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Thursday, January 21, 2010

Physiology and Pathophysiology of Diabetes Mellitus

Physiology and Pathophysiology of Diabetes
Insulin is secreted by the beta cells, which is one of four types of cell in Islet of Langerhans in the pancreas. Insulin is a storage hormone. When a person eats a meal, secretion of insulin increases and moves glucose from the blood into muscle, liver and fat cells. In those cells, insulin:
• Transports and metabolizes glucose for energy

• Stimulates storage of glucose in the liver and muscle (in the form of glycogen)
• Signals the liver to stop the release of glucose
• Enhances storage of dietary fat in adipose tissue
• Accelerates the transport of amino acids (derived from dietary protein) into cells.
Insulin also inhibits the breakdown of stored glucose, proteins and fat. When the person do not eat or during fasting periods, the pancreas continuously secrete small amounts of insulin (basal insulin); another pancreatic hormone secreted by the alpha cells of the Islets of Langerhans called glucagon is released when the blood drops and stimulate the liver to release stored glucose. Insulin and glucagon maintain a constant level of glucose in the blood. The liver produces glucose through the “breakdown of glycogen” (glycogenolysis). Liver utilizes the breakdown of carbohydrate substance including amino acids in the process called (glucogenesis).


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