When patients ask me where insulin comes from, the automatic answer is the pancreas. I will often show them a drawing of where that is in the body. Most patients note how large the organ appears to be and wonder how they can be losing the ability to make and secrete insulin from such a large organ. They seem quite shocked when they find out that the area that produces the insulin, amylin, and glucagon is about the size of a quarter. Often they have no idea what the rest of pancreas is used for. Although there are some beta cells spread throughout the exocrine part of the pancreas, it is that small part of the organ that is responsible for maintaining glucose homeostasis. To understand how the exocrine and endocrine system actually work together, you will want to check out this week’s Clinical Gem from the International Textbook of Diabetes Mellitus, 4th Ed.
Your partner in diabetes care,