Patient Education and Resources
Your pancreas is located on the left side of your abdomen, above the intestines and behind the stomach. A slender organ about 6 to 9 inches long, the pancreas has two main functions:
- It produces digestive juices or enzymes
- It produces hormones such as insulin and glucagon to help your body regulate blood sugar
A small, hollow tube, called the pancreatic duct, runs through the middle of the pancreas. The digestive juices or enzymes that the pancreas makes travel through the pancreatic duct to the small intestine, where they mix with partially digested food from the stomach. These pancreatic enzymes help turn digested food into a form of sugar called glucose. Glucose, our body's primary source of energy, passes through the intestinal wall into the bloodstream, and eventually into every cell in our body.
Insulin and Glucagon Production
The pancreas also produces two hormones - insulin and glucagon - to regulate the amount of sugar, or glucose, in our body. These hormones do not travel through the pancreatic duct, but rather, are released directly into the bloodstream.
The pancreas contains clusters of cells called islets. Each islet - a mixture of alpha, beta, gamma and delta cells - contains about 1,000 cells. The alpha cells produce glucagon. The beta cells produce insulin.
The beta cells, in particular, are highly specialized, very fragile and require a lot of metabolic, or chemical, energy to make insulin. The beta cells account for 1 percent of the pancreatic mass, but use 80 percent of the pancreatic blood supply.
Regulating Blood Sugar
It is important to keep a constant supply of blood sugar - spreading it out between meals - to power our cells and keep up our energy. Here's how the cycle works. Our body digests the food we eat into glucose or sugar, the rising level of glucose triggers the pancreas to produce insulin, and the insulin helps the cells uptake the glucose, which is used immediately for energy or stored for later. Gradually the glucose level in our bloodstream drops and the pancreas powers down the insulin.
Glucagon has the opposite effect. During exercise, for instance, when our body uses glucose for energy, the pancreas detects a decrease in blood sugar. The low level of glucose stimulates the pancreas to release glucagon, which triggers the liver to produce and release glucose into the bloodstream. Gradually our blood sugar rises and the pancreas turns off the glucagon.
People who are not able to clear glucose from their bloodstream have a disease called diabetes. In type 1 diabetes, also called juvenile diabetes, the pancreas does not produce any insulin. In type 2 diabetes, the pancreas makes insulin, but the body is not able to use it.
Typical signs and symptoms of high blood glucose can include:
- Low energy level
- Frequent urination
- Weight loss
- Blurred vision
Over time and without treatment, high levels of glucose or blood sugar can cause kidney failure, cardiovascular disease including heart attacks, eye disease leading to blindness, nerve damage, and other devastating health complications.
Individuals with diabetes need medical treatment to control blood glucose levels. People with type 1 diabetes need daily insulin injections to replace what their bodies are unable to make. People with type 2 diabetes benefit most often from pills (oral medication) to help their bodies use the insulin they produce more effectively. For both types of diabetes, essential treatment also includes a healthy diet, physical activity and regular visits to a physician who specializes in diabetes (a diabetologist or endocrinologist).
The Joslin/BIDMC Alliance
Our longstanding clinical collaboration with Joslin Diabetes Center - the global leader in diabetes research, care and education - helps provide preeminent specialty care to people with diabetes. Joslin Diabetes Center and BIDMC, two Harvard-affiliated institutions, have been working together for years to improve treatment and services for people with diabetes. Our multidisciplinary approach helps ensure continuity of care in both the inpatient and outpatient setting. Pancreas transplantation is one treatment option, and together we have established one of the more active pancreas transplant programs in New England.
A pancreas transplant may be considered as a treatment option for people who have severe symptoms and/or complications brought on by type 1 diabetes, with deteriorating quality of life as a result. These are people who may experience wide and unpredictable fluctuations in blood sugar levels despite insulin therapy. Sometimes doctors will perform a pancreas and kidney transplant at the same time, for people who have kidney failure related to diabetes. Or, some people may receive a pancreas transplant after their kidney transplant to help protect the donor kidney from the long-term complications of diabetes.