Читать книгу Handbook of Diabetes - Rudy Bilous - Страница 28

 Islets of Langerhans in the endocrine pancreas contain β (insulin‐producing) and α (glucagon‐producing) cells that regulate glucose homeostasis. Pancreatic β cells may change in size, number, and function during normal ageing and development.

 Insulin secretion is biphasic: an acute first phase response that lasts a few minutes followed by a more gradual sustained second phase. Glucose is the main stimulator of insulin secretion, but other hormones, nutrients and neurotransmitters play an important role in the regulation of insulin secretion.

 The so‐called incretin effect (meal‐stimulated augmentation of insulin secretion) is diminished in type 2 diabetes, mainly because of reduced GLP‐1 secretion. The discovery, characterisation and clinical development of glucagon‐like peptides has been a major success over the last 30 years.

 Insulin receptor signalling in key tissues (skeletal muscle, fat and liver) is complex, resulting in various biological effects of insulin on glucose, lipid and protein metabolism.