The principal pancreatic hormones are insulin and glucagon, whose opposing effects on the liver regulate hepatic storage, production, and release of energy-rich fuels. Insulin is an anabolic hormone that promotes sequestration of carbohydrate, fat, and protein in storage depots throughout the body. Its powerful actions are exerted principally on skeletal muscle, liver, and adipose tissue, whereas those of glucagon are restricted to the liver, which responds by forming and secreting energy-rich water-soluble fuels: glucose, acetoacetic acid, and ^-hydroxybutyric acid. Interplay of these two hormones contributes to constancy in the availability of metabolic fuels to all cells. Somatostatin is a third islet hormone, but a physiologic role for pancreatic somatostatin has not been established. A fourth substance, pancreatic poly-peptide, is even less understood. Glucagon acts in concert with other fuel-mobilizing hormones to counterbalance the fuel-storing effects of insulin. Because compensatory changes in secretion of all of these hormones are readily made, states of glucagon excess or deficiency rarely lead to overt human disease. Insulin, on the other hand, acts alone, and prolonged survival is not possible in its absence. Inadequacy of insulin due either to insufficient production [diabetes mellitus type I, also called insulin-dependent diabetes mellitus (IDDM)] or end-organ unresponsiveness [diabetes mellitus type II, also called noninsulin-dependent diabetes mellitus (NIDDM)] results in one of the most common of the endocrine diseases and affects more than 3% of the American population.

Delicious Diabetic Recipes

Delicious Diabetic Recipes

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