Clock Time (hours)
Fig. 3. Twenty-four-hour glucose and insulin profiles in normal and obese volunteers. Arrows represent meals. (Adapted from Polonsky KS, Given BD, Van Cauter E. Twenty-four-hour profiles and pulsatile patterns of insulin secretion in normal and obese subjects. J Clin Invest 1988;81:442-8; with permission.)
modulates insulin secretion by alpha and beta receptors. In general, stimulation of (3-2 receptors increases insulin secretion, whereas a-adrenergic pathways, which predominate with epinephrine and norepinephrine, inhibit insulin secretion.
Nutrient signals involve all three classes with glucose predominating as the major stimulus; amino acids and fatty acids have individual hierarchies of stimulation but effectively amplify and augment glucose effects on insulin secretion. The islets, each encased in a cocoon-like structure and distributed throughout the exocrine pancreas, are ideally situated to sense nutrient composition, which must also signal exocrine cells to secrete their digestive enzymes. Exocrine and endocrine actions of the pancreas are linked and some data support classification of diabetes mellitus
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All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.