ENDOCRINOLOGY ENDOCRINE VS EXOCRINE PANCREAS

AY 2019 -2020 Dr. Lapak

Module 6 12/13/19

PANCREAS
• Soft, lobulated, and elongated organ
• Maintains the body’s blood glucose (sugar)
balance
• Primary hormones of the pancreas include insulin
and glucagon
• Diabetes mellitus is the most common disorder
• Gland with both exocrine and endocrine functions
• Endocrine part produce and secretes hormones
into the bloodstream
• Exocrine part secretes enzymes through ducts

EXOCRINE PANCREAS
Figure 2. Islets of Langerhans are the endocrine cells of the pancreas that
FUNCTION: To produce pancreatic juice containing secrete hormones into the bloodstream which maintain the blood glucose
enzymes that digests carbohydrates level
• Consists of a large number of lobules made up of
small acini Type of Cell Secretion Function
• Each lobule is drained by a tiny duct and unite to A cell - 70% Glucagon Increases blood
form the pancreatic duct glucose levels
• Parasympathetic stimulation increases the B cell – 25% Insulin Lowers blood glucose
secretion of pancreatic juice while sympathetic levels
stimulation depresses it D cell – 4% Somatostatin Inhibits growth
• Composed of “exocrine cells” that produce hormone release
enzymes to help with the digestion of food from pituitary
F/PP cell – 1% Pancreatic Regulate digestive
polypeptide secretion and
motility

GLUCAGON
the primary counter regulatory hormone that
increases blood glucose levels
ü Regulation of glucagon secretion
• The major factor that regulates glucagon
secretion is the blood glucose concentration
**Decreased blood glucose stimulates glucagon secretion

Figure 1. Acinar cells are the exocrine cells of the pancreas that produce
and transport enzymes that are passed into the duodenum

ENDOCRINE PANCREAS
FUNCTION: To produce and secrete hormones into
the bloodstream and help control blood sugar levels
• Composed of small islands of cells, called the
islets of Langerhans
• These islets have no ducts so the hormones
diffuse directly into the blood
• There are 4 types of endocrine cells;
1. Alpha cells – secrete glucagon
2. Beta cells – secrete insulin
3. Delta cells – release somatostatin; a
paracrine inhibitor of insulin and glucagon
4. PP cells – produce pancreatic polypeptide
which regulate ion transport in the body
ü Actions of glucagon
• Glucagon acts on the liver and adipose tissue
• The second messenger for glucagon is cAMP
a.Glucagon increases the blood glucose concentration
1. It increases glycogenolysis; stimulates the liver to
convert its stores of glycogen back into glucose
2. It increases gluconeogenesis; stimulates the liver
to take up amino acids from the blood and convert
them into glucose

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b. Glucagon increases blood fatty acid and ketoacid
concentration
1. Glucagon increases lipolysis; the breakdown of
stored triglycerides into free fatty acids and
glycerol
**The activity of glucagon is regulated through a negative
feedback mechanism; rising blood glucose levels inhibit further
glucagon production and secretion.
INSULIN
Primary function is to facilitate the uptake of
glucose into body cells
üIncreases the cells permeability to glucose
üDecreases glucose concentration in the blood by
promoting the utilization of the glucose by the
tissue cells
üPromotes the storage of glycogen in the liver
• The primary anabolic hormone that dominates
regulation of metabolism during the digestive phase
• RBCs, brain, liver, kidneys, and the lining of the
small intestines do not have insulin receptors on
their cell membranes
• Skeletal muscle cells and adipose tissue is the
primary target of insulin
• Synthesized as preproinsulin, which is converted to
proinsulin as the hormone enters the endoplasmic
reticulum. Proinsulin is packaged in the Golgi
apparatus into membrane-bound secretory
granules. Proinsulin contains the AA sequence of
insulin plus the C (connecting) peptide
Ø Regulation of insulin secretion
• Glucose is the primary stimulus of insulin
secretion
Ø Insulin receptor
• insulin appears to activate a tyrosine kinase
receptor, triggering the phosphorylation of many
substrates within the cell
• insulin-receptor complexes enter the target cells
• insulin down-regulates its own receptros in target
tissues; the number of insulin receptors is
increased in starvation and decreased in obesity
Ø Action of insulin
• Insulin acts on the liver, adipose tissues and
muscle
• Insulin decreases blood glucose concentration
1. It increases uptake of glucose into target
cells. As glucose enters the cells, the blood
glucose concentration decreases
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2. It promotes formation of glycogen from glucose
in muscle and liver, and simultaneously inhibits
glycogenolysis.
3. Insulin promotes triglyceride and protein
synthesis. The secretion of insulin is regulated
through a negative feedback mechanism. As
blood glucose levels decrease, further insulin
release is inhibited
COUNTERREGULATORY HORMONES
GLUCAGON & CATECHOLAMINES
CATECHOLAMINE: EPINEPHRINE AND
NOREPINEPHRINE
• Epinephrine is the primary product of the adrenal
medulla, whereas norepinephrine is released from
postganglionic sympathetic nerve endings;
• Catecholamines are released in response to
decreased glucose concentrations, various forms
of stress, and exercise;
• Decreased glucose levels (i.e., hypoglycemia) are
primarily sensed by neurons in the CNS, which
initiate an integrated sympathetic response
through the hypothalamus;
• The direct metabolic actions of catecholamines
are mediated primarily by α1-, β2-, and β3-
adrenergic receptors located on muscle, adipose,
and liver tissue.
**Like the glucagon receptor, β-adrenergic receptors
(β2 and β3) increase intracellular cAMP.
Diabetes Mellitus - dysfunction of insulin production
and secretion,as well as the target cells’
responsiveness to insulin.
Signs and Symptoms
3Ps
• Polyphagia-increased appetite
The body cells are unable to access the
glucose in the bloodstream-cell starvation
• Polyuria-increased urination
Excessive blood glucose draws water into the
urine, and as a result the person eliminates
an abnormally large quantity of urine
• Polydipsia-increased thirst
The use of body water to dilute the urine
leaves the body dehydrated, and so the
person is unusually and continually thirsty
Plus:
Glycosuria-glucose excreted in the urine
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 Type 1
• autoimmune disease affecting the beta cells
of the pancreas
• beta cells do not produce insulin; thus,
synthetic insulin must be administered by
injection or infusion
• young onset
• 5% of DM cases

Type 2
• cells become resistant to the effects of
insulin
• It is acquired, and lifestyle factors such as
poor diet, inactivity, and the presence of
pre-diabetes greatly increase a person’s risk
• 80-90% are obese or overweight
• maturity onset
• 95% of DM cases

SOURCES:

Doc Lapak’s PPT

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