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Pancreas anatomy

Pancreas

• Mixed endocrine / exocrine gland
• Secretes 1-1.5l pancreatic juice daily

Function of the pancreas

1. Endocrine
   • Alpha cells: Glucagon
   • Beta Cells: Insulin
     1. Carbs: - Increase glucose uptake, stimulates glycogensis
     2. Proteins: Enhances AA into peripheral tissues, stimulates protein synthesis
     3. Fats: Stimulates lipid uptake
     4. Potassium: into cells
   • [Gamma cells: pancreatic polypeptide - reduces appetite]
   • Delta Cells: Somatostatin
2. Exocrine
   • 1 - 1.5l pancreatic juice / day
   • Aqueous component - water, bicarbonate
   • Enzymatic component - digestive enzymes
     1. (1) Proteases (secreted as inactive zymogen form) - trypsinogen, chymotrypsinogen, procarboxypeptidase, proelastase
     2. (2) Lipolytic - Lipase, Phospholipase A2
     3. (3) Starch digestion - Amylase

Glucose metabolism

• Sources

1. Diet
2. Glycogenolysis
3. Gluconeogenesis
   • Lactate, glycerol, Amino acids

• Blood sugar control

1. Increase BM: Catecholamines, Glucocorticoids, Somatotrophin
2. Decrease BM: Insulin

Ketosis

1. Starvation
   • Diabetes - (omission of insulin, infection, drug induced)
   • Improper utilisation of TCA components
2. Increased lipolysis and increased FFA production (readily transportable fatty acids that can be utilised by organs such as heart and brain)
3. Ketone production - acetone, acetoacetate, B-hydroxybutyrate