Let’s focus on two vital organs—the pancreas and the liver—and the essential hormones they produce that regulate our blood sugar levels: insulin and glucagon. These hormones work in harmony to create a balance that is crucial for our overall health. Disruptions in their function can lead to serious health conditions, such as diabetes.

The Pancreas: The Body’s Hormone Factory

Nestled behind the stomach and in front of the liver, the pancreas is an organ essential for both hormone production and digestion. This remarkable organ secretes a variety of enzymes that are crucial for breaking down carbohydrates and fats, aiding the digestive process. Its dual role makes it vital for maintaining metabolic equilibrium. Additionally, the pancreas plays a central role in blood sugar regulation by producing insulin and glucagon. These hormones help maintain stable glucose levels. Without a functioning pancreas, medicinal insulin is needed to manage blood sugar levels, as seen in type 1 diabetes and, in some cases, type 2 diabetes.

Insulin: The Key to Cellular Energy

Insulin is a vital hormone tasked with regulating blood sugar levels and ensuring they do not rise too high. Imagine insulin as a key that unlocks cell membranes, allowing glucose to enter the cell and be converted into energy. In the absence of insulin, glucose remains outside the cells, depriving them of their primary fuel. This can lead to severe metabolic complications. Understanding how this hormone works is crucial for individuals with diabetes.

A common aspect of type 2 diabetes is hyperinsulinemia, which refers to an excess of insulin in the bloodstream. To understand this better, let’s revisit the insulin key analogy.

Visualize the body’s cells as doors with locks. In a healthy system, insulin acts as a key, unlocking the door to allow glucose, the primary fuel, into the cell. However, in insulin resistance, these locks become rusty, and the keys struggle to open them. The pancreas, detecting that cells are not getting glucose, produces even more insulin keys in an effort to unlock these stubborn doors. This overproduction leads to a surplus of insulin in the bloodstream, known as insulin resistance.

While these extra insulin keys are ineffective at allowing glucose into cells, they still encourage fat storage, worsening the problem. The more insulin produced, the greater the fat storage and insulin resistance, creating a vicious cycle. Over time, not only do the locks on the cells become rusty, but the keys themselves can also degrade, further complicating the issue.

Medicinal Insulin

When blood sugar remains “out of control” despite efforts to improve nutrition, exercise, and oral medications, there could be an issue with the pancreas’ ability to produce insulin. Think of it as your pancreas “burning out” and not being able to produce enough insulin keys. In scenarios like this, insulin therapy may be necessary.

Many people ask how insulin therapy helps manage diabetes. These injections deliver insulin directly into the bloodstream, helping to mimic the natural release of insulin from the pancreas when the pancreatic beta cells are not functioning properly. By doing so, they assist in regulating blood sugar levels, preventing the spikes that can lead to serious health complications.

Some people need to take insulin for their entire lives, as in type 1 diabetes, but others might be able to stop or take less insulin through lifestyle changes such as losing weight, eating better, exercising more, and taking other medications. This shows that the body can sometimes heal itself with the right changes. There is evidence supporting that individuals with type 2 diabetes who have been on insulin for less than ten years can experience recovery of their pancreas through lifestyle changes. Close attention to nutrition, movement, and weight loss is linked to this reversal, where the pancreas can become fully functional again (7)!

In some cases, factors like taking steroids, pregnancy, and sickness may require temporary insulin use. It’s important to consult with doctors for personalized advice to ensure the treatment plan is effective and safe.

Glucagon: The Guardian Against Hypoglycemia

The body has an amazing ability to self-regulate. One example of this is glucagon, a hormone that serves as the counterbalance to insulin, ensuring blood sugar levels do not plummet too low. While insulin is produced by pancreatic beta cells, glucagon is made by pancreatic alpha cells. It prompts the liver to release stored glucose, called glycogen, and convert other substances like fat and protein into glucose, helping to maintain a steady supply of energy.

When the body’s demand for glucose increases, such as during fasting or intense physical activity, glucagon becomes especially important. You can see glucagon in action while you’re sleeping for 6–8 hours each night. During sleep, the body isn’t receiving glucose from food, but instead, it relies on stored sugar. This stored sugar is broken down when glucagon is released into your system. Without glucagon, you wouldn’t be able to get the high-quality, consecutive hours of sleep needed to recover from each day!

The Liver: The Master of Metabolism

The liver is an incredibly important organ, known for its ability to repair itself when injured. This regenerative quality makes it unique among the body’s major organs. The liver also plays a crucial role in keeping your blood sugar levels balanced. When there’s too much sugar in your blood, the liver stores it. Later, when you need more sugar in your blood, such as during physical activity or after fasting, the liver releases the stored sugar, also known as glycogen, back into your bloodstream. This helps keep your energy levels steady and underscores the liver’s importance for overall health.

The Balance of Blood Sugar

The way insulin and glucagon work together is like a balancing act that keeps your blood sugar levels stable. Insulin lowers blood sugar, while glucagon raises it. This balance is crucial because it ensures the body’s cells receive the energy they need from glucose. One of the root causes of diabetes and high blood sugar is when insulin and glucagon are out of balance.

Understanding how this balance works is particularly important when considering lifestyle interventions for diabetes and how diabetes medications work. For instance, it may be useful for you to know that Metformin does not increase insulin levels in the body. Instead, it reduces the amount of sugar the body releases from the liver and absorbs in the intestines. On the other hand, medications like Glipizide, Glyburide, and Glimepiride stimulate the beta cells to produce more insulin. When treating type 2 diabetes, it’s essential to not only consider how much insulin is being produced but also how effectively that insulin is being used within the body.

Here are some factors that can disrupt the balance between insulin and glucagon, making it harder to maintain stable blood sugar levels (8-16):

1. Stress – Increases glucagon release and can cause insulin resistance, making blood sugar harder to control.
2. Sleep Deprivation – Reduces insulin sensitivity and increases cortisol, which can raise glucagon levels.
3. Exercise – Moderate exercise enhances insulin sensitivity, while intense exercise can trigger glucagon release to supply extra energy.
4. Food Intake – High-carb meals spike insulin, while fasting or low-carb intake increases glucagon activity.
5. Hormonal Changes – Menstrual cycles, pregnancy, and conditions like PCOS can alter insulin sensitivity and glucagon response.
6. Medications – Some steroids, birth control pills, and diuretics can affect both insulin and glucagon levels, impacting blood sugar regulation.
7. Illness or Infection – Triggers stress hormones that increase glucagon and reduce insulin efficiency.
8. Dehydration – Concentrates blood sugar levels, reducing insulin efficiency and potentially increasing glucagon activity.
9. Caffeine – In some people, caffeine can increase cortisol, which may raise glucagon levels and affect insulin function.

Improving the Balance Between Insulin and Glucagon

Just as insulin and glucagon affect the body significantly, the body can participate in activities that purposefully affect insulin and glucagon, ensuring they work for the body rather than against it.

• Physical activity helps your body use insulin more effectively, making it easier for cells to access the energy they need. Exercise has short-term effects, helping your cells use insulin for up to 72 hours after you work out. If you continue exercising regularly, you’ll see even better results over time. This physical activity includes all forms of muscle movement, such as strenuous work, active transport (like walking to the store), playing with children outside, and tasks around the house like cleaning and gardening.

• Choosing beneficial nutrition, such as consuming high-fiber foods, helps maintain steady blood sugar levels, reducing the need for insulin. Lower insulin levels decrease the likelihood of reactive hypoglycemia, where blood sugar dips too low after a meal due to excessive insulin release. When you eat, your body releases insulin to transport sugar from your bloodstream into your cells for energy. In cases of reactive hypoglycemia, the body releases too much insulin, causing blood sugar levels to drop. High-fiber foods help slow down the digestion of carbohydrates, preventing spikes and drops in blood sugar. This process promotes stable blood sugar levels and overall balance in the body.

• Managing stress through mindfulness, stretching, and deep breathing can lower stress hormones, which is important for blood glucose control. Stress hormones, like cortisol, increase both insulin and glucagon levels, making it harder to regulate blood sugar. When you’re stressed, your body prepares for a ‘fight or flight’ response by releasing glucagon, which signals the liver to convert stored glycogen into glucose for energy. At the same time, stress can also lead to insulin resistance, meaning cells don’t respond to insulin as effectively. This combination can make blood sugar levels fluctuate unpredictably, making management more difficult.

By understanding how insulin and glucagon work together, you can take proactive steps to manage your blood sugar levels and enhance your overall well-being. Remember, small lifestyle changes can make a big difference in maintaining balance and staying healthy!

Sending Health Your Way!

The Tula Clinical Team

Reviewed by:
Aubree RN, BSN
Austin MS, RDN, CSR, LDN, CD