What is a Pancreas?
By Joe Guarneri
dLife Contributing Writer
The pancreas, located in the abdomen (the area of the body between the chest and the pelvis), is a gland organ that has two roles, digestive and hormonal. One is to make and secrete the enzymes you need to digest food you eat, and the other is to produce hormones that regulate how your body uses food for energy.
The role of the pancreas can be split into two parts: The digestive juices (enzymes) produced by the pancreas are needed to digest food. The hormones produced by the pancreas are key in deciding how the body uses that broken down food for energy.
Each Role, in Depth
The hormonal roles of the pancreas take place in small clusters of cells, which are called "islets." Even though these clusters make up only 1-2% of the organ's bulk, they are very important to the function of the pancreas. Insulin and glucagon, among other hormones, are made in these islets. Receptors on the surface of each cluster are always keeping track of our blood glucose levels. When the levels get too high, the beta cells release insulin. If our blood glucose levels become too low, a different set of cells called alpha cells make glucagon. Glucagon prevents low blood glucose by helping the liver produce glucose.
The pancreas releases the digestive juices (enzymes) needed to take nutrients out of our food and put them into our body. To do this, the pancreas has a complicated system of ducts, which collect and transport digestive enzymes. Through these ducts, the enzymes are led to the duodenum, the upper part of the small intestine. The nutrients of the food are then absorbed in the small intestine. The pancreas also protects us from the stomach acids that could damage the sensitive lining of the small intestine. It does this by releasing a substance called ‘bicarbonate' into the duodenum, which neutralizes the acids, which creates a safe path for food during digestion.
The Pancreas and Diabetes
With its roles now clear, the pancreas' link to diabetes is even clearer.
In type 1 diabetes:
• The immune system destroys the beta cells, which means the body can no longer produce insulin.
• This leaves people with type 1 in need of insulin in order to survive.
In type 2 diabetes:
• The pancreas still produces insulin but the body doesn't respond to the insulin as it should. This causes insulin resistance.
• When there is insulin resistance, the beta cells of the pancreas' islets can no longer keep up with the body's demand for insulin and lower blood glucose levels as it should.
The Pancreas and Diabetes Treatment
Treatment for type 1 diabetes:
• Insulin. All people who have type 1 diabetes need to take insulin. At this time, insulin is approved to be taken by needle and syringe, insulin pens, and insulin pumps.
• Pancreas transplant – either with the entire organ or just the islets. Although transplants are usually a success, there is always a risk of the body rejecting the donor pancreas. If this does happen, powerful medications can be used to treat it.
• There are other treatments in research at this time such as oral insulin, artificial pancreas, and vaccines to prevent type 1 diabetes.
Treatment for type 2 diabetes:
• Decreasing insulin resistance, which includes healthy eating, being active, and for many, weight loss.
• Oral medications that increase insulin sensitivity such as metformin.
• Oral medications that stimulate the pancreas to produce more insulin
• Insulin. Many people who have type 2 diabetes need to take insulin
• Medications that work in the gut, such as GLP-1 agonists or DPP-4 inhibitors.
Reviewed by Joy Pape, RN, BSN, CDE, WOCN, CFNC. 8/13
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