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Title: Endocrinological Function of the Pancreas
Description: Endocrinological functions of the Pancreas, revision of insulin and glucagon control of blood glucose levels. Suitable for 1st/2nd year medical students
Description: Endocrinological functions of the Pancreas, revision of insulin and glucagon control of blood glucose levels. Suitable for 1st/2nd year medical students
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ENDOCRINOLOGY
The Pancreas
The pancreas sits in the duodenum; is partly obliterated by the
liver and stomach; is deep and lies towards back – Therefore
pancreas is hard to image
Pancreatic duct: drains endocrine secretions from the pancreas
Exocrine Pancreas
Exocrine pancreatic enzymes include:
-‐ Pancreatic amylase: continues the digestion of carbohydrates
-‐ Pancreatic lipase: hydrolyses natural fats to fatty acids and monoglycerides
-‐ Cholesterol esterase: hydrolyses cholesterol esters
-‐ Phospholipase: splits fatty acids from phospholipids
-‐ Deoxyribonucleases/ ribonucleases: digest DNA and RNA
Endocrine Pancreas
Cells
%
Function
α
20%
Secrete glucagon
Glucagon counteracts insulin; promotes glycogenolysis and
gluconeogenesis and lipolysis
β
70%
Secrete insulin and amylin
Insulin: promotes uptake of glucose (glycolysis and
glycogenesis), lipogenesis, proteogenesis
δ
5-‐10%
Secrete somatostatin (GHIH)
GHIH acts in GIT to decrease acid secretion (via inhibition of
secretin and gastrin); inhibits GH release by pituitary gland;
suppresses release of pancreatic insulin and glucagon
F
1-‐2%
Produces Pancreatic polypeptide
Pancreatic polypeptide inhibits pancreatic and gastric
secretions
ε
1-‐2%
Produce Ghrelin
Ghrelin promotes appetite and weight gain
D1/Type
Minor
Produce VIP
IV cells
Entero-‐
Minor
Produce Serotonin
chromaffin
cells
The islets of Langerhans produce 4+ hormones
...
Islets of Langerhans are most numerous in the tail region of the pancreas
...
Other causes:
-‐ Trauma
-‐ Mumps
-‐ Autoimmune disease
-‐ High blood calcium
-‐ Hypothermia
Pancreas diversum is a common congenital malformation which may underlie some
recurrent cases
...
The Pancreas and Diabetes Mellitus
Insulin dependent diabetes mellitus is a common complication of chronic pancreatic
damage; may require treatment with long term insulin therapy
-‐ Islet cell dysfunction à abnormal insulin and glucagon dynamics in type 2
diabetes
-‐ Type 2 diabetics:
o Have a delayed and suppressed insulin response
o Fail to exhibit normal post-‐prandial declines in glucagon concentrations,
despite marked hypergylcaemia
Reduced insulin à increased blood sugar
The pathophysiology of hyperglycaemia in T2DM involves three main defects:
1) Insulin deficiency due to insufficient pancreatic insulin release
2) Excess hepatic glucose output
3) Insulin resistance (decreased glucose uptake) in peripheral tissues (including
muscle and fat) and the liver)
Two groups of pancreatic islet cells contribute to hyperglycemia:
-‐ Alpha cells
o Produce excess glucagon despite sugar levels being high; reason
unknown
o Elevated glucagon levels à increased hepatic glucose output
-‐ Beta cells
o In T2DM, a decline in functional beta-‐cell mass causes insulin deficiency
Title: Endocrinological Function of the Pancreas
Description: Endocrinological functions of the Pancreas, revision of insulin and glucagon control of blood glucose levels. Suitable for 1st/2nd year medical students
Description: Endocrinological functions of the Pancreas, revision of insulin and glucagon control of blood glucose levels. Suitable for 1st/2nd year medical students