1. Pancreatic Hormones
Glucagon
Insulin

2. Pancreas Histology

3. Pancreas
13-34

4. Islets of Langerhan (Pancreatic Islets)

5. Pancreatic Hormones, Insulin & Glucagon Regulate Metabolism
Figure 22-8: Metabolism is controlled by insulin and glucagon

10. Insulin Stimulates Cellular Glucose Uptake
Adipocytes
Skeletal Muscle
Liver
Insulin
Intestine & Pancreas

11. Glucagon and Insulin

12. Action of Insulin on Adipose Tissue
Stimulates glucose uptake
Stimulates glycolysis
Stimulates lipogenesis
Inhibits lipolysis and ketogenesis

13. Actions of Glucagon on the Liver
Stimulates glycogenolysis
Stimulates gluconeogenesis
Inhibits glycolysis
Stimulates lipolysis and ketogenesis

17. Actions of Insulin on the Liver
Stimulates glucose uptake
Stimulates glycogenesis
Stimulates glycolysis
Stimulates HMP shunt activity
Inhibits glycogenolysis
Inhibits gluconeogenesis
Stimulates lipogenesis
Inhibits lipolysis
Stimulates cholesterol synthesis
Increases VLD lipoprotein
Increases potassium and phosphate uptake

18. Actions of Insulin on Muscle
Stimulates glucose uptake
Stimulates glycogenesis
Stimulates glycolysis
Inhibits glycogenolysis
Inhibits FFA uptake and oxidation
Stimulates proteogenesis
Inhibits proteolysis
Stimulates uptake of potassium, phosphate and magnesium
Increases blood flow

19. GLUCAGON Alpha cells Hypoglycemia = glucagon secretion Actions
hypoglycemia (<90mg%)
alpha cells secrete glucagon
liver cells:
increase glycogenolysis
increased gluconeogenesis
normoglycemia (>90mg%)
( -)
negative feedback
increased blood glucose
increased glycogenolysis
increased gluconeogenesis
Result = normoglycemia

20. INSULIN Beta cells Hyperglycemia = insulin secretion Actions
hyperglycemia (<110mg%)
beta cells secrete insulin
increased glucose uptake into body cells increase glycogenesis
(skeletal muscle, liver)
increased lipogenesis
normoglycemia (<110mg%)
( -)
negative feedback
decreased blood glucose
increased glucose uptake
increased glycogenesis
increased lipogenesis
Result = normoglycemia
Diabetes mellitus

21. Normal Insulin Glycerol Lipolysis Free fatty acids Triglyceride
LPL
Triglyceride
Lipolysis
Glycerol
Free fatty acids
Free fatty acids
Glucose
Synthesis
Insulin

22. Type 1 Diabetes Mellitus
Triglyceride
LPL
Glycerol
Lipolysis
Free fatty acids
Synthesis
Free fatty acids
Glucose

23. Diabetes Mellitus This is a disease caused by elevated glucose levels
2 Types of diabetes:
Type I diabetes (10% of cases)
Type II diabetes (90% of cases)

24. Type I Diabetes (10% of cases)
Develops suddenly, usually before age 15
Caused by inadequate production of insulin because T cell-mediated autoimmune response destroys beta cells
Controlled by insulin injections

25. Type II diabetes (90% of cases)
Usually occurs after age 40 and in obese individuals
Insulin levels are normal or elevated but there is either a decrease in number of insulin receptors or the cells cannot take it up.
Controlled by dietary changes and regular exercise

26. Homeostasis: Normal blood glucose level (about 90 mg/100 mL)
Glucose homeostasis
Body cells take up more glucose
Insulin
Beta cells of pancreas stimulated to release insulin into the blood
Liver takes up glucose and stores it as glycogen
Blood glucose level declines to a set point; stimulus for insulin release diminishes
High blood glucose level
STIMULUS: Rising blood glucose level (e.g., after eating a carbohydrate-rich meal)
Homeostasis: Normal blood glucose level (about 90 mg/100 mL)
STIMULUS: Declining blood glucose level (e.g., after skipping a meal)
Blood glucose level rises to set point; stimulus for glucagon release diminishes
Alpha cells of pancreas stimulated to release glucagon into the blood
Liver breaks down glycogen and releases glucose to the blood
Glucagon
Figure 26.8

27. Type 2 diabetes: patophysiology
Exxagerated lipolysis I
Glucose G I
Beta Cell
Dysfunction I
Insulin G G G I G
Pancreas I G G I I G G I
Decreased Glucose
Uptake I
Increased SGO G G
Insulin Resistance

28. FOOD I Glucose Insulin Insulin Effects Storage In Fat Depots
Inhibition of Lipolysis I
Glucose G I
Insulin
Secretion I G
Insulin G G I G
Pancreas I G G I I G
Restrain of HGO G I I
Uptake of glucose G G
Insulin Effects

29. Prevention of obesity
قال صلى الله عليه وسلم (ما ملأ آدمي وعاء شرا من بطنه، بحسب ابن آدم لقيمات يقمن صلبه، فان كان لابد فاعلا فثلث لطعامه وثلث لشرابه وثلث لنفسه). رواه أحمد والترمذي