22.2.8 Pancreas

Pancreas is a composite gland (Figure 22.1) which acts as both exocrine and endocrine gland. The endocrine pancreas consists of ‘Islets of Langerhans’. There are about 1 to 2 million Islets of Langerhans in a normal human pancreas representing only 1 to 2 per cent of the pancreatic tissue.

The two main types of cells in the Islet of Langerhans are called α-cells and β-cells. The α-cells secrete a hormone called glucagon, while the β-cells secrete insulin. Glucagon is a peptide hormone, and plays an important role in maintaining the normal blood glucose levels.

Glucagon acts mainly on the liver cells (hepatocytes) and stimulates glycogenolysis resulting in an increased blood sugar (hyperglycemia). In addition, this hormone stimulates the process of gluconeogenesis which also contributes to hyperglycemia.

Glucagon reduces the cellular glucose uptake and utilisation. Thus, glucagon is a hyperglycemic hormone. Insulin is a peptide hormone, which plays a major role in the regulation of glucose homeostasis. Insulin acts mainly on hepatocytes and adipocytes (cells of adipose tissue), and enhances cellular glucose uptake and utilisation.

As a result, there is a rapid movement of glucose from blood to hepatocytes and adipocytes resulting in decreased blood glucose levels (hypoglycemia). Insulin also stimulates conversion of glucose to glycogen (glycogenesis) in the target cells.

The glucose homeostasis in blood is thus maintained jointly by the two – insulin and glucagons. Prolonged hyperglycemia leads to a complex disorder called diabetes mellitus which is associated with loss of glucose through urine and formation of harmful compounds known as ketone bodies. Diabetic patients are successfully treated with insulin therapy.

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