Cited by 96Pancreatic function and diabetesDiabetes Management and ResearchDiabetes and associated disorders

The Physiology of Glucagon

Open access
Taborsky, Gerald J.·2010·Journal of Diabetes Science and Technology

Abstract

This short review outlines the physiology of glucagon in vivo, with an emphasis on its neural control, the author's area of interest. Glucagon is secreted from alpha cells, which are a minority of the pancreatic islet. Anatomically, they are down stream from the majority islet beta cells. Beta-cell secretory products restrain glucagon secretion. Activation of the autonomic nerves, which innervate the islet, increases glucagon secretion. Glucagon is secreted into the portal vein and thus has its major physiologic action at the liver to break down glycogen. Glucagon thereby maintains hepatic glucose production during fasting and increases hepatic glucose production during stress, including the clinically important stress of hypoglycemia. Three different mechanisms proposed to stimulate glucagon secreted during hypoglycemia are discussed: (1) a stimulatory effect of low glucose directly on the alpha cell, (2) withdrawal of an inhibitory effect of adjacent beta cells, and (3) a stimulatory effect of autonomic activation. In type 1 diabetes (T1DM), increased glucagon secretion contributes to the elevated ketones and acidosis present in diabetic ketoacidosis (DKA). It also contributes to the hyperglycemia seen with or without DKA. The glucagon response to insulin-induced hypoglycemia is impaired soon after the development of T1DM. The mediators of this impairment include loss of beta cells and loss of sympathetic nerves from the autoimmune diabetic islet.

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Registry

Crossref · 10.1177/193229681000400607

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76 of 76 references verified0 citation errors · 0 not checkable

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  • Clinically, glucagon is used as a rescue drug to treat severe hypoglycemic episodes.

    “Clinically, glucagon is used as a rescue drug to treat severe hypoglycemic episodes.”
  • Impaired endogenous glucagon response increases the risk of severe hypoglycemia and requires use of exogenous glucagon injections as rescue treatment in the most severe cases.

    “In T1DM patients, endogenous glucagon response to insulin-induced hypoglycemia is impaired,2 which increases the risk of severe hypoglycemia and requires use of exogenous glucagon injections as a rescue treatment in the most severe cases.”
  • In type 1 diabetes mellitus patients, the endogenous glucagon response to insulin-induced hypoglycemia is impaired.

    “In T1DM patients, endogenous glucagon response to insulin-induced hypoglycemia is impaired,2 which increases the risk of severe hypoglycemia and requires use of exogenous glucagon injections as a rescue treatment in the most severe cases.”

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Authors
Taborsky, G. J.
Affiliations
VA Puget Sound Health Care System (US)
Corresponding author
Taborsky, Gerald J.
Venue
Journal of Diabetes Science and Technology
Published
2010-11
Volume
4
Issue
6
Pages
1338-1344
ISSN
1932-2968 (ISSN-L)
OpenAlex
W2131867652
Cited by
96
References
77
Citations by year
2026: 2 · 2025: 5 · 2024: 4 · 2023: 8 · 2022: 14 · 2021: 8 · 2020: 5 · 2019: 6 · 2018: 7 · 2017: 7 · 2016: 6 · 2015: 3 · 2014: 7 · 2013: 6 · 2012: 4
Type
conference abstract
Language
en
Open access
Locations
  • Journal of Diabetes Science and Technology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK050154)
Topics
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Keywords
glucagon, glucagon secretion, alpha cells, pancreatic beta cells, hepatic glucose production, glycogenolysis, hypoglycemia, type 1 diabetes, diabetic ketoacidosis, insulin-induced hypoglycemia, beta cell destruction, islet autoimmunity
MeSH terms
Animals, Autonomic Nervous System, Blood Glucose, Diabetes Mellitus, Type 1, Glucagon, Glycogen, Homeostasis, Humans, Hypoglycemia, Insulin, Islets of Langerhans, Liver, Glucagon-Secreting Cells

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