Islet Function

A key role for the pancreatic islets is to deliver an optimal amount of peptide hormones into the bloodstream to optimize carbohydrate metabolism. Of most importance in this respect is insulin, which facilitates the transport of glucose into insulin-dependent cells for storage as glycogen and fat with a concomitant reduction in blood glucose and free fatty acid levels as a consequence. One of the most important target organs for insulin action is the liver, in which at least 50% of the insulin secreted from the endocrine pancreas is extracted before reaching the systemic circulation. Other important target organs are skeletal muscle and adipose tissue, which express the insulin receptor. Insulin reduces circulating levels of glucose by inhibiting glucose release from the liver and augmenting glucose uptake in skeletal muscle and adipocytes. Glucagon is also an important hormone regulating carbohydrate metabolism. Glucagon increases blood glucose levels mainly by increasing hepatic glucose delivery through stimulation of glycogenolysis. A thorough understanding of the regulation of carbohydrate metabolism therefore requires a detailed knowledge of the pancreatic islets and their anatomy and physiology as well as pathophysiologic importance for conditions of impaired glucose tolerance and diabetes.

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