THE ENDOCRINE SYSTEM

Part 6: Pancreas
Definitions

Gluconeogenesis-the production of glucose, especially in the liver, from

amino acids, fats, and other substances that are not carbohydrates.
Glycogenolysis-the breakdown of glycogen to glucose.
Gangrene-local death and decay of soft tissues of the body as a result of lack
of blood to the area.

The Pancreas
The pancreas is a slender, pale-colored organ that lies transversely in
the abdomen between the kidneys and near the duodenum of the small
intestine.
It is about 20 cm long and 3 cm thick and weighs about 80 g.
Most of it is an exocrine digestive gland, but scattered through the exocrine
tissue are endocrine cell clusters called pancreatic islets (islets of
Langerhans).
The islets secrete at least five hormones, the most important of which are
insulin, glucagon, and somatostatin.
Insulin is secreted by the beta cells of the islets when we digest a meal and
the level of glucose and amino acids in the blood rises.
In such times, insulin stimulates cells to absorb glucose and amino acids from
the blood and especially stimulates muscle andadipose tissue to store
glycogen andfat.
Insulin promotes the livers synthesis of glycogen from the absorbed glucose.
Insulin stimulates cells to store excess nutrients for later use, and it
suppresses the use of already-stored fuels. The stored nutrients are then
available for use between meals and overnight.
By stimulating glycogen, fat, and protein synthesis, insulin promotes cell
growth and differentiation.
Insulin also antagonizesthe effects of glucagon.

 Glucagon is secreted by alpha cells when blood glucose concentration falls

between meals.
In the liver, it stimulates gluconeogenesis, glycogenolysis, and the release of
glucose into circulation.
In adipose tissue, it stimulates fat catabolism and the release of free fatty
acids.
Glucagon is also secreted in response to rising amino acid levels in the blood
after a high-protein meal. By promoting amino acid absorption, it provides
cells with raw material for gluconeogenesis.

Diabetes mellitus

Diabetes mellitus is a fairly common hormonal disease in which liver cells,

and indeed most body cells, are unable to take up glucose as they should.
Therefore, cellular famine exists in the midst of plenty, and the person
becomes extremely hungry.
As the blood glucose level rises, glucose, along with water, is excreted in the
urine. Urination is frequent and the loss of water in this way causes the
diabetic to be extremely thirsty.

Type 1 Diabetes

There are two types of diabetes mellitus.

In type 1 diabetes, the pancreas is not producing insulin. This condition is
believed to be brought on by exposure to an environmental agent, most likely
a virus, whose presence causes cytotoxicT cells to destroy the pancreatic
islets.
The body turns to the metabolism of fat, which leads to the buildup of
ketones in the blood, called ketonuria, and, in turn, to acidosis (acid blood),
which can lead to coma and death. As a result, the individual must have daily
insulin injections.
These injections control the diabetic symptoms but still can cause
inconveniences, since either an overdose of insulin or missing a meal can
bring on the symptoms of hypoglycemia (low blood sugar).
These symptoms include perspiration, pale skin, shallow breathing, and
anxiety.
Because the brain requires a constant supply of glucose, unconsciousnesscan
result.
Immediate ingestion of a sugar cube or fruit juice can very quickly counteract
hypoglycemia.

Type 2 Diabetes

Often, the patient is obeseadipose tissue produces a substance that impairs

insulin receptor function.
Normally, but not in the type 2 diabetic, the binding of insulin to a receptor
causes the number of glucose transporters to increase in the plasma
membrane.
Also, the blood insulin level is low andcells do not have enough insulin
receptors.

 It is possible to prevent or at least control type 2 diabetes by adhering to a

low-fat, low-sugar diet and exercisin gregularly. If this fails, oral drugs that
stimulate the pancreas to secrete more insulin and enhance the metabolism
of glucose in the liver and muscle cells are available.

Types of Diabetes

Long-term complications of both types of diabetes are blindness, kidney

disease, and cardiovascular disorders, including atherosclerosis, heart
disease, stroke, andreduced circulation. The latter can lead to gangrenein the
arms and legs.