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Manual The Diabetic Pancreas

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Written by Robert M. Sargis MD, PhD. In other words, the pancreas has the dual function of secreting hormones into blood endocrine and secreting enzymes through ducts exocrine. However, the pancreas performs the vital duty of producing hormones—most notably insulin—to maintain the balance of blood glucose sugar and salt in the body.

Chronic pancreatitis and diabetes.

The pancreas is a 6 inch-long flattened gland that lies deep within the abdomen, between the stomach and the spine. It is connected to the duodenum, which is part of the small intestine. These cells are clustered in groups within the pancreas and look like little islands of cells when examined under a microscope.

These groups of pancreatic endocrine cells are known as pancreatic islets or more specifically, islets of Langerhans named after the scientist who discovered them. The production of pancreatic hormones, including insulin, somatostatin, gastrin, and glucagon, play an important role in maintaining sugar and salt balance in our bodies. Problems in the production or regulation of pancreatic hormones will cause complications related to blood sugar imbalance.

Despite the fact that the great majority of pancreatic cells are devoted to digestive function, the endocrine cells play a major role in your overall health. By regulating your blood sugar levels, the pancreatic hormones are directly related to some of the most common diseases of today, including diabetes.

Related Discussions Tips for mainting safe blood sugar levels? Subscribe to eAlerts What is this? In addition, approximately 79 million people in the US are estimated to have pre-diabetes, a condition in which blood glucose levels are abnormally high, but not yet high enough to be classified as diabetes. There are two main forms of diabetes mellitus. Type 1 diabetes is an autoimmune disease affecting the beta cells of the pancreas. Certain genes are recognized to increase susceptibility. The beta cells of people with type 1 diabetes do not produce insulin; thus, synthetic insulin must be administered by injection or infusion.

This form of diabetes accounts for less than five percent of all diabetes cases.

Treating Diabetes May be as Simple as Growing New Pancreatic Cells​

Type 2 diabetes accounts for approximately 95 percent of all cases. About 80 to 90 percent of people with type 2 diabetes are overweight or obese.

Understanding Insulin and Diabetes

In type 2 diabetes, cells become resistant to the effects of insulin. In response, the pancreas increases its insulin secretion, but over time, the beta cells become exhausted. In many cases, type 2 diabetes can be reversed by moderate weight loss, regular physical activity, and consumption of a healthy diet; however, if blood glucose levels cannot be controlled, the diabetic will eventually require insulin.

What is diabetes?

Two of the early manifestations of diabetes are excessive urination and excessive thirst. They demonstrate how the out-of-control levels of glucose in the blood affect kidney function. The kidneys are responsible for filtering glucose from the blood. Excessive blood glucose draws water into the urine, and as a result the person eliminates an abnormally large quantity of sweet urine. The use of body water to dilute the urine leaves the body dehydrated, and so the person is unusually and continually thirsty. The person may also experience persistent hunger because the body cells are unable to access the glucose in the bloodstream.

Over time, persistently high levels of glucose in the blood injure tissues throughout the body, especially those of the blood vessels and nerves.


  1. What is Insulin?;
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  4. An Overview of the Pancreas - Understanding Insulin and Diabetes.

Inflammation and injury of the lining of arteries lead to atherosclerosis and an increased risk of heart attack and stroke. Damage to the microscopic blood vessels of the kidney impairs kidney function and can lead to kidney failure. Damage to blood vessels that serve the eyes can lead to blindness. Blood vessel damage also reduces circulation to the limbs, whereas nerve damage leads to a loss of sensation, called neuropathy, particularly in the hands and feet. Together, these changes increase the risk of injury, infection, and tissue death necrosis , contributing to a high rate of toe, foot, and lower leg amputations in people with diabetes.

Uncontrolled diabetes can also lead to a dangerous form of metabolic acidosis called ketoacidosis. Deprived of glucose, cells increasingly rely on fat stores for fuel. However, in a glucose-deficient state, the liver is forced to use an alternative lipid metabolism pathway that results in the increased production of ketone bodies or ketones , which are acidic.

Diabetes is diagnosed when lab tests reveal that blood glucose levels are higher than normal, a condition called hyperglycemia. The treatment of diabetes depends on the type, the severity of the condition, and the ability of the patient to make lifestyle changes. As noted earlier, moderate weight loss, regular physical activity, and consumption of a healthful diet can reduce blood glucose levels.

Some patients with type 2 diabetes may be unable to control their disease with these lifestyle changes, and will require medication. Historically, the first-line treatment of type 2 diabetes was insulin.

The Birth of Beta Cells

Research advances have resulted in alternative options, including medications that enhance pancreatic function. Visit this link to view an animation describing the role of insulin and the pancreas in diabetes. The pancreas has both exocrine and endocrine functions.

Chronic pancreatitis and diabetes.

The pancreatic islet cell types include alpha cells, which produce glucagon; beta cells, which produce insulin; delta cells, which produce somatostatin; and PP cells, which produce pancreatic polypeptide. Insulin and glucagon are involved in the regulation of glucose metabolism. Insulin is produced by the beta cells in response to high blood glucose levels. It enhances glucose uptake and utilization by target cells, as well as the storage of excess glucose for later use.

Dysfunction of the production of insulin or target cell resistance to the effects of insulin causes diabetes mellitus, a disorder characterized by high blood glucose levels. The hormone glucagon is produced and secreted by the alpha cells of the pancreas in response to low blood glucose levels. Glucagon stimulates mechanisms that increase blood glucose levels, such as the catabolism of glycogen into glucose.

If an autoimmune disorder targets the alpha cells, production of which hormone would be directly affected? What would be the physiological consequence of a disease that destroyed the beta cells of the pancreas? Skip to content Increase Font Size. Chapter The Endocrine System. Learning Objectives By the end of this section, you will be able to: Describe the location and structure of the pancreas, and the morphology and function of the pancreatic islets Compare and contrast the functions of insulin and glucagon. Review Questions 1. Which of the following statements about insulin is true?