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Pathophysiology of Diabetes Mellitus

Updated on May 7, 2013

The role of glucagon-insulin-somatostatin in blood sugar regulation in diabetes mellitus is a complex process that can only be understood by reviewing the normal processes of the body. This article provides the basic explanation of the glucagon, insulin, and somatostatin functions, why they are important and how they are regulated by the pancreas to have a normal blood glucose level. The roles these hormones in blood glucose regulation cannot be denied to be one of the major factors in the occurrence of diabetes mellitus.

There is no such word as abnormal if we do not have normal concepts which serve as our basis. In the case of diabetes mellitus, the insulin is the primary concern. Let us try to dissect what glucagon, insulin, and somatostatin are, what produces them, and their function in the regulation of blood sugar, and its special connection to diabetes mellitus.



The pancreas is one of the major organs of the body. It has both exocrine (produces digestive enzymes) and endocrine (produces hormones) function.

The exocrine function of the pancreas focuses in the production of enzymes that are needed for proper digestive processes in the body. The pancreatic enzymes are delivered via the pancreas’ special connection with the first segment of the small intestine known as the duodenum. But we’ll skip from discussing further on the exocrine function of the pancreas because it is fairly not the focus of this topic.

The endocrine function of the pancreas focuses on its special group of cells known as the Islets of Langerhans. The Islets of Langerhans has three distinct types of cell, the alpha, the beta, and the delta cells.

1. Alpha Cells

The alpha cells secrete glucagon. One of the major actions of glucagon is it stimulates the liver to convert glycogen and amino acids to glucose. The secretion of glucagon is actually a regulatory mechanism wherein it is released once the body transmits negative feedback in cases of low blood sugar level. This is an automatic response. In cases that blood glucose level is on its desired level or exceeds the normal level, glucagon secretion stops.


2. Beta Cells

The beta cells secrete insulin. Insulin has two major functions in response to blood glucose concentration. First, it counters the effects of glucagon by stimulating the liver to convert glucose to glycogen and inhibits the conversion of other non-carbohydrates like amino acid to glucose. Second, it facilitates the diffusion of glucose into the cells through insulin receptors. Insulin secretion is also regulated by a negative feedback by the body to respond in cases of high blood glucose level.

3. Delta Cells

The delta cells secrete somatostatin. Somatostatin is released by the delta cells to help regulate carbohydrates by inhibiting the secretion of glucagon.


The normal body has various hormones secreted by various endocrine glands. Most of these hormones come at least in pairs. There is at least one hormone from each organ doing excitatory effects, and, there is also at least one hormone from each organ regulating or countering the effects of the first hormone. This mechanism is innate, keeping homeostasis (balance) in the body.

In the pancreas, the low blood sugar level in the body is responded by the pancreas by producing glucagon to elevate blood glucose concentration. Once it reaches the desired or above normal level, it releases insulin and somatostatin to counter the effects of glucagon. This is a wonderful automatic response in the body. It cannot be found only in the pancreas, but all other endocrine glands in the body as they perform their specific tasks.

In cases of pancreatic malfunction due to diseases and ailments, the automatic response is altered. The malfunctioning may either cause abnormally too low or abnormally too high production of hormones. In diabetes mellitus, the beta cells fail to release what is required while the alpha cells are either normal or hyperactivated.

As the insulin production cannot cope up with the production of glucagon, the blood glucose level remains above normal. Also, this is aggravated by constant carbohydrates and protein intake. The insulin is highly jeopardized in diabetes mellitus; this is the reason why diet and exercise is recommended to help decrease the insult through lowering blood glucose level. Diet and exercise are proven to have significant effects on the early stages of diabetes, but, will have lesser effect once diabetes progresses. Insulin supplementation plays the major role in bringing back the balance of glucose level in the body.



The processes involved with diabetes are internal; it can only be managed by things that can access the internal problem, medications. External ways are good facilitators in the absorption and interaction of medications.

The glucagon-insulin-somatostatin balance is altered; a life threatening condition is playing inside the body. There is no known cure for diabetes; but there are health managements. If you don’t have diabetes yet, you are lucky, continue your healthy living. If you have mild diabetes, be responsible to know the dos and don’ts of diabetes, consult a diabetologist as soon as possible, before you run out of time. If you already have complications of diabetes, never fail to have a regular check-up, do what were medically advise religiously, and try to warn family members of your faults why you developed such complications. This is the easiest yet most effective way to prevent your loved ones from having what you supposed to not have.


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