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Pancreas Functions, Pancreatitis, and Type 1 and 2 Diabetes

Linda Crampton is an experienced teacher with a first-class honors degree in biology. She writes about the scientific basis of disease.

An Important Organ and Gland

The pancreas is an elongated organ in the upper abdominal cavity. It's located next to the duodenum (the first part of the small intestine) and behind the stomach. The organ acts as a gland and releases vital secretions. The pancreas is really two glands in one because it has two different functions that are performed in different tissues. One function is to produce digestive enzymes that break down food into a form that our bodies can use. The other is to produce hormones, two of which control our blood sugar level.

Three major disorders related to the pancreas are pancreatitis (inflammation of the pancreas) and type 1 and type 2 diabetes. A variety of factors can cause pancreatitis. Type 1 diabetes is an autoimmune disorder. An unhealthy lifestyle is often a contributor to the development of type 2 diabetes, although not everyone with the disorder has a lifestyle problem.

Location of the pancreas within the abdomen

Location of the pancreas within the abdomen

Pancreatic Enzymes

The pancreas contains cells that produce and secrete digestive enzymes. The enzymes travel to the duodenum through a tube called the pancreatic duct. Once in the intestine, the digestive enzymes break down food into tiny particles. These particles are then absorbed through the lining of the small intestine into the bloodstream and distributed around the body to the cells that need them.

The pancreas produces many types of digestive enzymes, including proteases, which digest protein, pancreatic lipase, which digests fats, and pancreatic amylase, which digests starch. The enzymes are released from the pancreas as part of a liquid known as pancreatic juice, which contains sodium bicarbonate and water in addition to digestive enzymes. The sodium bicarbonate neutralizes the acidic material entering the duodenum from the stomach.

The proteases in pancreatic juice are released in an inactive form, which prevents digestion of the proteins that form part of the pancreas. Normally, the inactive proteases (trypsinogen and chymotrypsinogen) don't become active until they enter the duodenum. Here they are converted into trypsin and chymotrypsin, which digest the proteins in food.

Pancreatic Hormones

The pancreas contains patches of tissue called islets of Langerhans or pancreatic islets. Each islet contains endocrine tissue, which is tissue that produces hormones and secretes them into the blood. Two important pancreatic hormones are insulin and glucagon. Insulin is made by the beta cells in the islets. Glucagon is made by the alpha cells.

Insulin is a small protein that has a very important function. It helps to regulate the blood sugar level by joining to a receptor on the membrane that covers the body's cells. Once the insulin molecule has joined to the receptor, the membrane's permeability changes, allowing glucose to enter the cell. As a result, the blood glucose level drops. Cells produce energy from the glucose molecules. In the liver, the absorbed glucose is converted to glycogen, a storage form of energy.

Glucagon stimulates the breakdown of liver glycogen into glucose molecules, which then enter the blood to travel to cells. Glucagon therefore raises the blood glucose level and has the opposite effect to insulin. In a healthy person, insulin and glucagon work together to maintain a fairly constant glucose level in the blood. Glucose is absorbed from the blood when it's abundant and released into the blood when its level falls too low.

A pancreatic islet (lighter stain) surrounded by acini (darker stain)

A pancreatic islet (lighter stain) surrounded by acini (darker stain)

Possible Causes of Acute Pancreatitis

The two common forms of pancreatitis are an acute and a chronic type. Acute pancreatitis is a sudden inflammation of the pancreas that generally lasts for a short time if it's treated. There are several possible causes of the condition. Two of these are blockage of passageways with gallstones or the ingestion of an excessive amount of alcohol. Gallstones are solid lumps that sometimes form in bile while it's in the gall bladder. Bile is a liquid that emulsifies fat in the large intestine, making it easier to digest. It's made by the liver and stored in the gall bladder.

Acute pancreatitis may develop when a gallstone is released from the gall bladder into the common bile duct. This duct transports bile from the gall bladder and the liver to the duodenum. (It can be seen in illustrations shown above.)

At the surface of the duodenum, the common bile duct joins the pancreatic duct to form a structure called the ampulla of Vater. The structure is named after Abraham Vater (1684–1751), a German anatomist. A gallstone in the ampulla of Vater can block the opening of the pancreatic duct, causing pancreatic juice to back up and collect in the pancreas. The excess juice and its contents may cause swelling and inflammation in the pancreas. The digestive enzymes in the juice may become active and damage tissues.

Acute pancreatitis can also develop several hours after drinking alcohol, although the exact mechanism by which alcohol inflames the pancreas is not known. Less common causes of acute pancreatitis include certain medications or infections, injury to the pancreas, a high blood fat level (hyperlipidemia), or a high blood calcium level (hypercalcemia). People with cystic fibrosis may experience periods of acute pancreatitis. Sometimes the cause of the condition is never discovered.

Possible Symptoms and Treatment

A common symptom of acute pancreatitis is pain in the middle of the abdomen, which ranges from mild to extremely severe. The pain may radiate to the back. A person may also experience nausea, vomiting, a fever, and a rapid pulse. In severe cases, they may experience dehydration and low blood pressure. These symptoms might indicate the presence of a different condition. A doctor must be consulted for a diagnosis and treatment.

The treatment for acute pancreatitis depends on how severe the attack is. Pain killers are often given to the patient. Gallstones may need to be removed, and antibiotics will probably be given if an infection is present. Other supportive steps, such as intravenous fluids, may be necessary in severe cases. Surgery may be required to remove damaged pancreatic tissue.

If a specific medication is suspected of causing the pancreatitis, the medication will probably need to be changed. Medication may be needed to reduce the blood fat or blood calcium level. Patients are usually advised to drink no alcohol after an attack of acute pancreatitis—even if alcohol wasn’t the cause of the attack—and to eat a low fat diet.

Chronic Pancreatitis

In chronic pancreatitis, the pancreas is continually inflamed. The pancreas is gradually destroyed and filled with scar tissue. The most common cause of chronic pancreatitis is long-term alcohol abuse. However, other factors, such as chronic or recurring hyperlipidemia and hypercalcemia, certain autoimmune conditions, and some inherited conditions, such as cystic fibrosis, can also cause chronic pancreatitis.

The symptoms of the condition are similar to those of acute pancreatitis, but in addition the patient often suffers from weight loss. This is due to the fact that the pancreas is no longer making enough digestive enzymes. Without enzymes, food can’t be digested. If food isn’t digested, it can’t be absorbed. The patient may also have diarrhea and oily feces. He or she will develop diabetes if the beta cells in the pancreas are destroyed.

Diabetes Mellitus Facts

There are two main types of diabetes mellitus—type 1 and type 2. Type 1 diabetes used to be called insulin-dependent diabetes or juvenile diabetes because it always requires insulin treatment and generally first appears in children, teenagers, or young adults. It may sometimes appear in older people, however. In North America, about ten percent of people with diabetes have type 1 diabetes.

Type 2 diabetes used to be called non-insulin dependent diabetes or adult-onset diabetes. “Adult-onset” is no longer considered to be an appropriate term since young people can develop type 2 diabetes, especially if they are overweight. Approximately ninety percent of people in North America with diabetes have type 2 diabetes.

Autoimmune Disease and Type 1 Diabetes

In type 1 diabetes, the pancreas no longer makes insulin or makes an insignificant amount. The disorder is an autoimmune condition, or one in which the immune system mistakenly attacks the body's own tissues instead of bacteria and other microbes. The immune system attacks and destroys the beta cells in the islets of Langerhans. The patient forms antibodies to his or her own cells.

Why the body attacks the pancreas is unknown. The phenomenon is thought to be partly genetically controlled, but scientists think there needs to be another trigger in genetically susceptible people in order to stimulate the immune system to attack the pancreas. The trigger may be infection by certain viruses or exposure to certain toxins. Some viruses suspected of being triggers are the Epstein-Barr virus, the cytomegalovirus, the mumps virus, and the coxsackievirus.

Symptoms of type 1 diabetes include frequent urination, increased thirst, hunger, fatigue, and weight loss. The patient may also experience blurred vision and tingling in the feet. Wounds may be slow to heal.

People with type I diabetes need to replace the insulin normally made in the body with insulin injections and need to carefully manage their nutrition and exercise. Insulin cannot be taken in tablet form because the stomach would digest it.

Insulin Resistance and Type 2 Diabetes

Insulin resistance is the name for the condition in which the body becomes less responsive to the usual amount of insulin in the body. For a while, the pancreas makes more insulin to overcome the insulin resistance. Eventually, the pancreas is unable to make enough insulin for the body’s needs. At this point, insulin resistance has become type 2 diabetes. In this type of diabetes, the pancreas makes an inadequate amount of insulin and the person’s body is unable to use the insulin that is made properly.

Heredity plays a role in type 2 diabetes. Having a close relative with this form of diabetes increases the risk that a person will develop the disorder. However, lifestyle also strongly affects the probability of developing the disease. Risk factors include being older than forty, being overweight, having high blood pressure, and having high blood cholesterol or triglycerides.

It’s very important for older people to maintain a healthy diet and lifestyle because this will greatly decrease the chance of developing type 2 diabetes. An alarming trend in many countries is an increasing incidence of type 2 diabetes and obesity, even in young children.

Symptoms of type 2 diabetes are generally similar to those for the type 1 condition. In the early stages of the disease, diet and exercise may be able to control the symptoms. Unfortunately, type 2 diabetes is often a progressive disorder. Medications may eventually be necessary.

The Importance of Treatment

Type 1 and type 2 diabetes can’t be cured, but they can often be successfully managed. The goal is to prevent complications of diabetes from developing, or at least to delay them. These complications include nerve, kidney, and eye damage, circulatory problems, heart disease, and the development of feet, skin and mouth problems. Diabetes may also increase the risk of osteoporosis and hearing problems.

Other Forms of Diabetes

Some types of diabetes don't fall neatly into the type 1 or type 2 category. Gestational diabetes is a temporary condition that develops in some women during pregnancy. The cause of the condition is uncertain. It's thought to arise because chemicals released by the placenta interfere with the action of insulin in the mother's body, increasing her blood sugar level. Gestational diabetes can be treated. This treatment is important in order to protect the developing baby.

Diabetes can also develop when parts of the pancreas are destroyed or removed, which may happen in pancreatitis or pancreatic surgery. Some drugs and hormonal problems can also produce the disorder.

Life Without a Pancreas

It's possible to live without a pancreas. It's not possible to live without pancreatic functions, however. Supplemental enzymes and hormones must be taken by someone without a functioning pancreas. Special attention must be paid to these chemicals with respect to the time of administration and the quantities of the substances that are administered. The patient must also pay attention to their overall health.

The pancreas is an important organ. It's wonderful that science has found a way for patients to survive without the organ. The patient has some vital things to consider and remember as they perform substitutions for the natural processes in their pancreas, however. The substitution process may be demanding, but it's very important.


This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

Question: Is <500 pancreatic elastase-1 normal?

Answer: Pancreatic elastase-1 is a digestive enzyme made by the pancreas and released into the small intestine, where it digests certain proteins. The enzyme travels through the small and large intestine and leaves the body in the feces. The level of the enzyme in the feces is tested to assess the health of the pancreas.

Your doctor is the best person to interpret the results of your lab test. (I'm assuming that the doctor has a copy of the lab results. It's important that they do because they have to assess the results.) The doctor will likely want to see the precise numbers on the lab result sheet as well as any other important information.

My doctor contacts patients if lab test results are abnormal, and doesn't if they are normal. I don’t know how your doctor handles the results. If you don’t know the physician’s routine and they don’t contact you, you should get in touch with them to ask about the results.

© 2010 Linda Crampton


Linda Crampton (author) from British Columbia, Canada on November 02, 2016:

Hi, James. As I say in the article, people must visit a doctor if they want to know whether they have a pancreas problem.

James on November 02, 2016:

How will I know if I have this problem.

Linda Crampton (author) from British Columbia, Canada on June 17, 2013:

Thank you for the comment, las81071. I'm sorry that you are in such pain. I hope you find an explanation for your stomach problem very soon. Good luck!

las81071 on June 17, 2013:

thanks for the info. I have been researching why I always have terrible pains in my stomach very often. My doctors took out my gallbladder said the pain was from that. Although I have some different pain now it seems to be in the same area really high in the stomach right under the chest. I read a bit about the pancreas but luckily that does not seem to be the same. I appreciate the info.

Linda Crampton (author) from British Columbia, Canada on July 22, 2012:

Thank you very much for the comment, Curiad!

Curiad on July 22, 2012:

This is very informative, Thank you for sharing this!

Linda Crampton (author) from British Columbia, Canada on January 26, 2012:

Hi, BlissfulWriter. It certainly is a good idea to restrict sugar in the diet! Thank you for the comment.

BlissfulWriter on January 26, 2012:

Since the beta cells are so important for producing insulin, I think it is a good idea to try not to burn them out by over-indulgence of sugar. Whenever we eat sugar, it causes rise in our blood glucose level which make the pancreas work harder to produce insulin.

Linda Crampton (author) from British Columbia, Canada on October 09, 2011:

Hi, Steve T. I'm not a doctor, but I have read that when a pancreas is chronically inflamed it may stop making insulin.

Steve T on October 09, 2011:

Is it possible that inflamation of the pancreas is blocking insulin and being diagnosed as type 1 diabetes

Linda Crampton (author) from British Columbia, Canada on September 20, 2011:

Thanks for the comment, Whimsical Chair. It's nice to meet you!

Whimsical Chair on September 20, 2011:

Nice informative hub. Thank you for sharing your knowledge.

Linda Crampton (author) from British Columbia, Canada on January 02, 2011:

Thanks, Katie! I appreciate your comment.

Katie McMurray from Ohio on January 02, 2011:

Very well done, so much information to absorb and vital to know! I'm impressed with your work and well written facts on Pancreas function and health problems. Katie :)

Linda Crampton (author) from British Columbia, Canada on January 01, 2011:

You're welcome! :)

Martie Coetser from South Africa on January 01, 2011:

{sigh} My eyes jumped over 'who have diabetes' :))) Thanks for correcting me so discreetly :))

Linda Crampton (author) from British Columbia, Canada on January 01, 2011:

Thank you so much! Yes, it is a shock to discover that so many people who have diabetes are suffering from Type 2 diabetes.

Martie Coetser from South Africa on January 01, 2011:

Now why was I under the impression the pancreas is situated in the liver? Thanks so much for enlighten me. What a shock: “Approximately ninety percent of people in North America are suffering diabetes type 2.” This hub about the functions of the pancreas and relative health problems has been bookmarked by me and rated UP in all ways.

Linda Crampton (author) from British Columbia, Canada on January 01, 2011:

Thank you for your comment, Debby!

Debby Bruck on December 31, 2010:

Good work. Educational.