INSULIN AND DIABETES HANDOUT

(Raab, Ricasio, Sayson, Sumayo - 118 MTH BAP)

● Exocrine- secretes enzymes

through the pancreatic ducts.

I. Diagram of the Organ: Pancreas

*Location- The Pancreas is located below
and behind the stomach and is surrounded
by the spleen, liver, and small intestine.

II. Anatomy of the Pancreas

A. Pancreatic islets or islets of
-The shape of the pancreas resembles that
Langerhans
of a tadpole; that’s why it can be divided into
-The Pancreatic islets are small islands of
4 parts. The head, neck, body, and tail.
hormone-producing (endocrine) cells that
-The TAIL releases pancreatic polypeptide
regulates our blood sugar levels.
or amino acids, which helps keep a check
-Also, Pancreatic islets produce hormones
on the secretory activity of the organ.
that are secreted directly into the blood flow
by five different hormone-producing cells:
1. Alpha cells (α)- produces
Glucagon, a hormone that
helps insulin maintain normal
blood sugar levels but it
stimulates cells to release
glucose and raise blood
sugar levels, and Alpha cells
III. Pancreas make up 15-20% of islet
-Made up of glandular tissue and a system cells.
of ducts but the main duct is the Pancreatic
Duct, which drains the pancreatic fluid from 2. Beta cells (β)- produce
the gland into the duodenum (first part of insulin and amylin (approx.
the small intestine). ratio is 100:1, respectively).
-Maintains the body’s blood sugar levels Insulin regulates glucose by
-It’s an organ that secretes hormones and absorbing and using glucose
enzymes. to drop blood sugar levels.
*It’s both an Endocrine and Exocrine gland Amylin plays a role in
● Endocrine- secretes hormones gylcemic regulation by
into the blood.
 slowing digestion, blocking
glucagon secretion, and
enhancing satiety (being of
full); also prevents spikes in
blood sugar levels. Beta cells
make up 65-80% of the total
islet cells.
3. Delta cells (δ)- produce
Somatostatin, this
hormone is secreted when
Insulin and Glucagon gets
too high to maintain the
balance of sugar and salt
in the blood. Delta cells
make up 3-10% of the total
islet cells.
4. Gamma cells (γ)- produce
Gastrin, aids digestion by
prompting certain cells in the
stomach to produce acid,
and Vasoactive Intestinal
Peptide (VIP), this hormone
releases water and salt in the
intestine to control water
secretion and absorption by
stimulating the intestinal
cells. Gamma cells make up
3-5% of the total islet cells.
5. Epsilon cells (ε)- produce
Ghrelin, also known as the
“Hunger hormone” because it
increases food intake,
stimulates appetite, and
promotes fat storage. Epsilon
cells make up less than 1%
of the total islet cells.
*Feedback system of the
pancreatic islets is the Paracrine, relating a
hormone or other secretions produced from
endocrine cells into the surrounding tissue
instead of into the bloodstream.
Insulin
- Is a hormone made in the pancreatic
β-cells
- Helps regulate how the body uses
and stores glucose and fat.
- Also controls blood sugar levels by
signaling the liver, muscle and fat
cells to absorb glucose from the
blood.
- Insulin also uses glucose from the
food you eat transforming it into
energy
Insulin’s Role in Homeostasis
- Can be seen in the Glucose
Transport 1 (GLUT1), where after a
person eats, the pancreas releases
insulin to absorb glucose
Insulin Defects
- Insulin defects can result to Type 1
or 2 Diabetes. People with Type 1
Diabetes produces little to no insulin,
while those with Type 2 Diabetes
often affects the body which resists
insulin or do not make enough
insulin.
MUST KNOW: Calculating Insulin Dose
A. Carbohydrate Coverage Dose
- The bolus dose for food coverage is
prescribed as an insulin to
carbohydrate ratio.The insulin to
 carbohydrate ratio represents how
many grams of carbohydrate are
covered or disposed of by 1 unit of
insulin.
- Generally, one unit of rapid-acting
insulin will dispose of 12-15 grams of
carbohydrate. This range can vary
from 4-30 grams or more of
carbohydrate depending on an
individual’s sensitivity to insulin.
Insulin sensitivity can vary according
to the time of day, from person to
person, and is affected by physical
activity and stress.
NOTE: the grams of CHO disposed of by 1
unit of insulin is the bottom number or
denominator of the Insulin:CHO ratio.
Example: You are going to eat 60 grams of
carbohydrate for lunch. Your Insulin: CHO
ratio is 1:10.
To get the CHO insulin dose, plug the
numbers into the formula:
CHO insulin dose =
Total grams of CHO in the meal (60 g)
÷ grams of CHO disposed by 1 unit of
insulin (10) = 6 units
You will need 6 units of rapid acting insulin
to cover the carbohydrate.
B. High blood sugar correction
(also known as insulin sensitivity factor)
- The bolus dose for high blood sugar
correction is defined as how much
one unit of rapid-acting insulin will
drop the blood sugar.
- Generally, to correct a high blood
sugar, one unit of insulin is needed
to drop the blood glucose by 50
mg/dl. This drop in blood sugar can
range from 15-100 mg/dl or more,
depending on individual insulin
sensitivities, and other
circumstances.
High blood sugar correction dose =
Difference between actual blood sugar and
target blood sugar ÷ correction factor
Example: 1 unit will drop your blood sugar
50 points (mg/dl) and the high blood sugar
correction factor is 50. Pre-meal blood
sugar target is 120 mg/dl. Your actual blood
sugar before lunch is 220 mg/dl.
220 minus 120 mg/dl = 100 mg/dl
High blood sugar correction dose = (220
minus 120 mg/dl = 100 mg/dl) ÷ correction
factor (50)
= 2 units of rapid acting insulin
So, you will need an additional 2 units of
rapid acting insulin to “correct” the blood
sugar down to a target of 120 mg/dl.
C. Total mealtime dose
To get the total mealtime insulin dose, add
the CHO insulin dose together with the high
blood sugar correction insulin dose:
CHO Insulin Dose + High Blood Sugar
Correction Dose = Total Meal Insulin
Dose
Example:
The carbohydrate coverage dose is 6 units
of rapid acting insulin.
The high blood sugar correction dose is 2
units of rapid acting insulin.
Now, add the two doses together to
calculate your total meal dose.
Carbohydrate coverage dose (6 units) +
high sugar correction dose (2 units)
= 8 units total meal dose
The total lunch insulin dose is 8 units of
rapid acting insulin.
NICE TO KNOW : Diabetes
- Disease which blood sugar levels
are too high
- Gives people with the disease a
hard time converting food into
energy.
Type 1 Diabetes
- This type of diabetes occurs when
the pancreas produces little to no
insulin
Causes of Type 1 Diabetes
- This occurs when the body’s own
immune system targets the insulin
producing cells (beta cells) in the
pancreas
- This could be due to genetics or
other environmental factors
Symptoms of Type 1 Diabetes
- Some symptoms include and
increased thirst and hunger which
leads to frequent urination, weight
loss, fatigue, blurred vision, slow
healing of wounds such as blood
clotting, and darkened skin in certain
areas
Treatments for Type 1 Diabetes
- Taking insulin (normally injected
directly into the body)
- Proper diet prescribed by a doctor
- Exercising regularly
- In general there is no direct cure for
type 1 diabetes
Type 2 Diabetes
- This is a condition that affects the
way your body metabolizes sugar in
which your body either resists the
effects of insulin or does not produce
enough insulin to maintain normal
blood sugar or homeostasis
Causes of Type 2 Diabetes
- The exact cause of type 2 diabetes
is not exactly known but inactivity
and an imbalanced diet are
contributing factors
- Glucose stays in the blood without
enough insulin
- Prediabetes means having a higher
than normal blood sugar but not
enough to be considered Diabetes,
having prediabetes can be a factor
of getting type 2 diabetes
Symptoms of Type 2 Diabetes
- Type 1 and type 2 diabetes have
similar symptoms which include and
increased thirst and hunger which
leads to frequent urination, weight
loss, fatigue, blurred vision, slow
 healing of wounds such as blood
clotting, and darkened skin in certain
areas
Treatments for Type 2 Diabetes
- Healthy eating mainly high-fiber low-
fat foods, and fewer consumption of
animal products, refined
carbohydrates, and sweets
- Regular exercise, making physical
activity part of your daily routine.
- Insulin therapy, involves the use of
insulin injections; varies depending
on the prescribed type of insulin by
the doctor.
- Careful blood sugar monitoring
keeps track if your blood sugar
levels remain within your target
range.
Gestational Diabetes
- A type of diabetes developed during
pregnancy, affects how cells use
sugar
Causes of Gestational Diabetes
- Researchers believe that the
hormones produced by the placenta
impairs the actions of insulin which
in turn raises blood sugar
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