The pancreatic islets (islets of Langerhans) are about a million tiny clusters of hormone-making cells scattered through the pancreas, most densely in the tail. Though they make up only 1-2 percent of the pancreas, they control blood sugar: beta cells release insulin, alpha cells glucagon and delta cells somatostatin.
| Location | Scattered throughout the pancreas among the exocrine acini, most numerous in the body and tail |
|---|---|
| Secretes |
|
| Nerve Supply | Vagus nerve (parasympathetic); Sympathetic fibres from the coeliac plexus |
| Blood Supply | Pancreatic branches of the splenic artery; Superior and inferior pancreaticoduodenal arteries |
| Venous drainage |
|
Regulates blood glucose: insulin lowers it by promoting uptake and storage, glucagon raises it by mobilizing liver glycogen, and somatostatin dampens both.
Type 1 diabetes results from autoimmune destruction of beta cells, while type 2 diabetes combines insulin resistance with progressive beta cell failure. Islet cell (neuroendocrine) tumours include insulinomas, which cause fasting low blood sugar, and gastrinomas, which cause severe peptic ulcers. Removing much of the pancreas, or chronic pancreatitis, can cause diabetes.
Autoimmune destruction of beta cells leading to absolute insulin deficiency, high blood sugar and risk of ketoacidosis.
Insulin resistance with gradually failing beta cell output, causing chronically raised blood sugar.
A usually benign beta cell tumour that secretes insulin inappropriately, causing episodes of hypoglycaemia relieved by eating.
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