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
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
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
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
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.