Diabetes and Other Endocrine System Diseases

Introduction

The endocrine system comprises glands that secrete the body’s chemical messengers, hormones. The system influences every cell in the human body since hormones carry information and commands from one cell to another. The endocrine system releases hormones

into the bloodstream and lets them travel throughout the body thus regulating body activities (Peate, 2021). Moreover, it regulates the number of hormones released based on the body’s needs. The hormones produced by glands aid in the control of mood, growth, reproduction, metabolism, and development (Yang & Ma, 2021). Excess or limited hormones can harm the body hence the need for hemostatic regulation.

The Pancreas

The pancreas is both an exocrine digestive organ and an endocrine gland secreting hormones. The exocrine component, which is made up of many serous pancreatic acini cells, makes up the majority of the pancreatic tissue (Nolan & Kawamura, 2022). These acini produce and secrete several enzymes that are needed to effectively “rest and digest.” A significantly smaller, but no less significant, portion of the pancreas is the endocrine component. It is made up of pancreatic islets, which are cell-filled islands scattered among the pancreatic acini. Hormone-producing pancreatic cells cluster together in small groups forming islets (Boehmer et al., 2020). These cells create and emit hormones that control the metabolism of glucose, lipids, and proteins.

The pancreas produces pancreatic fluids known as enzymes that aid in digestion by disintegrating carbohydrates, lipids, and sugars. The pancreatic beta cells are the cells that produce insulin hormone. About 75% of the cells that make up pancreatic hormones are beta cells (Boehmer et al., 2020). The hormone insulin aids in the body’s utilization of sugar as fuel. Diabetes is brought on by high blood sugar levels and insufficient insulin. Bile is the greenish-yellow fluid that the liver cells make to take away waste and break down lipids during digestion. Bile is composed of cholesterol, bile salts, and waste products. The pancreatic acini and endocrine cells share a common exit with the bile duct network.

Major endocrine glands in the human body include the hypothalamus, thyroid gland, pituitary gland, parathyroid glands, adrenal glands, pineal body, and testes or ovaries. The pancreas is an organ located behind the stomach and the liver and forms part of the endocrine and digestive systems. It is spongy, enclosed in a fibrous capsule, and shaped like a pear (Saladin, Gan, and Cushman, 2021). The widest part is located close to the duodenum since it is where digestive enzymes are released. The central portion is known as the neck, while the distal part forms the tails and it secretes hormones into the bloodstream and secretes enzymes into the digestive tract (Urbas et al., 2021). Several blood vessels surround the organ, including the superior mesenteric artery, veins, and portal vein. It contributes to the transformation of food into the required bodily fuel. The pancreas secretes insulin that aid in the control of blood glucose levels.

Pancreatic Disorders

Disorders affecting the pancreas include pancreatitis, diabetes mellitus, and pancreatic cancer. Diabetes mellitus is a disease resulting from inappropriate hyperglycemia and disordered metabolism due to a deficiency of insulin secretion or resistance, resulting in low energy levels.

Pancreatitis is the inflammation of the pancreas that occurs due to the buildup of pancreatic secretions. Pancreatic cancer is a tumor affecting the gland, potentially resulting in a total shutdown of its functions. Impaired pancreatic function results to undesired effects such as fatigue, malnutrition, and excessive weight loss.

Diabetes Mellitus

Diabetes mellitus is a disease in which the body fails to control glucose in blood. There are three types of diabetes mellitus: type 1, type 2, and gestational. Types 1 and 2 of Diabetes mellitus have an impact on how the body uses glucose. The immune system is responsible for fighting infections. However, it might attack the body accidentally instead of protecting it. Insulin-producing beta cells in the pancreas are attacked and destroyed in type 1 diabetes mellitus by the body’s immune system. It has been established that beta cell autoantigens, macrophages, dendritic cells, B lymphocytes, and T lymphocytes have a role in the development of autoimmune diabetes (Ríos-Ríos, Sosa-Luis, and Torres-Aguilar, 2021). Antigen-presenting cells are considered for processing and presenting beta cell autoantigens to T helper cells after beta cells release them due to cellular turnover or injury. T cell-mediated death of pancreatic beta cells is a defining feature of the autoimmune disease (Joshi et al., 2019).

Type 2 diabetes mellitus occurs when the pancreas fails to produce enough insulin or cells ignore it. Such begins as insulin resistance, and as the need for more insulin arises, the pancreas loses its ability to secrete it. Type 2 diabetes mellitus results in excessive circulation of sugar in the bloodstream which might eventually lead to immune system and circulatory disorders.

Homeostatic Effects

Elevated blood sugar levels are likely to result in several health issues. For instance, such a condition might result in decreased blood vessel elasticity and narrowing, thus impeding blood flow (Zhou et al., 2022). Consequently, oxygen and blood supply to tissues might be impaired, increasing the risk of damaged blood vessels and high blood pressure. Moreover, increased blood glucose might damage vessels of the retina, causing blindness. The leaky blood vessels result in the swelling of the macula and hence cause distorted vision. Due to a lack of oxygen and nutrients, poor blood circulation may hinder the body’s capacity to heal an injury or infection. Narrowed vessels in the kidney are likely to lead to renal failure.

Poorly controlled diabetes mellitus can lead to the damage of blood vessels in the kidneys and nephrons making them to fail to function effectively (Zaki et al., 2020). The urinary bladder is affected by the condition since urine production is increased. High blood glucose levels results in elevated glucose filtered load which exceeds the reabsorption capacity resulting in osmotic dieresis. Such alters the water balance of the body resulting in dehydration.

In uncontrolled type 2 diabetes mellitus, glucose levels are likely to remain high due to insulin resistance (Saladin, Gan, and Cushman, 2021). As a result, the body’s mechanism of converting food into energy becomes impaired, resulting in increased hunger. Cells are likely to have less glucose resulting in fatigue and weakness.

Limited insulin in people with type 1 diabetes inhibits the body from transporting glucose from the blood into cells for use as energy. In such circumstances, the body starts to burn excess fat and muscles resulting in unintended weight loss.

Diabetes mellitus alters the normal functioning of the nervous system since the hormones epinephrine and norepinephrine constrict the blood vessels in the brain, causing discomfort (Saladin, Gan, and Cushman, 2021). The outcome of diabetes mellitus without prior treatment is an increased risk of infections (Erener, 2020). Elevated blood glucose levels can weaken an individual’s immunity and predispose them to infections. Peripheral nerve damage and reduced blood flow to the extremities contribute to increased chances of infections. Moreover, it is likely to increase the risk of heart problems such as coronary artery disease with angina, stroke, and heart attack.

Long Term Prognosis

Diabetic patients and those with signs of the disease should seek early medical aid and control their blood glucose levels. Failure to do so might cause devastating effects likely to harm the body or cause death since type 1 and type 2 diabetes can cause heart attack, coma, or kidney failure (Peate, 2021). Uncontrolled blood glucose levels can lead to poor circulation and without oxygen, one might be prone to developing sores and cuts that can cause infections that rarely heal. Organs located far from the heart are likely to experience such effects, and hence toes and feet are likely to be amputated if infections with poor healing develop.

Type 2 diabetes mellitus has no known cure, though some individuals may be able to correct it through dietary adjustments and weight loss since these actions help to keep blood glucose levels normal (Magkos et al., 2020). However, this does not offer a guarantee since there might be a remission. Patients might go for years without trouble controlling their glucose levels if treated properly.

Pancreatitis

Pancreatitis is an inflammation of the pancreas with diverse controversial causes. Sendler et al. (2020) suggest that inflammation is a hallmark of acute pancreatitis’ first phase. The body responds by releasing cytokines and other inflammatory mediators, resulting in vasodilation and hypo-perfusion. When digestion enzymes that remain in the pancreas get activated, it stimulates the pancreatic cells, resulting in inflammation. The common causes of this condition are excessive alcohol consumption and gallstones that impair the distal common bile duct. The common bile duct, which drains the gallbladder and the pancreas, can occasionally become blocked with gallbladder stones, irritating the pancreas (Saladin, Gan, and Cushman, 2021). Patients with long-term alcohol abuse are likely to experience pancreatic irritation.

Alcohol significantly increases viscous secretions that obstruct small pancreatic ducts and early stimulation of digesting and lysosomal enzymes inside acinar cells, that contributes to alcohol-induced pancreatitis. Walkowska et al. (2022) suggest that pancreatitis results from bile duct obstruction and increased pancreatic stimulation and thus increases pancreatic duct pressure and trypsin reflux. High pancreatic duct pressure results in pancreatic juice regurgitation resulting in pancreatic damage. Moreover, the increased pressure can lead to atrophy of the gland and hence inflammation sets in. The obstruction can be localized in either the bile or pancreatic duct or sometimes in both.

Other uncommon and controversial causes of the condition are pancreas divisor (congenital anatomical variation of the pancreatic duct) and hypertriglyceridemia (Walkowska et al., 2022). The pancreas divisor prevents the normal drainage of pancreatic secretions, increasing intraductal pressure. A dysfunction in the functioning of the sphincter of Oddi might trigger pancreatic inflammation and increase intra-pancreatic pressure. Pancreatitis might result from the damage to the ducts and pancreas during surgery or injury from an accident.

Homeostatic Effects

Since the inflammation involves the whole pancreas and some parts might be damaged such as the beta cells resulting in diabetes mellitus. Acute pancreatitis might result in the entry of pancreatic enzymes and toxins into the bloodstream during an acute attack (Lee & Papachristou, 2019). Such might result in the injury of other organs such as the lungs, the heart and the kidney. Leaked pancreatic juices might collect in a cyst-like pocket that might rupture, resulting in internal bleeding and infections. Moreover, acute pancreatitis can result in several chemical changes within the body and respiratory problems. The affected organ is the lung since blood oxygen levels are likely to be altered, resulting in breathing problems. Since the pancreas avails few enzymes for digestion, patients might experience increased weight loss and malnutrition. Eventually, all other organs of the body are affected due to low oxygen supply resulting to a reduction in their functioning.

Pancreatitis leads to increased intra-abdominal volume resulting in distention and bloating. Such condition results from the activation of enzymes that leak into the small intestines (Lee & Papachristou, 2019). The disease results in retroperitoneal bleeding, causing bluish discoloration of mucoid membranes. Since pancreatitis impairs the release of pancreatic juices, the digestive system is affected. It results in quick food movement through the gut resulting in pale clay-colored stool.

Patients presenting with pancreatitis are likely to experience electrolyte imbalance and thus have hypocalcemia. One of the elements of Ransom’s grading system used to determine the severity of pancreatitis is hypocalcemia (Liu et al., 2019). Pancreatic enzymes facilitate the auto digestion of mesenteric fat and release free fatty acids that form calcium salts in the acute phase. The preceding phase might be complicated by sepsis resulting in low calcium levels. In sepsis, elevated levels of circulating catecholamine drive circulating calcium into the intracellular compartment, resulting in low levels. Blockage of the pancreatic opening results in intense abdominal pain, nausea, and vomiting. Severe cases of pancreatitis might result in low blood volume and shock. Low blood pressure increases the heart’s workload resulting in a high heart rate.

Long Term Prognosis

Unfortunately, there is no known cure for the condition, and it is managed through the administration of antibiotics. Acute pancreatitis increases one’s vulnerability to infections and bacteria hence the need for antibiotics (Lee & Papachristou, 2019). Patients with mild cases of pancreatitis fully recover since it might resolve independently. However, they should eat a low-fat diet, stop alcohol consumption, and quit smoking to prevent remission.

If pancreatitis is left untreated, parts of it might fail to function completely. Such might cause blood and pancreatic fluid to seep into the abdominal cavity resulting in decreased blood pressure and volume. As mentioned, during an acute attack, pancreatic enzymes and toxins might enter the bloodstream and cause toxicity (Yin et al., 2021). The pancreas can virtually return to normal, though, provided the attack’s root cause is identified and addressed by the medical team.

Patients with chronic pancreatitis are likely to experience recurrent episodes of abdominal pain. Unfortunately, in certain individuals, a large portion of the pancreatic tissue might be damaged, and there is severe inflammation coupled with poisonous, fluid, and enzyme leaks (Lee & Papachristou, 2019). Such a condition might make the pancreas swollen and slushy and lead to fluid collection. The long-term complication of untreated chronic pancreatitis is pancreatic cancer. As a result, the pancreas’ endocrine and exocrine activities gradually decline. Endocrine failure results from the continuing inflammatory activities gradually destroying the gland. Chronic pancreatitis might cause activation of enzymes in the pancreas resulting in tissue digestion manifested by abdominal pain and internal bleeding.

Pancreatic Cancer

Pancreatic cancer can either be exocrine, adenocarcinoma, or neuroendocrine pancreatic cancer. The exocrine gland is involved in the release of digestive enzymes that aid inthe break down of proteins, lipids, and carbohydrates in the duodenum. Adenocarcinoma, which accounts for 90% of pancreatic neoplasms, is the most prevalent kind of pancreatic cancer (Haeberle and Esposito, 2019). Pancreatic neuroendocrine cancer develops from cells in the endocrine gland, impairing insulin release.

A pancreatic net is formed when a tumor is formed in the islets and can be benign or malignant. Pancreatic nets can be classified into several types, such as gastronome (impairs gastrin production), insulinoma (impairs insulin secretion) and glucinum (impairs glucagon secretion). Multiple endocrine neoplasia type 1 syndrome, a hereditary condition, is one of the disease’s risk factors (Qian et al., 2019). The disorder results in the formation of benign tumors within the pancreas.

Homeostatic Effects

Pancreatic cancer has several effects affecting the endocrine mechanism of the pancreas. A tumor in the pancreas affects its endocrine function, and as a result, blood glucose levels rise, producing similar effects as diabetes mellitus. The tumor causes blood clots in large veins of the leg, causing redness, swelling, and pain. Individuals with pancreatic cancer are likely to experience abdominal and back pain. Ito et al. (2020) suggest that cancers that originate in the pancreas is likely to grow large and begin compressing neighboring organs and hence cause abdominal pain. The tumor might spread to the adjacent nerves resulting in back pain. Metastasis of pancreatic cancer in the stomach might block it, making it hard for food to get through, resulting in pain, nausea, vomiting, and increased weight loss.

A blockage in the common bile duct obstructs bile flow, resulting in the body’s buildup of bilirubin, a condition known as jaundice (Saladin, Gan, and Cushman, 2021). Cancers that begin close to the common bile duct press on it, causing jaundice. Cancer may spread to the liver, impairing bile flow and resulting in dark urine, itchy skin, and greasy stool. Impaired bile flow results in its buildup in the gallbladder, making it large.

Long Term Prognosis

Pancreatic cancer can be treated by the removal of the tumor surgically, and those that fail to be extracted can be managed through chemotherapy, hormone therapy, freezing, and radiofrequency ablation. Resection of tumors before metastasis can improve patients’ survival rates. Rawal, Sunkara, and Gaduputi (2019) suggest pancreatic cancer has a five-year survival rate and early diagnosis and treatment leads to a better prognosis. Patients who receive early diagnosis and treatment are likely to become disease-free. However, the patient should get the right nutrition and frequent exercise to tolerate the side effects of the treatment and prevent remission.

If one is left untreated, the disease will likely metastasize and affect the whole body. It might lead to death since its metastasis results in liver failure and impaired early detection due to a lack of diagnostic tools (Qian et al., 2019). Therefore, early tumor diagnosis might limit its spread and adverse effects such as death.

Conclusion

Hormonal imbalance occurs when one has too much or too little of hormones. Hormones are signal mediators used for communication within the body. As a result, hormonal imbalance causes impairment in signal transmission in the body. Several medical conditions, such as diabetes mellitus, pancreatitis, and pancreatic cancer, contribute to hormone imbalance. Therefore, an endocrine imbalance results in effects that affect the normal functioning of the body.

Similarities and Differences

Pancreatitis, pancreatic cancer, and diabetes mellitus are conditions affecting the pancreas. A similarity of these disorders is that they impair the pancreatic ability to produce insulin resulting in fatigue. Moreover, they reduce the rate of secretion of hormones. Pancreatitis and pancreatic cancer can be quite similar in their effects, whereas diabetes mellitus is different from the other two.

Pancreatitis mainly occurs due to pancreatic obstruction by gall stones and excessive alcohol consumption. On the other hand, diabetes mellitus results from the destruction of beta cells or insulin resistance by the tissues. Homeostatic effects of diabetes mellitus include frequent urination, thirst, and blurred vision, whereas pancreatitis and pancreatic cancer mainly cause abdominal pain. Pancreatic cancer and pancreatitis are similar since they result in impaired pancreatic juice production.

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