The insulin your pancreas makes (or doesn’t make) is at the center of how the body regulates blood glucose levels. Learn more about how this vital organ works and how you can help maintain the health of your pancreas.
When learning about diabetes and how to manage it, it’s easy to get lost in the buzz about the newest drugs, new diets, and new methods of controlling diabetes. Sometimes, it seems as if there is more information about new developments than fundamental knowledge. Knowing a bit about what’s actually going on inside your body will help you contextualize the latest news.
Basic knowledge about the biological mechanisms of diabetes will allow a person who has it or a person with a family history of it to have a more holistic understanding of what is happening with their bodies.
With that in mind, here is a brief overview of the main organ involved in diabetes – the pancreas – including how it functions and what you can do to keep your pancreas as healthy as possible.
What is the pancreas?
The pancreas is an organ located in the abdomen (midsection) of the body. Specifically, it sits behind the stomach and close to the spine. It is considered an “accessory organ” to the digestive tract. This means that, unlike the stomach and intestine, the pancreas does not come into direct contact with the food you eat. Instead, the pancreas helps the digestive process move forward smoothly.
Its function is to release fluids, hormones, and other components that aid digestion and absorption of food. The function of the pancreas can be broken down into two parts: exocrine and endocrine.
The exocrine function of the pancreas
The exocrine function of the pancreas is responsible for secreting (releasing) the substances required to digest the food we eat, so that it can be absorbed by the body. The organ secretes around one liter of fluid per day into the small intestine as a direct response to the body’s signal that food has arrived.
This fluid includes enzymes, which are proteins that help break down other substances like carbohydrates (sugars and starches), fats, and proteins into nutrients that can be absorbed into the blood and carried to all parts of the body.
This pancreatic function is important because without it, we would have trouble digesting all the different components of our food.
The endocrine function of the pancreas
The endocrine function of the pancreas is more widely known than the exocrine function. The endocrine function of the pancreas is responsible for releasing the hormones that help your body maintain stable blood glucose (sugar) levels. These hormones come from cells in the organ that are arranged in small clusters, known as the “islets of Langerhans.” These islets include different types of cells known as beta cells, alpha cells and delta cells. Although these cells only represent about 10% of the entire pancreas, their impact is much larger than that. Here is a brief description of each of these hormones and the roles they play in maintaining stable blood glucose levels:
This is the most well-known hormone released by the pancreas. Insulin allows most cells to take in glucose to be used by the body. When a person eats a meal or snack, the body digests and absorbs the glucose into the bloodstream. This may cause an increase in the body’s blood glucose levels.
In response to the meal, the pancreas rapidly secretes insulin, which is produced by the beta cells. From there, the glucose is taken in by many of the different cells of the body, where it is broken down and used as energy.
With type 1 diabetes, the body produces little or no insulin. In people with type 2 diabetes, the amount of insulin produced is reduced, and cells in the body do not respond as efficiently to the insulin that is being produced.
This is why people with diabetes, especially those with type 1, require insulin. Taking insulin can help make up for the lack of insulin production in the pancreas. This makes it possible for the body to use glucose normally so that it doesn’t accumulate in the blood. Prescribed insulin is slightly different from what the body normally produces, as it is typically created from bacteria and/or yeast through recombinant DNA.
The hormone glucagon is secreted by the alpha cells of the pancreas. Glucagon is seen as the “mirror image” of insulin; while insulin helps lower blood glucose levels, glucagon can help raise those levels if they’re too low.
After a meal, when the body has extra glucose but does not need to use it right away for energy, the extra glucose is stored in the liver to be used in the future. As time passes and a person has not eaten food for a while, blood glucose levels will go down, which usually triggers the secretion of glucagon. This hormone tells the liver to release its stored glucose into the blood.
What happens to your pancreas when you have diabetes?
Understanding how the pancreas works allows us to have more insight into how diabetes occurs, how it is diagnosed, and how it is managed.
For example, recall that insulin and amylin are released from the same beta cells within the pancreas. For people with type 1 diabetes, the body’s immune system attacks the cells in the islets of Langerhans, including beta cells. This means that the body is no longer able to produce insulin or regulate glucose levels.
The problem for individuals with type 1 diabetes is that excessive hunger and thirst causes blood glucose levels to increase. There are no hormones being secreted to tell the body to begin using this glucose for energy or storage.
Even without a properly functioning endocrine pancreas, the exocrine pancreas can still function as it is supposed to. The exocrine pancreas will help the stomach break down food into components to be absorbed into the blood. But without insulin, this results in high blood glucose levels, which can damage other organs like the kidneys, nerves, eyes, and heart.
In those with type 2 diabetes, the issue is slightly different. The pancreas still secretes some, but not enough, insulin. In addition, the body’s cells cannot properly use the insulin being made. This is called insulin resistance. This also leads to blood glucose levels that are higher than they should be.
However, many medications and other interventions can help people manage their type 2 diabetes and lower glucose levels into a healthy range. These interventions include insulin (the medication), other diabetes medications like metformin, SGLT-2 inhibitors, and GLP-1 receptor agonists, and lifestyle modifications that focus on eating less and exercising more.
How to keep your pancreas as healthy as possible
Dr. Jill Paulson, an endocrinologist at Ryse Health, offers insight into what helps to keep a pancreas healthy:
Minimizing internal injury: Many people don’t realize that trauma to the pancreas from alcohol, other illnesses or even physical trauma could result in the onset of diabetes, or other problems.
Losing weight and increasing physical activity: Maintaining a healthy weight can help reduce the amount of fat around the midsection as well as in the liver and pancreas. This allows the organs, including the pancreas, to function properly. This is especially important in people with diabetes. Maintaining a healthy weight ensures that your pancreas maintains the best function possible. Some people even find that they no longer need medications to maintain a normal blood glucose levels.
Following a healthy diet: Consistently high blood glucose levels have been shown to be more harmful than an occasional spike. It is best to eat a balanced diet that focuses on moderation, and avoid foods that cause your glucose levels to remain high.
Healthy balance of insulin and glucagon: Glucagon works almost as a mirror to insulin. It is important for the pancreas to have a healthy balance of the two. This includes monitoring your glucose levels, taking your medications on time, and consulting your doctor if there are any challenges or difficulties.
Dr. Paulson also recommends managing blood pressure and cholesterol as well as blood sugar, not only to try to maintain a healthy pancreas, but to help overall health and prevent diabetes-related complications including heart disease and stroke.