What is the pancreas?

The pancreas makes hormones that control your blood sugar level and ensure your body gets the fuel it needs for energy.

We look at the vital role the pancreas plays in your body, how your risk of diabetes can be influenced by diet and lifestyle choices, and how to check your blood sugar levels.

We explore:

• The function of the pancreas
• What hormones are made by the pancreas?
• What can go wrong with the pancreas?
• What’s the difference between type 1 and type 2 diabetes?
• What is pre-diabetes?
• How to check your blood sugar levels

The function of the pancreas
 

The pancreas is a long, tapered gland in your abdomen, located behind your stomach. It has a dual role in your body:

1. Blood sugar regulation: as part of the endocrine system, the pancreas produces hormones that regulate blood sugar levels.
2. Digestion: as an organ of the digestive system, it releases pancreatic juices containing digestive enzymes. These enzymes break down food in your small intestine.

What hormones are made by the pancreas?
 

The pancreas makes two hormones, insulin and glucagon, which work in tandem to keep your blood glucose level optimal:

• Insulin — this hormone is produced by the beta cells of the pancreas when your blood sugar (glucose) level rises after eating. Insulin works like a key that opens the doors of your body’s cells. This lets glucose enter the cells to be used for energy. Insulin also allows excess glucose to be stored in the liver for future use.
• Glucagon — a hormone produced by the alpha cells of the pancreas when it senses that blood glucose levels are too low. Glucagon signals the liver to release stored glucose into the bloodstream. It also restricts the amount of glucose entering the liver to retain as much as possible in the blood.

What can go wrong with the pancreas?
 

The main condition that affects the pancreas’ ability to produce hormones is type 1 diabetes. This is an autoimmune condition where the body’s immune system mistakenly attacks and destroys the beta cells in the pancreas that produce insulin.

This can lead to dangerously high blood glucose levels (hyperglycaemia) if the condition is not treated appropriately.

What’s the difference between type 1 and type 2 diabetes?
 

The main differences between type 1 and type 2 diabetes are:

• Type 1 diabetes is a condition where the immune system destroys the cells in the pancreas that make insulin. It’s a lifelong condition that cannot be prevented.
• Type 2 diabetes is where the body doesn’t produce enough insulin, or the body’s cells become resistant to its effects. It’s often associated with lifestyle factors, such as obesity, a sedentary lifestyle, and poor diet. So, it’s possible to reduce your risk of type 2 diabetes with healthy lifestyle changes.

What is pre-diabetes?
 

Pre-diabetes, or non-diabetic hyperglycaemia, is a condition where blood sugar levels are above the normal range, but not high enough for a diagnosis of diabetes.

People with this condition are at higher risk of developing type 2 diabetes. However, this risk can be reduced with healthy lifestyle changes, which can reverse pre-diabetes.

If you have diabetes, you may be eligible for the NHS Diabetes Prevention Programme, which helps people make lasting lifestyle changes and has been shown to help prevent type 2 diabetes [1].

What are the symptoms of diabetes?
 

Everyone’s experience of the condition is different. However, the most common symptoms of diabetes are [2]:

• Extreme thirst
• Frequent urination
• Fatigue
• Weight loss

How is diabetes diagnosed?
 

Diabetes is normally diagnosed through tests to measure the amount of glucose in the blood or urine.

A blood test can measure glucose levels after an overnight fast. Another method is to measure the amount of glucose that has attached itself to the haemoglobin in the red blood cells. Known as a haemoglobin A1c (HbA1c) or glycated haemoglobin test, this gives a better long-term picture of your blood glucose level.

Type 1 diabetes can develop at any stage, but it’s typically diagnosed in childhood or early adulthood. Type 2 diabetes is more commonly diagnosed in older adults.

If you’re experiencing symptoms, we recommend you see your doctor. Early diagnosis and management can help you feel better, improve your health, and avoid complications.

How is diabetes treated?
 

Treatment for diabetes depends on the type of the condition, and, in the case of type 2 diabetes, its stage.

Treatment for type 1 diabetes:

People with type 1 diabetes need to take insulin to control their blood sugar for the rest of their lives. New treatments, called immunotherapies, have also been developed to prevent the immune system from attacking insulin-producing cells in the pancreas.

Treatment for type 2 diabetes:

People with type 2 diabetes may be prescribed medications to lower their blood sugar, such as metformin. But the longer someone has type 2 diabetes, the higher the probability they will need insulin to control their blood sugar in the future.

In its early stages, type 2 diabetes may be controlled with lifestyle changes, such as following a healthy, low-calorie diet and taking regular exercise. These changes can put the condition into remission, where medication is no longer needed to control blood sugar levels.

New research shows that one third of participants with type 2 diabetes who completed the NHS England Type 2 Diabetes Path to Remission programme entered remission [3]. This programme involves following the soups and shakes diet over a 12-week period, with support from coaches and clinicians.

What are the health complications of diabetes?
 

It’s important that diabetes is well-managed and monitored. This helps prevent serious health complications, which can affect your longevity.

Health complications with diabetes include:

• Diabetic retinopathy — regular eye screens can help prevent this condition, which can lead to sight loss if left untreated.
• Foot problems — nerve damage can cause a loss of feeling in the feet and may reduce blood supply, making injuries slower to heal.
• Gum disease — excess sugar in the saliva can lead to bacteria that produces acid, which attacks the gums and teeth enamel.
• Heart attack and stroke — high blood sugar over a long period can damage blood vessels and increase the risk of cardiovascular disease.
• Kidney disease (diabetic nephropathy) — a deterioration in kidney function, which can lead to kidney failure.
• Nerve damage (neuropathy) — this can affect the messages between the brain and other parts of the body.

How to check your blood sugar levels
 

If you have symptoms or would like to find out more about your risk of diabetes, try our home diabetes blood test. It checks your levels of HbA1c to give an accurate picture of your blood sugar level over the past two to three months.

Your results can help detect diabetes and are accompanied by a doctor’s advice on any next steps.

References

1. NHS (2023) Diabetes. Available at: https://www.nhs.uk/conditions/diabetes/ [Accessed 05 September 2024].
2. Diabetes UK (no date) What are the signs and symptoms of diabetes? Available at: https://www.diabetes.org.uk/diabetes-the-basics/diabetes-symptoms [Accessed 05 September 2024].
3. Valabhji, J. et al. (2024) Early findings from the NHS Type 2 Diabetes Path to Remission Programme: a prospective evaluation of real-world implementation. The Lancet Diabetes & Endocrinology, 12(9), 653–663.