Hormone Hoopla: Movers and Shakers of Diabetes (Part 1)

There are so many facets to diabetes, from glucose to A1C to lipids to hormones. What do hormones have to do with diabetes? As it turns out, quite a bit. Is it crucial that you understand all the different pieces of the diabetes puzzle? Maybe not, but since I know the most of you are keenly attuned to your diabetes, you might find this week’s posting of interest (at least, I hope you do!).


What the Heck Are Hormones, Anyway?
According to the National Institutes of Health (NIH), hormones are “your body’s chemical messengers.” Hormones travel in your blood and target specific organs or tissues, and they’re involved in a whole bunch of things, ranging from growth and development to reproduction to metabolism and even to mood. The word “hormone” comes from a Greek word that means “to spur on.” Hormones are given as medicine (think insulin injections, thyroid hormone, estrogen replacement) when the body’s own production goes awry.

The endocrine glands make hormones, which are actually types of protein. Endocrine glands include the pancreas, the adrenal glands, the thyroid, the thymus, ovaries, testes, and the pituitary and pineal glands. Even the gastrointestinal system is an endocrine gland, in some ways. The brain sends the signal to the endocrine glands to release hormones, which then seek out target cells. Target cells have receptors on them, which allow the hormone to work its magic, such as activating a gene or producing energy, for example. I like to think of hormones as “movers and shakers” because they make things happen in the body.

Diabetes-Related Hormones
The body produces many different kinds of hormones, and you certainly don’t need to know about all of them. Some hormones you’re probably already familiar with, such as estrogen, testosterone, growth hormone, and adrenalin, just to name a few. Some hormones are specifically or indirectly related to diabetes, so here’s a partial run-down:

Insulin. But of course! Insulin is made in the beta cells of the pancreas. It’s released in response to an increase in blood glucose (typically after a meal is eaten). Most of the cells in the body have insulin receptors to which insulin binds. Once insulin hitches on, the cells allow glucose to enter to then be used for energy. The problem comes in with diabetes, when the pancreas either stops making insulin (or makes very little), as in the case of Type 1 diabetes, or when insulin cannot be used properly or the beta cells tucker out, as in the case of Type 2 diabetes.

Glucagon. Insulin’s counterpart is glucagon, a hormone made in the alpha cells of the pancreas. Glucagon works in the opposite manner of insulin, as it acts to raise blood glucose and help keep blood glucose levels steady between meals. When glucose levels drop too low, glucagon is released and it targets the liver, which is prompted to release some of its glucose stores to help bring blood glucose levels back up into a safe range.

Glucagon is available as an injection (by prescription), and is given when a person with diabetes is hypoglycemic and is unable to take glucose by mouth or is unconscious. The glucagon injection typically raises blood glucose within about 15 minutes. Glucagon injections are rarely needed for people with Type 2 diabetes, however.

Amylin. Lest you thought that insulin and glucagon were the only pancreatic hormones to contend with, along comes another one: amylin. Amylin was discovered in 1987 and it too has a role in diabetes management. Secreted by the beta cells along with insulin, amylin also works to lower blood glucose levels after a meal. Specifically, it promotes satiety (makes you feel full so you stop eating), suppresses the release of glucagon, and slows the rate at which food leaves the stomach.

Amylin is available as the prescription drug Symlin (pramlintide), and is available for people with Type 1 or Type 2 diabetes who inject insulin and who have difficulty managing blood glucose with insulin or insulin and diabetes pills. Symlin must be given by injection, generally before each meal. It cannot be mixed with insulin.

I’ll let you digest these hormones for this week, and next week, we’ll look at even more hormones that play a role in diabetes.

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  • renee touriel

    this information was well written so we can understand how these hormones work…I wasnt clear about glycogen before but now I understand it better….question…what happens at night between mealtime of 7 pm and morning of 7 am? I was told that glycogen is released during that time but the nurse who gave me this information made it sound complicated…..then I heard from Dr. Oz tv program that its good to exercise excess glycogen in the morning before eating breakfast…do we have excess glycogen at night and why do we need to get rid of it in the morning? thanks for this information…I will keep posted for more help in understand diabetes and inflammation….renee touriel,beverly hills, ca ^.^

  • acampbell

    Hi renee,

    Thanks for the feedback! I’m glad this was helpful to you. What happens overnight can depend on the person, but often, in the case of Type 2 diabetes, the liver may release stored glycogen (which is essentially glucose), as a result of glucagon. Glucagon can be released from the pancreas overnight because typically, a person is sleeping, not eating. In someone without diabetes, this doesn’t present a problem, but for a person with diabetes, it can indeed be an issue as fasting, or morning, blood glucose levels are often high. And this may have nothing to do with what the person ate the night before. In many situations, bedtime insulin is needed to help prevent high fasting glucose levels the next day. Dr. Oz is correct in that exercising in the morning can certainly help to lower morning blood glucose levels, but the main thing is to prevent the high blood glucose in the first place.