If you talk to enough people about diabetes, eventually you might hear someone say “Your pancreas sucks!” Heck, I have heard people with diabetes say their own pancreas sucks. Are they right and should we all start wearing shirts denouncing the evil pancreas?
NO!! is the short answer
Wait. How can my pancreas be anything but sucky if it can’t even make insulin? It’s hard to forget I have to check my blood sugar all the time and then somehow get insulin under my skin, EVERY DAY! That sucks!
To understand why my pancreas doesn’t suck we have to understand all the jobs a normal pancreas takes on. For the readers who like the science details, keep reading. For the Reader’s Digest version skip to the heading “Does Any of My Pancreas Suck?” below.
Endocrine and Exocrine Functions
When broken down by function, 95% of the pancreas is comprised of cells with exocrine function and the remaining 5%, known as the islets of Langerhans perform endocrine function. Exocrine means the enzymes produced in the pancreas are released to another part of the body via ducts directly to the target area. Endocrine means the hormones produced are sent in the blood to the entire body before finding their target.
According to Medical News Today the pancreas produces about 1 liter of exocrine enzymes everyday. These aid directly with digestion in the first part of the small intestine and are produced by the acinar cells. Some of these enzymes include amylase, used to break down carbohydrates, trypsin and chymotripsin used to break down protein, and lipase used to break down dietary fats.
The endocrine function of the pancreas is broken down to different cell types in the islets of Langerhans that each produce specific hormones. These include Alpha, Beta, Delta, Epsilon, and F cells.
Alpha cells produce glucagon which travels to the liver and stimulates glycogen (the liver’s stored form of glucose) into glucose to be used right away. It also converts amino acids into carbohydrates for the same function. Both of these processes lead to increased blood sugar values.
Beta cells produce the hormone insulin. Once released, insulin travels to cells of the body to allow glucose uptake for immediate use or storage. When sugar leaves the blood and goes into the cells, the blood sugar drops. Because the brain uses a lot of glucose and does not store much itself, difficulty with thought processing and confusion can result when the blood sugar supply drops too low.
Since insulin is a hormone it is not very resilient. Gastric acids and heat can easily break it down rendering it non functioning fairly easily. This is why insulin is not supposed to be in hot environments prior to use and why there is not any way to take insulin as a pill. Here is a good article explaining insulin.
Delta cells produce the inhibitory hormone somatostatin. This hormone blocks the release of both glucagon and insulin. It acts to block growth hormone and also decreases acid production in the stomach.
Epsilon cells produce ghrelin. This hormone plays a role in energy balance. When the stomach is empty ghrelin is released leading to increased hunger sensation. It also stimulates the GI system indirectly to begin peristalsis movement in order to make space for a meal. Once a meal is consumed and the stomach stretches, grhelin secretion stops.
F Cells (sometimes referred to as PP cells) produce pancreatic polypeptide which aids to self regulate the endocrine and exocrine function of the pancreas. Its release increases with protein meals, fasting, hypoglycemia and exercise. It decreases with somatostatin release and with IV glucose.
Does Any of My Pancreas Suck?
It’s a numbers game. Of all the diabetics living in the US an estimated 5-10% are type 1. Since type one diabetes typically involves an autoimmune attack of the Beta cells alone within the islets of Langerhans that means there is still a lot of good tissue in your pancreas. According to this page beta cells make up about 70% of the Islets of Langerhans. As we talked about earlier the Islet cells make up about 5% of the total pancreas so if we knock out 70% of the 5% of total pancreas that means 96.5% of your pancreas is still awesome! That means we have a lot to be thankful for!
Does your pancreas annoy you sometimes? – Sure
Does your pancreas perform below 100%? -Yes
Is your pancreas the culprit? NO!
Don’t forget your pancreas was attacked by antibodies your own body produced! Let’s not pick on the victim here. After all this little 6 inch organ withstood the attack with only damage to about 3.5% of its total mass which is great. There are many bad things that can happen to a pancreas causing awful disease. Diabetes and it’s treatment often sucks but we can live long healthy lives if we play our cards right. I recently found a great quote from at irunoninsulin.com
” Well controlled diabetes is the leading cause of nothing.” ~Alexis Hauptman
From one fighter to another, keep up the good work pancreas! You do NOT suck.
Thanks to Johns Hopkins and Healthjade.com for the graphics used for educational illustration purposes.