 00:27:44,010
the first phase ended ุจุชุจุฏุฃ ุจุนุฏ ุงู„ุนุดุฑ ุฏู‚ุงุฆู‚ูˆุจุชุณุชู…ุฑ

300
00:27:44,010 --> 00:27:50,030
ู„ุบุงูŠุฉ ู…ุง ูŠุฑุฌุน ู…ุณุชูˆู‰ ุงู„ู€ glucose ููŠ ุงู„ุฏู… ุฅู„ู‰

301
00:27:50,030 --> 00:27:58,570
ุงู„ู…ุณุชูˆู‰ ุงู„ุทุจูŠุนูŠ ูˆู‡ุฐู‡ ู…ู…ูƒู† ุชุณุชู…ุฑ ูŠุนู†ูŠ ู„ู…ุฏุฉ 60 ุฅู„ู‰

302
00:27:58,570 --> 00:28:08,940
120 ุฏู‚ูŠู‚ุฉ ุฃูˆ ูŠุนู†ูŠ ุชู†ุชู‡ูŠ ุจุนุฏ 60 ุฅู„ู‰ 120 ุฏู‚ูŠู‚ุฉู‡ุฐุง

303
00:28:08,940 --> 00:28:15,200
ุงู„ู€ figure ุจูŠูˆุถุญ ุงุณุชุฌุงุจุฉ ุฃูˆ

304
00:28:15,200 --> 00:28:20,060
ุงู„ู€ concentration ู„ู„ู€ ุงู„ุงู†ุณูˆู„ูŠู† ุจู†ุงุก ุนู„ู‰ ุงู„

305
00:28:20,060 --> 00:28:28,060
injection ู„ุฌู„ูˆูƒูˆุฒ ููŠ ุงู„ุฏู… ูŠุจูŠู† ู‡ู†ุง ุฅู†ู‡ ูƒู…ูŠุฉ

306
00:28:28,060 --> 00:28:34,720
ุงู„ุงู†ุณูˆู„ูŠู† ุงู„ู„ูŠ ุตู„ู‡ุง detection ููŠ ุงู„ุฏู… ูˆ ู‡ู†ุง ุฅู†ู‡ ุงู„

307
00:28:34,720 --> 00:28:42,190
timeู‡ู†ุง ุฅู† ู‡ูˆ ุดุฎุต ุทุจูŠุนูŠ ูˆุฒูŠ ู…ุง ู‚ู„ู†ุง ุฅู†ู‡ ุจูŠุตูŠุฑ ููŠู‡

308
00:28:42,190 --> 00:28:48,750
ุฅู†ู‡ release ู„ู„ุฅู†ุณูˆู„ูŠู† ุนู„ู‰ ู…ุฑุญู„ุชูŠู† ู‡ุงู† ุงู„ู„ูŠ ู‡ูˆ ูƒู…ูŠุฉ

309
00:28:48,750 --> 00:28:54,310
ุงู„ุฅู†ุณูˆู„ูŠู† ู‚ุจู„ ู…ุง ูŠุชู… ุญู‚ู† ุงู„ุดุฎุต ุจุนุดุฑูŠู† ุฌุฑุงู… ู…ู† ุงู„

310
00:28:54,310 --> 00:28:59,630
glucose ู‡ุงู† ุนู†ุฏ ุณูุฑ ุตุงุฑ ุฅู† ุนู…ู„ูŠุฉ ุงู„ุญู‚ู†ุฒูŠ ู…ุง ุฃุญู†ุง

311
00:28:59,630 --> 00:29:03,990
ุดุงูŠููŠู† ุฃู†ู‡ ุจุชุจุฏุฃ ุนู†ุฏู†ุง ุงู„ phase one ุงู„ู…ุฑุญู„ุฉ ุงู„ุฃูˆู„ู‰

312
00:29:03,990 --> 00:29:07,930
ุฒูŠ ู…ุง ู‚ู„ู†ุง ุฎู„ุงู„ ุฏู‚ูŠู‚ุฉ ุฅู„ู‰ ุฏู‚ูŠู‚ุชูŠู† ุจูŠุตูŠุฑ ููŠ ุนู†ุฏูŠ ุงู„

313
00:29:07,930 --> 00:29:14,730
release ู„ ุงู„ู„ูŠ ู‡ูˆ ูƒู…ูŠุฉ ูƒุจูŠุฑุฉ ู…ู† ุงู„ incidentุจุนุฏ ู‡ูŠูƒ

314
00:29:14,730 --> 00:29:18,050
ุจุนุฏ ูˆู‡ุฐู‡ ุจุชุณุชู…ุฑ ู„ ุชู‚ุฑูŠุจุง ุนุดุฑ ุฏู‚ุงุฆู‚ ุจุนุฏ ู‡ูŠูƒ ุจุชุจุฏุฃ

315
00:29:18,050 --> 00:29:22,850
ุนู†ุฏูŠ ุงู„ concentration ู„ ุงู„ insulin ู‚ู„ ุจู†ุจุฏุฃ ุจูŠู‡

316
00:29:22,850 --> 00:29:27,670
ุงู„ู…ุฑุญู„ุฉ ุงู„ุชุงู†ูŠุฉ ูƒู„ ู…ุง ู†ุฒู„ ุงู„ glucose concentration

317
00:29:27,670 --> 00:29:33,650
ูƒู„ ู…ุง ู‚ู„ุช ูƒู…ูŠุฉ ุงู„ insulin ุงู„ู…ูˆุฌูˆุฏุฉ ู„ุบุงูŠุฉ ู…ุง ุชุฑุฌุน

318
00:29:33,650 --> 00:29:39,070
ูƒู…ูŠุฉ ุงู„ู„ูŠ ู‡ูˆ ุงู„ insulin ู„ ุงู„ basal levels ุนู†ุฏู…ุง

319
00:29:39,070 --> 00:29:44,940
ุชุฑุฌุน ุงู„ู„ูŠ ู‡ูˆ ุงู„ concentration ู„ glucoseุฅู„ู‰ ุงู„ู…ุณุชูˆู‰

320
00:29:44,940 --> 00:29:50,860
ุงู„ุทุจูŠุนูŠ ุงู„ figures ุงู„ุชุงู†ูŠุฉ ุงู„ู„ูŠ ู‡ูˆ ุงู†ู‡ุง figure B

321
00:29:50,860 --> 00:29:57,780
ู‡ุฐุง ุจูŠูˆุถุญ ูƒู…ูŠุฉ ุงู„ insulin ุนู†ุฏ ุดุฎุต ู…ุตุงุจ ุจุงู„ type 2

322
00:29:57,780 --> 00:30:01,640
diabetes mellitus ูˆ ุงู„ู†ุงุณ ุงู„ู…ุตุงุจูŠู† ุจุงู„ type 2

323
00:30:01,640 --> 00:30:07,040
diabetes mellitus ุจูŠูู‚ุฏูˆุง phase one ุจูŠูƒูˆู†ุด ู…ูˆุฌูˆุฏ

324
00:30:07,040 --> 00:30:13,730
ุนู†ุฏู‡ู… phase one ุนุดุงู† ู‡ูŠูƒู„ู…ุง ุจูŠุชู†ุงูˆู„ูˆุง ุงู„ู€

325
00:30:13,730 --> 00:30:18,610
carbohydrates ูˆุจูŠุฏุฎู„ ุงู„ุฌู„ูˆูƒูˆุฒ ู„ู„ุฏู… ุจู†ู„ุงู‚ูŠ ุฃู†ู‡ ุจูŠุธู„

326
00:30:18,610 --> 00:30:23,150
ุงู„ู€ ุงู„ู€ ุงู„ู€ glucose concentration ู…ุฑุชูุนุฉ ูุชุฑุฉ

327
00:30:23,150 --> 00:30:28,430
ุทูˆูŠู„ุฉ ููŠ ุงู„ุฏู… ู„ุฃู†ู‡ ุงู„ู€ phase one ุงู„ู…ุฑุญู„ุฉ ุงู„ุฃูˆู„ู‰

328
00:30:28,430 --> 00:30:34,470
ู…ู‡ู…ุฉ ู„ูŠู‡ ุงู„ู„ูŠ ู‡ูˆ ุฎูุถ ู…ุณุชูˆู‰ ุงู„ุณูƒุฑ ุณุฑูŠุนุง ู„ุฃู† ุฒูŠ ู…ุง

329
00:30:34,470 --> 00:30:38,070
ู‚ู„ู†ุง ุจูŠุตูŠุฑ release ู„ูƒู…ูŠุฉ ูƒุจูŠุฑุฉ ู…ู† ุงู„ุงู†ุณูˆู„ูŠู† ูˆ ุงู„ู„ูŠ

330
00:30:38,070 --> 00:30:44,370
ู‡ูˆ ุจุดูƒู„ ุณุฑูŠุน ู„ูƒู† ุงู„ู€ type twoุงู„ู€ diabetic patients

331
00:30:44,370 --> 00:30:48,730
ุงู„ู€ phase one ู…ุด ู…ูˆุฌูˆุฏุฉ ุนู†ุฏู‡ู… ูŠุนู†ูŠ ุฌู‡ุงู† ุนู†ุฏ ุณูุฑ

332
00:30:48,730 --> 00:30:53,330
ุตุงุฑ ููŠู‡ ุนู†ุฏูŠ ุงู„ู„ูŠ ู‡ูˆ injection ู„ุนุดุฑูŠู† ุฌุฑุงู… ู…ู†

333
00:30:53,330 --> 00:30:57,210
ุงู„ุฌู„ูˆูƒูˆุฒ ุฒูŠ ู…ุง ุฃุญู†ุง ุดุงูŠููŠู† ุฃู†ู‡ ู…ุงููŠุด ุนู†ุฏู†ุง spike

334
00:30:57,210 --> 00:31:01,770
ุฒูŠ ู…ุง ุตุงุฑ ููŠ ู‡ุงู† ูŠุจู‚ู‰ ุงู„ phase one ู…ุด ู…ูˆุฌูˆุฏุฉ ู„ูƒู†

335
00:31:01,770 --> 00:31:08,150
ุงู„ phase two ู…ูˆุฌูˆุฏุฉ ุจูŠุจุฏุฃ ุจูŠุฑุชูุน ุนู†ุฏู†ุง ุงู„ insulin

336
00:31:11,130 --> 00:31:18,650
ูˆ ุฒูŠ ู…ุง ุญูƒูŠู†ุง ุฅู†ู‡ ู‡ุฐุง ุจูŠุงุฎุฏ ูŠุนู†ูŠ ูุชุฑุงุช ุทูˆูŠู„ุฉ

337
00:31:18,650 --> 00:31:27,430
ู„ู„ูˆุตูˆู„ ุฅู„ู‰ ุงู„ normal concentration ูŠุนู†ูŠ

338
00:31:27,430 --> 00:31:30,270
ู„ุฃ ุทุจุนุง ุจุงู„ type 2 diabetes ู…ุด ู‡ูŠุตู„ ู„ ุงู„ normal

339
00:31:30,270 --> 00:31:34,670
ูŠุนู†ูŠ ุนุดุงู† ูŠุฎูุถ ุงู„ glucose ู„ูƒู† ุทุจุนุง ู…ุด ู‡ูŠุตู„ ู„ ุงู„

340
00:31:34,670 --> 00:31:41,520
normal ู‡ูŠุธู„ ู„ู†ุง ุงู„ glucose ู…ุฑุชูุนุจูŠู†ู…ุง ุจูŠ ุงู„

341
00:31:41,520 --> 00:31:45,920
patients with type 1 ุทุจุนุง ุฅู†ุง ู…ุดูƒู„ุฉ ุฃุตู„ุง ุฅุญู†ุง ููŠ

342
00:31:45,920 --> 00:31:52,280
ุงู„ release of insulin ู„ุฃู†ู‡ ุนู†ุฏู†ุง ุงู„ู„ูŠ ู‡ูˆ ุตุงุฑ ููŠ

343
00:31:52,280 --> 00:31:56,040
destruction ู„ ุงู„ beta cells ูˆุจุงู„ุชุงู„ูŠ ูŠุนู†ูŠ ุงู„

344
00:31:56,040 --> 00:31:59,720
insulin ู…ุด ู…ูˆุฌูˆุฏ ุฃูˆ ู…ูˆุฌูˆุฏ ูŠุนู†ูŠ ุจ very low

345
00:31:59,720 --> 00:32:00,860
concentrations

346
00:32:03,380 --> 00:32:06,720
ูŠุจู‚ู‰ ุฒูŠ ู…ุง ุดูˆูู†ุง ููŠ ุงู„ figure ุงู„ุตุงุจู‚ with

347
00:32:06,720 --> 00:32:09,360
progressive failure of beta cell function first

348
00:32:09,360 --> 00:32:15,740
phase insulin response ู„ู„ุฌู„ูˆูƒูˆุฒ is lost ู„ูƒู† ุฃู† ุงู„

349
00:32:15,740 --> 00:32:21,060
second phase ุจุชุธู„ ุงู„ู„ูŠ ู…ูˆุฌูˆุฏุฉ is preserved both

350
00:32:21,060 --> 00:32:23,520
the first phase response and normal pulsatile

351
00:32:23,520 --> 00:32:26,760
insulin secretion are lost ูŠุจู‚ู‰ ุงู„ first phase

352
00:32:26,760 --> 00:32:32,790
ุจูŠูู‚ุฏ ุงู„ pulsatile insulin secretion ุจูŠูู‚ุฏู„ูƒู† ุงู„ู€

353
00:32:32,790 --> 00:32:39,550
second phase ุจุชุธู„ ู…ูˆุฌูˆุฏุฉ ูˆุทุจุนุง ุงู„ word type one

354
00:32:39,550 --> 00:32:44,510
ุฃู†ู‡ ุฃุตู„ุง ู…ุดูƒู„ุฉ ููŠ ุงู„ release ู„ู„ุฅู†ุณู„ูŠู† ูˆุจุงู„ุชุงู„ูŠ

355
00:32:44,510 --> 00:32:50,110
minimal or no insulin response ุงู„ู†ู‚ุทุฉ ุงู„ุชุงู„ูŠุฉ ุงู„

356
00:32:50,110 --> 00:32:51,750
insulin degradation

357
00:32:56,300 --> 00:32:58,660
ุนู„ู‰ ุงู„ุทุฑูŠู‚ ุงู„ุฃูˆู„ ู…ู† ุฎู„ุงู„ ุงู„ู€ Portal Circulation

358
00:32:58,660 --> 00:33:04,300
ู†ุญู† ุฒูŠ ู…ุง ู‚ู„ู†ุง ุฃู†ู‡ ุจูŠุตูŠุฑ ููŠู‡ ุฅุทู„ุงู‚ ู„ู„ุฅู†ุณู„ูŠู† ุจูŠุฏุฎู„

359
00:33:04,300 --> 00:33:09,160
ู„ู„ูƒุจุฏ ุนู† ุทุฑูŠู‚ ุงู„ู€ Portal Circulation ูŠุจู‚ู‰ ุนู†ุฏู†ุง

360
00:33:09,160 --> 00:33:12,040
ุงู„ุทุฑูŠู‚ ุงู„ุฃูˆู„ ู…ู† ุฎู„ุงู„ ุงู„ู€ Portal Circulation

361
00:33:12,040 --> 00:33:20,050
ุชู‚ุฑูŠุจู‹ุง 50% ู…ู† ุงู„ุฅู†ุณู„ูŠู† ูŠุชู… ุฅุฎุฑุงุฌู‡ ู…ู† ุงู„ุฌู„ุฏูŠุนู†ูŠ

362
00:33:20,050 --> 00:33:25,530
where it is degraded ูŠุนู†ูŠ ู…ุด ู…ู…ูƒู† ุงู„ .. ูŠุนู†ูŠ ู…ุด ูƒู„

363
00:33:25,530 --> 00:33:29,030
ุงู„ูƒู…ูŠุฉ ู…ู…ูƒู† ุชุณุชุฎุฏู… ุงู„ degradation ูŠุนู†ูŠ ู…ู…ูƒู† ูŠุตูŠุฑ

364
00:33:29,030 --> 00:33:32,950
ููŠู‡ ูุนู„ูŠู‹ุง extraction ู„ุฎู…ุณูŠู† ุจุงู„ู…ูŠุฉ ู…ู† ุงู„ุงู†ุณูˆู„ูŠู†

365
00:33:32,950 --> 00:33:41,390
ู„ูƒู† ู…ู…ูƒู† ูŠุตูŠุฑ ู„ุงุญู‚ู‹ุง release ู„ุจุนุถ ู…ู† ู‡ุฐู‡ ุงู„ูƒู…ูŠุฉ

366
00:33:41,390 --> 00:33:46,630
ู…ุฑุฉ ุฃุฎุฑู‰ ู„ู„ circulation ู‡ูˆ ูŠุนู†ูŠ ู…ุด ูƒุชูŠุฑ ุฏู‚ูŠู‚ุฉ ุฃู†ู‡

367
00:33:46,990 --> 00:33:51,570
ุงู„ุฎู…ุณูŠู† ุจุงู„ู…ูŠุฉ ู‡ุฐู‡ ุจูŠุตูŠุฑ ู„ู€ degradation ูŠุจู‚ู‰ ุจูŠุตูŠุฑ

368
00:33:51,570 --> 00:33:55,410
ููŠู‡ extraction ู„ุฎู…ุณูŠู† ุจุงู„ู…ูŠุฉ ู…ู† ุงู„ุงู†ุณู„ูŠู† ู„ูƒู† ู…ู…ูƒู†

369
00:33:55,410 --> 00:33:59,930
ู„ุงุญู‚ุง ุจุนุถ ู…ู† ู‡ุฐู‡ ุงู„ูƒู…ูŠุฉ ุงู„ู„ูŠ ุตุงุฑุช ุงู„ extraction

370
00:33:59,930 --> 00:34:04,190
ู…ู…ูƒู† ุชุฑุฌุน ุชุฏุฎู„ ู„ ุงู„ circulation ู…ุฑุฉ ุฃุฎุฑู‰

371
00:34:04,190 --> 00:34:07,370
additional insulin degradation occurs in the

372
00:34:07,370 --> 00:34:12,300
kidneysูˆุนู…ู„ูŠุฉ ุงู„ู€ degradation ู‡ุง ุจุชุตูŠุฑ ููŠู‡ ุงู„ู€

373
00:34:12,300 --> 00:34:17,280
tubules ูˆุจูŠู‡ ุงู„ู€ proximal tubules ุจุดูƒู„ ุฎุงุต ูŠุจู‚ู‰

374
00:34:17,280 --> 00:34:21,580
ุจูŠุตูŠุฑ ููŠู‡ ุนู†ุฏู†ุง filtration ู„ู„ุฅู†ุณู„ูŠู† ุนู† ุทุฑูŠู‚ ุงู„ู€

375
00:34:21,580 --> 00:34:27,760
glomeruli ุจุนุฏ ู‡ูŠูƒ ุจูŠุตูŠุฑ ููŠู‡ reabsorption ู„ู„ุฅู†ุณู„ูŠู†

376
00:34:27,760 --> 00:34:31,520
ุจูŠู‡ ุงู„ proximal convoluted tubule ูˆุจุชุตูŠุฑ

377
00:34:31,520 --> 00:34:37,000
degradation ู„ู„ุฅู†ุณู„ูŠู† ููŠ ุฏุงุฎู„ ุฎู„ุงูŠุง ุงู„ proximal

378
00:34:37,000 --> 00:34:38,620
convoluted tubule

379
00:35:01,390 --> 00:35:07,330
ุจู†ุณุจุฉ ู„ู‡ุง ุงู„ู€ Pro Insulin ุจุดูƒู„ ุทุจูŠุนูŠ ุงู†ู‡ุง ุนุฏุฏ ุตุบูŠุฑ

380
00:35:09,190 --> 00:35:13,870
of proinsulin enter the circulation ู„ุชู‚ุฑูŠุจุง ุชู„ุงุชุฉ

381
00:35:13,870 --> 00:35:18,310
ุจุงู„ู…ูŠุฉ of the amount of insulin ุจุชู„ุงุชุฉ ุจุงู„ู…ูŠุฉ ู…ู†

382
00:35:18,310 --> 00:35:21,230
ูƒู…ูŠุฉ ุงู„ insulin ุงู„ู„ูŠ ุจุชุฏุฎู„ ุงู„ู„ูŠ ู‡ูˆ ุนู†ุฏู†ุง ุจุชูƒูˆู†

383
00:35:21,230 --> 00:35:25,830
ุนุจุงุฑุฉ ุนู† ุงู„ proinsulin ู„ูƒู† ุจุงู„ู†ุณุจุฉ ู„ู„ proinsulin

384
00:35:25,830 --> 00:35:29,310
ุงู„ hepatic clearance rate for proinsulin is only

385
00:35:29,310 --> 00:35:34,630
25% of that for insulin ูŠุนู†ูŠ ุนู†ุฏู†ุง ุงู„ clearance

386
00:35:34,630 --> 00:35:41,940
ุฃู‚ู„ ู…ู‚ุงุฑู†ุฉ ุจุงู„ุฅู†ุณู„ูŠู†ูˆุจุงู„ู…ู‚ุงุจู„ ุฃูŠุถู‹ุง ุงู„ู€ half-life

387
00:35:41,940 --> 00:35:47,260
ู„ู€ ุงู„ู€ Proinsulin ุชู‚ุฑูŠุจู‹ุง ุชู„ุงุชูŠู† ุฏู‚ูŠู‚ุฉ ูŠุจู‚ู‰ ุงู„

388
00:35:47,260 --> 00:35:50,320
clearance ุงู„ู„ูŠ ุจู‚ุช ุงู„ clearance ุฃู‚ู„ ู…ู‚ุงุฑู†ุฉ

389
00:35:50,320 --> 00:35:54,400
ุจุงู„ุฅู†ุณู„ูŠู† ุงู„ half-life ู„ุงู„ู€ Proinsulin ุฃุนู„ู‰

390
00:35:54,400 --> 00:36:01,320
ุชู‚ุฑูŠุจู‹ุง ุจุณุช ู…ุฑุงุช ู…ู† ุงู„ุงู†ุณู„ูŠู† ูˆุจุงู„ุชุงู„ูŠุฎู„ุงู„ ุงู„ู„ูŠ ู‡ูˆ

391
00:36:01,320 --> 00:36:04,420
ุงู„ู€ fasting state ู…ู…ูƒู† ู†ู„ุงู‚ูŠ ุฅู† ุงู„ู€ circulating

392
00:36:04,420 --> 00:36:10,100
pro-insulin concentration approximately 10% to 15%

393
00:36:10,100 --> 00:36:15,800
of insulin concentration ุงู„ู„ูŠ ู‡ูˆ ุจุณุจุจ .. ุฒูŠ ู…ุง

394
00:36:15,800 --> 00:36:21,500
ุฐูƒุฑู†ุง ุงู„ุณุจุจูŠู† ุฅู†ู‡ ุงู„ู€ clearance ุฃู‚ู„ ููŠ ุงู„ูƒุจุฏ ูˆ ุงู„ู€

395
00:36:21,500 --> 00:36:28,120
half-life ุฃุทูˆู„ ุจุงู„ู†ุณุจุฉ

396
00:36:28,120 --> 00:36:29,680
ู„ู„ู€ C-peptide

397
00:36:32,210 --> 00:36:34,850
was initially thought to be devoid of biological

398
00:36:34,850 --> 00:36:38,950
activity ูˆูƒุงู†ูˆุง ุจุงู„ .. ุจุงู„ุฃูˆู„ ุจูŠููƒุฑูˆุง ุฃู†ู‡ ู…ุงููŠุด ุฃูŠ

399
00:36:38,950 --> 00:36:45,950
ูˆุธูŠูุฉ ู…ู‡ู…ุฉ ู„ู€ C-peptide and

400
00:36:45,950 --> 00:36:48,510
was necessary only to ensure the correct structure

401
00:36:48,510 --> 00:36:57,150
of insulin ู„ูƒู† ู…ู† ุฎู„ุงู„ ุฃุจุญุงุซ ุงู„ู„ูŠ ุชู…ุชุนู„ู‰ ุงู„ู€ C

402
00:36:57,150 --> 00:36:59,770
-peptide ู„ุฌูˆุง ุฅู† ุงู„ู€ C-peptide็ถญุณ ุจูŠูˆู„ูˆุฌูŠูƒุงู„

403
00:36:59,770 --> 00:37:02,550
activity but its possible physiological

404
00:37:02,550 --> 00:37:07,010
significance remains controversally ูŠุนู†ูŠ ู…ุงููŠุด ู„ุณู‡

405
00:37:07,010 --> 00:37:11,490
ุงุชูุงู‚ ุนู„ู‰ ุฅูŠุด ูุนู„ูŠู‹ุง ุงู„ูˆุธูŠูุฉ ุงู„ู„ูŠ ุจูŠู‚ูˆู… ููŠู‡ุง ุงู„ู€ C

406
00:37:11,490 --> 00:37:16,150
-peptide ู„ูƒู† ุนุฏูŠุฏ ู…ู† ุงู„ุฃุจุญุงุซ ุจูŠู†ุช ุฅู†ู‡ ููŠ functions

407
00:37:16,150 --> 00:37:20,470
ู…ุฎุชู„ูุฉ ู„ู€ C-peptide ู…ู†ู‡ุง ุงู„ู„ูŠ ู‡ูˆ ุนู…ู„ูˆุง ูƒู€

408
00:37:20,470 --> 00:37:21,930
antioxidant

409
00:37:23,940 --> 00:37:29,620
ูˆูŠู…ูƒู† ู‡ุฐุง ุดูˆูŠุฉ ูŠุนู†ูŠ ู…ู†ุทู‚ูŠ ู„ุฃู†ู‡ ุทุจุนุง ุฅุฐุง ูƒุงู†

410
00:37:29,620 --> 00:37:36,320
ุงุฑุชูุงุนู†ุง ู„ุฌู„ูˆูƒูˆุฒ ุจุงู„ุฏู… ุฒูŠ ู…ุง ุงุญู†ุง ุนุงุฑููŠู† ูˆู…ู†

411
00:37:36,320 --> 00:37:39,360
ุฎู„ุงู„ ุงู„ู„ูŠ ู‡ูˆ ุงู„ู€ glycolysis ูˆุฅู†ุชุงุฌ ุงู„ุทุงู‚ุฉุŒ ู‡ูŠุตูŠุฑ

412
00:37:39,360 --> 00:37:43,100
ููŠ ุนู†ุฏู†ุง release ู„ู€Reactive Oxygen Species

413
00:37:43,100 --> 00:37:46,140
ูˆุจุงู„ุชุงู„ูŠ

414
00:37:46,140 --> 00:37:51,520
ูŠุนู†ูŠ ูˆุฌูˆุฏ ุงู„ู€C-Beptide ูƒู€Antioxidant ู…ู…ูƒู†ุงู„ู„ูŠ ู‡ูˆ

415
00:37:51,520 --> 00:37:58,620
ูŠู‚ู„ู„ ู…ู† ุงู„ู€ Reactive Oxygen Species ุงู„ู„ูŠ ู‡ุชุชูƒูˆู†

416
00:37:58,620 --> 00:38:03,440
ุงู„ุงู†ุณูˆู„ูŠู†

417
00:38:03,440 --> 00:38:06,300
ูˆ ุงู„ู€ C-peptide secreted into the portal

418
00:38:06,300 --> 00:38:09,960
circulation in equimolar amounts ูŠุจู‚ู‰ ู†ูุณ ุงู„ูƒู…ูŠุฉ

419
00:38:09,960 --> 00:38:13,540
ู„ุฃู† ุฒูŠ ู…ุง ุดูู†ุง ุฃู†ู‡ ุฃู†ุง ุงู„ู€ Proinsulin ุจูŠุตูŠุฑ ููŠ

420
00:38:13,540 --> 00:38:19,640
ุนู†ุฏูŠ a cleavage ูŠุจู‚ู‰ ูƒู„ ุงู†ุณูˆู„ูŠู† moleculeู…ู‚ุงุจู„ู‡ ููŠ

421
00:38:19,640 --> 00:38:25,000
ุนู†ุฏู†ุง C-peptide ูŠุจู‚ู‰ ููŠ ุนู†ุฏูŠ ู†ูุณ ุงู„ูƒู…ูŠุงุช ู…ู†

422
00:38:25,000 --> 00:38:28,520
ุงู„ุงู†ุณูˆู„ูŠู† ุงู„ู„ูŠ ุจูŠุณุชุฎุฏุนู‡ุง ุงู„ู„ูŠุฒ ุจุงู„ู…ู‚ุงุจู„ ุจูŠุตูŠุฑ ู†ูุณ

423
00:38:28,520 --> 00:38:34,600
ุงู„ูƒู…ูŠุฉ ู…ู† ุงู„ C-peptide fasting C-peptide

424
00:38:34,600 --> 00:38:37,760
concentration are five to ten fold higher than

425
00:38:37,760 --> 00:38:43,130
those of insulinูŠุจู‚ู‰ ู†ูุณ ุงู„ูƒู…ูŠุฉ ุจุชุฏุฎู„ ุงู„ุฏู… ู„ูƒู† ู„ู…ุง

426
00:38:43,130 --> 00:38:46,630
ู†ูŠุฌูŠ ู†ู‚ูŠุณ ูƒู…ูŠุฉ ุงู„ู€ C-peptide ุนู†ุฏ ุดุฎุตูŠู† ุจู†ู„ุงู‚ูŠ ุฃู†ู‡

427
00:38:46,630 --> 00:38:52,710
ุฎู…ุณ ุฅู„ู‰ ุนุดุฑ ุฃุถุนุงู ูƒู…ูŠุฉ ุงู„ู€ Insulin ุงู„ู…ูˆุฌูˆุฏุฉ ูˆุงู„ุณุจุจ

428
00:38:52,710 --> 00:38:57,630
ุจูŠุนูˆุฏ ุฅู„ู‰ ุงู„ู€ longer half-life ู„ู€ C-peptide ุงู„ู„ูŠ

429
00:38:57,630 --> 00:39:02,910
ุชู‚ุฑูŠุจุง ุฎู…ุณุฉ ูˆ ุชู„ุงุชูŠู† ุฏู‚ูŠู‚ุฉ ู…ู‚ุงุฑุฉ ุจุงู„ู€ half-life

430
00:39:02,910 --> 00:39:10,150
ู„ู„ุฅู†ุณู„ูŠู† ุงู„ู„ูŠ ู‚ู„ู†ุง ุนุจุงุฑุฉ ุนู† ุชู‚ุฑูŠุจุง ุฎู…ุณ ุฏู‚ุงุฆู‚ุฃูŠุถู‹ุง

431
00:39:10,150 --> 00:39:15,090
the liver does not extract C-peptide ุจูŠุจุตูŠุฑุด ูƒู…ุงู†

432
00:39:15,090 --> 00:39:19,370
extraction ู„ุฃ ู„ู€ C-peptide ู…ู‚ุงุฑู†ุฉ ุจุฅู†ุณู„ูŠู† ุงู„ู„ูŠ

433
00:39:19,370 --> 00:39:23,010
ู‚ู„ู†ุง ุชู‚ุฑูŠุจู‹ุง ุฎู…ุณูŠู† ุจุงู„ู…ูŠุฉ ู…ู† ุงู„ุงู†ุณู„ูŠู† ุงู„ู„ูŠ ุจุฏุฎู„ ุงู„

434
00:39:23,010 --> 00:39:28,490
portal circulation ุจูŠุตู„ู‡ extractionุงู„ู€ C-peptide

435
00:39:28,490 --> 00:39:32,830
ุจูŠุตูŠุฑู‡ุง ุงู„ู€ removal ู…ู† ุงู„ circulation ุจุฑุถู‡ ุนู† ุทุฑูŠู‚

436
00:39:32,830 --> 00:39:38,450
ุงู„ูƒุฏู†ู‰ ูˆ ุจูŠุตูŠุฑ ููŠู‡ degradation ููŠ ุงู„ูƒุฏู†ู‰ ูˆ ูƒู…ูŠุฉ

437
00:39:38,450 --> 00:39:46,070
ู‚ู„ูŠู„ุฉ ู…ู† ุงู„ intact C-peptide ุจุชุทู„ุน ููŠ ุงู„ urine

438
00:39:46,070 --> 00:39:49,670
ูŠุนู†ูŠ ุฒูŠ ู…ุง ู‡ูŠ ุจุฏูˆู† ุงูŠ degradation