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Table 2 Peripheral pathways involved in pancreatic secretion and benefit of modulating them for diabetes management

From: Review of the role of the nervous system in glucose homoeostasis and future perspectives towards the management of diabetes

Peripheral pathway

NT

Pancreatic receptor

Impact on endocrine pancreas

Impact on glucose homeostasis

Opportunities for diabetes management

Parasympathetic

ACh

Muscarinic receptors (m3AChR)

↑ insulin ↑ glucagon ↑ β-cell number

↓ postprandial glucose levels

Tighter control of glucose levels and preparation of the body to meals

 

VIP, PACAP, GRP

VIP, PACAP, GRP

↑ hormonal secretion (less studied)

-

-

Sympathetic

 

β-cells α-adrenoreceptors

Inhibit basal & glucose-dependent insulin secretion

↑ glucose levels

Reduction of hypoglycemia

 

NE

β-cells β-adrenoreceptors

↑ insulin secretion

↓ glucose levels

Reduction of hyperglycemia

  

α-cells β2-adrenoreceptors

↑ glucagon ↑ insulin

↓ glucose levels

Control of glucose homeostasis

 

Galanin & NPY

Specific receptors

Great range of responses

-

-

  1. This table shows the peripheral pathways that are most involved in the pancreatic secretion and the neurotransmitter (NT) involved in each of them. The effect of increasing their basal tone on glucose homeostasis and the potential benefits of modulating their firing pattern for diabetes management are summarised as well