The Pancreas and Blood Sugar
see many people today with “sugar handling” symptoms. This means the body does not handle the “glucose” it needs to get into the cells for
energy properly. It could be the patient
does not take in enough good sugar, or insulin which takes the sugar into the
cell is not working properly, or the cell membrane has become damaged and does
not allow the insulin in the cell to be used. Symptoms include: getting
hungry when we shouldn’t, we do not feel fulfilled after we eat, we feel our
brain needs a sweet after eating to enable us to feel right and think, we get
shaky or even mean when we do not get enough to eat or that the time we need
our food. These problems get worse and worse and maybe we get diabetes and
these causes inflammation throughout our body, neuropathy and heart disease.
pancreas, is at the center of handling
our sugar handling as it reacts to help digest and absorb our food for energy
and provides insulin to take the sugar into the cells. The pancreas is both an
exocrine gland and an endocrine gland.
The exocrine portion produces pancreatic juice that is carried to the stomach
and small intestine. The pancreatic
juice consists of an aqueous component that contains sodium, potassium, and
bicarbonate ions and an enzymatic component that contains digestive enzymes
(hepatic lipase, amylase, and protease) that are important in the breakdown of
lipids, protein, and carbohydrates. The
exocrine portion of the pancreas is under hormonal and neural control. For example, cholecystokinin stimulates the
release of bile from the gall bladder and digestive enzymes from the
pancreas. Parasympathetic stimulation
through the vagus nerves also stimulates pancreatic juice secretions. Sympathetic stimulation inhibits pancreatic
juice secretion which could cause a decrease in digestion, increase
indigestion, and cause GERD. Stress
increases this sympathetic stimulation which means stress=digestion problems,
portion of the pancreas produces hormones that are released into the
circulatory system. The hormones are
produced by specific cell types in the pancreas: alpha cells – glucagon, beta
cells – insulin, and delta cells – somatostatin. The autonomic nervous system innervates these
cells to release their hormones based on the body’s needs. The parasympathetic nervous system is
associated with food intake and acts on the pancreas to increase insulin
secretion. As blood glucose
concentration rises, the pancreas secretes insulin to decrease the
concentration of blood sugar and store the glucose in the cells. Insulin promotes cell uptake of glucose and
also promotes the synthesis of glycogen which is the storage form of glucose
inside cells. The sympathetic nervous
system inhibits insulin secretion to maintain blood glucose levels during
periods of physical activity and excitement.
When blood sugar levels are to low, the pancreas can also secrete
glucagon which increases the release of glucose from cells and promotes the
reaction gluconeogenesis in order to produce more glucose.
The pancreas is
not the only organ that maintains blood glucose levels. Many endocrine organs and hormones play a
vital role in the homeostasis of blood sugar concentration. Some other organs that are important are the
hypothalamus, pituitary, and the adrenal glands. The hypothalamus and the pituitary stimulate
the release of hormones that act on different tissues of the body that can
affect blood sugar maintenance. In times
of stress, the pituitary stimulates ACTH which will act on the adrenal glands
to produce cortisol and epinephrine.
Both of these hormones will cause an increase in blood sugar. Growth hormone is another example of a
hormone that plays a role in sugar maintenance.
Growth hormone will also increase blood concentrations of sugar. Many different hormones are responsible for
the glucose levels in an individual. If
any of these hormones are distributed unevenly, an imbalance of glucose might
partake. The body might be able to
normalize blood sugar levels by increasing the output of another hormone. This could lead to exhaustion of the
secondary organ and could cause long term consequences. It is important for every organ to support
the body properly. Glucose is maintained
endogenously however a lot of glucose can come from an outside source like
Glucose is obtained through eating
carbohydrates and is maintained through the functioning of the body’s endocrine
system. The digestion of carbohydrates
starts in the mouth with the enzyme amylase that is present in saliva. Then the food goes to the stomach and then
released into the small intestines. The
small intestine is where most of the carbohydrate digestion takes place. The pancreatic juices are carried to the
stomach and small intestine where the starchy carbohydrates are broken down by
the enzyme amylase into maltose or sucrose.
The maltose and sucrose are then absorbed into the lining of the
intestine and get further converted in glucose.
Once the carbohydrates are converted into glucose, the sugar gets absorbed
into the bloodstream. Then glucose
travels to different tissues in the body where it can be stored or used as
Glucose is the
main source of energy for the brain. The
nerves and the brain depend on normal sugar levels to function properly. Diabetics have shown to be at an increased
risk for mild cognitive impairment and Alzheimer’s disease due to hyperglycemia. Recent studies have shown that people with
diabetes are 1.5 times more likely to develop cognitive decline than people without
diabetes. The ongoing Memory in Diabetes
study show that a 1 percent increase in A1C levels corresponded to slightly
lower scores on psychomotor speed, cognitive function, memory, and multiple
task management. This study supports the
idea that the brain’s chronic exposure to elevated blood glucose levels may be
one explanation for memory and cognitive decline in the elderly and diabetics. There are a couple theories of why high blood
sugar could cause impaired mental function.
One theory is that high levels of blood sugar over a period of time may
cause direct damage to nerve cells due to the accumulations of certain
end-products. Nerve damage may also
result indirectly by damage to blood vessels in the brain due to
atherosclerosis. Another theory states
that elevated blood sugar reduces the volume of the hippocampus. The hippocampus plays an important role in
memory and spatial navigation. The
hippocampus is also one of the first regions of the brain to suffer damage in
people with Alzheimer’s disease.
disorders can have psychiatric presentations.
Hypoglycemia can cause people to become disoriented, confused, and even
hallucinate. If a person has continuous
states of hypoglycemia, then they can have persistent cognitive impairment
which could mimic psychiatric disorders.
The brain cannot store glucose, so the brain gets its energy supply
through the bloodstream. Also a
prolonged period of hyperglycemia could affect the brain. As mentioned previously, diabetic patients
have a faster decline in mental function compared to healthy individuals.
Written by Lynn Lafferty and Jason
click here for What To Do For “Sugar Handling” Problems