okay so the endocrine system is an internal regulatory system similar to the regulatory actions of the nervous system the endocrine system is going to help us maintain our internal environment by helping us stay in a homeostatic range and the effects of the endocrine system are wide-ranging so it'll help us regulate metabolism regulate our growth and development it regulates our sexual function and our ability to reproduce it regulates our sleep with our circadian rhythm it impacts our mood i could go on and on so the endocrine system is incredibly important to our health and influences this metabolic activity by means of hormones so hormones are like little chemical messengers that are secreted by cells into the extracellular fluid more often than not that's referring to the blood and these messengers will travel through the bloodstream to distant body cells to signal a specific physiological response in those cells so the whole reason why we call the endocrine system a regulatory system is because through these hormonal signals the endocrine system controls and integrates the functions of other body systems so for example we see the endocrine system specifically the pituitary gland controlling almost all of the signals for our reproductive system so every month in women of reproductive age her body prepares an egg for ovulation the lining of her uterus will build up to make a nice little nest for this leg for this egg and that is all controlled by follicle stimulating hormone and luteinizing hormone gentlemen have no fear you have fsh and lh2 and in men it stimulates the production of sperm and testosterone so through these hormonal signals the endocrine system is able to control and integrate the functions of other organ systems i really enjoy the endocrine system because it's so complex and there's so many moving parts but it really illustrates for us how everything is connected and in modern medicine we have this tendency to divide the body up and have a specific doctor for each body system but the endocrine system reveals a flaw in that system because the body systems are not separate from one another they are all interwoven and connected and so it's imperative that we don't lose sight of that whole body approach so the organs the organs containing endocrine cells can be divided up into primary endocrine organs and secondary endocrine organs that is pretty straightforward so let's just read the definition here primary endocrine organs produce and secrete hormones as their primary physiological role whereas secondary independent organs produce and secrete hormones in addition to their main function so with a primary endocrine organ their whole purpose in life serves an endocrine role so examples of primary endocrine organs are the things like the pituitary gland the thyroid gland the adrenal glands a secondary endocrine organ on the other hand will be an organ that essentially has its own thing going on but then in in addition to its real job it has a side gig with endocrine functions an example would be something like the kidney so clearly the kidneys main job is filtering the blood to make urine but in addition to that the kidneys also produce a hormone called erythropoietin which we talked about in the blood chapter with epo stimulating the production of red blood cells in the bone marrow another example with a secondary endocrine function is the skin so it's the skin's main function is protection right forming this external barrier to cushion and insulate the deeper body organs but is side hustle with the endocrine system works to synthesize vitamin d so when uv light hits our skin that starts the process to synthesize vitamin d and don't let its name confuse you vitamin d though we call it a vitamin it's actually a hormone and vitamin d is vastly critical to our health i will spare you my drawn out spiel for now uh but it's a critical nutrient for us because it supports the health of our brain our immune system our cardiovascular system it helps regulate insulin which helps us stabilize blood sugar levels so that could modulate the effects of diabetes and obesity it is linked to our mood and or depression with dopamine production and serotonin levels it plays a significant role in female fertility and all that to say roughly half of the u.s population is vitamin d deficient so that is rather concerning for the health of our overall population but nonetheless the skin is a secondary endocrine organ because of its side hustle with a variety of hormones okay so we talked about how hormones are like little chemical messenger molecules and they travel through the bloodstream to their destination location to signal a characteristic physiological response so unlike nerve impulses which fire and act very rapidly hormones travel slowly through the bloodstream so they'll float along until they reach their target tissue so the endocrine system regulates more slow processes but its actions have widespread effects since hormones are secreted into the bloodstream an important characteristic we need to consider is its solubility in water and this matters because we can't have hormones coming out of solution before they get to wherever they need to go to so there are two broad molecular categories of hormones that we'll talk about with it either being amino acid based or steroid based molecules the amino acid based hormones are our amines our peptides our proteins so think back to cellular physiology these molecules are typically water soluble with the exception of thyroid hormone so because they're water soluble they can't cannot easily cross the plasma membrane which is important because it affects how these hormones are able to bind on their target cells so we'll see the receptors for water-soluble hormones located on the surface of the cell so the hormone doesn't have to deal with trying to find a transporter protein to get inside on the other hand these steroid-based hormones are lipid soluble so they can diffuse across the sea of fatty acid tails of the plasma membrane with relative ease so their receptors are going to be located on the inside of the cell let me repeat that just in a more simplified way so receptors for water soluble hormones must be located on the surface of the cell so within the plasma membrane since these hormones cannot enter the cell the receptors for lipid soluble hormones so our steroid hormones and our thyroid hormones are going to be located on the inside of the cell because these hormones can enter the cell all right so let's get started with some actual glance and hormones then so the first gland we're going to talk about is the pituitary gland and you've probably heard this referred to as the master gland of the body before and that's because it secretes several major hormones the pituitary gland is very small about the size of a pea and its shape kind of resembles a golf club with the gland itself forming the head of the club which we can see here and then the stalk of the pituitary called the infundibulum forming the shaft of the club so the infundibulum is important because it connects the pituitary gland to the hypothalamus which will see the significance of that throughout these next few slides because the hypothalamus controls the release of hormones from the pituitary gland but in two different ways so you've probably noticed that the pituitary gland has two major lobes the anterior lobe of the pituitary and then the posterior lobe of the pituitary and the hypothalamus interacts with both the anterior and the posterior but in different ways so let's talk about the anterior pituitary first then so the hypothalamus interacts with the anterior pituitary gland primarily through the hypophyseal portal system and the hypophyseal portal system is just a capillary system so teeny tiny blood vessels that flow between the hypothalamus and the anterior pituitary and the hypothalamus will secrete hormones into this portal system and they will signal for the pituitary gland to produce and secrete its own hormones so what happens is when appropriately stimulated the hypothalamus will secrete either these releasing or inhibiting hormones into those special blood vessels and those will travel through the portal veins to the anterior pituitary where they will tell the anterior pituitary to either release or inhibit the release of its own hormones so we can see some examples in this table here with gonadotropin releasing hormone coming from the hypothalamus to stimulate the anterior pituitary to make and secrete fsh and lh so you don't need to memorize these specific hypothalamic hormones listed in this table i would just keep a general understanding that releasing and inhibiting hormones from the hypothalamus control the production and secretion from the anterior pituitary an important characteristic to point out is that hormones of the anterior pituitary are made in the anterior pituitary so the anterior pituitary synthesizes its own hormones and we'll see that in contrast with the posterior pituitary who does not make its own hormones we have six major anterior pituitary hormones described in this table so in contrast to the hypothalamic release and inhibiting hormones which you do not need to know you do need to know all of these hormones listed here they are pretty straightforward with thyroid stimulating hormone stimulating the thyroid to secrete thyroid hormones t3 and t4 growth hormone stimulating obviously growth we have fsh and lh which we've already talked about so the mnemonic flat peg which i have over here flat peg is useful in learning and memorizing these so f for fsh l for lh a for acth or adrenocorticotropic hormone and by its name we know that it's going to stimulate the adrenal gland specifically the cortex with adrenocortico right cortex adrenocorticotropic hormone p we have prolactin to stimulate milk production g we have growth hormone but what about e so e stands for endorphins which we don't cover in this class but if you're curious their role is in pain management so they're like natural opiates our own form of morphine so to speak so they reduce our perception of pain under stressful conditions again we aren't going to focus on endorphins in lab though because it just gets more complicated with the nervous system so you can think e4 endorphins or e for extra just like your free space in bingo or your extra letter in my mnemonic so with the posterior pituitary the posterior pituitary is different from the anterior pituitary in that the hypothalamus is going to make or synthesize these hormones and just deliver them to the posterior pituitary to be stored and then released when needed so with the posterior pituitary we have hypothalamic hypophyseal tract running through the infundibulum connecting the hypothalamus to the posterior pituitary by way of these long nerve fibers so we can see these here these long axon terminals running all the way down so what happens is the hypothalamus will synthesize both oxytocin and adh and then oxytocin and adh are transported down the axons of the hypothalamic hypophysial tract to the posterior pituitary where they are stored in axon terminals so the hypothalamus basically just delivers these like a little package to the posterior pituitary so whenever the associated hypothalamic neurons fire the action potential propagated down the axon terminals will cause the hormones to be released into the blood so i've said it a few times now but the distinction is really important the anterior pituitary will receive signals from the hypothalamus via these releasing and inhibiting hormones that cause the anterior pituitary to synthesize and secrete its hormones so the anterior synthesizes its own hormones and then with the posterior pituitary the hypothalamus synthesizes those hormones so the posterior pituitary does not make any it's just a storage site until it's time to be released a fun thing to point out are these other scientific names for the anterior and posterior pituitary and it may actually help you remember the relation to the hypothalamus so with the anterior pituitary then it can also be referred to as the adenohypophysis and so that suffix there adeno or adeno has a greek origin referring to gland so the anterior pituitary has this glandular tissue which you can see on the histology slide at the very end of the powerpoint the anterior is very dense with this glandular tissue which makes sense because the anterior is the one that has to manufacture and make all of its own hormones like a true endocrine gland and then with the posterior pituitary we can see that also referred to as the neurohypophysis so neuro obviously referring to nerves that's pretty easy for us to see that connection there with the hypothalamic neurons making these hormones and passing them along the nerve fibers to be stored in axon terminals so to just briefly touch on these hormones of the posterior pituitary adh or antidiuretic hormone also called vasopressin i'm hoping you remember this from the renal lecture we know that vasopressin is going to act on the kidneys specifically the distal convoluted tubule and the collecting duct to help us retain water so we will produce less urine so anti-diuretic or against diuresis so if you aren't aware diuresis is a clinical term that we use for excessive urination so if we give someone a diuretic we are encouraging urination if we give them an antidiuretic we would be discouraging urination oxytocin you have probably heard called the cuddle hormone or the love hormone so physiologically we'll see its most notable role in childbirth enhancing that motherly bond but we can also feel the effects of oxytocin in other social relationships often romantic relationships that have a strong feeling of connection and trust so it's just like that delicious moment that feel good bonded connection that you have with your partner fun fact estrogen promotes the release of oxytocin whereas testosterone blocks the release of oxytocin so men and women do not secrete the same levels of this hormone and that may be a physiological basis behind the stereotypical lovey-dovey let's just cuddle on the couch feeling from a woman and then the like not as intense uh feeling or desire for lovey-dovey stuff from a man the pineal gland has some really interesting history associated with it it's a bit of a mysterious gland so i find it to be really intriguing so the word pineal actually comes from the latin word for pinecone so it got its name just because of how it looks it kind of is shaped like an itty bitty pine cone and in the 17th century a french philosopher named descartes was particularly interested in anatomy and physiology and he had much to say about the pineal gland he referred to as the pineal gland as the seat of the soul and it is related to the third eye for spiritual reasons but also biological reasons because of its location deep in the center of the brain and also because of its connection to light so the pineal gland secretes only one hormone and that is called melatonin you've likely heard of melatonin before it's just the hormone that makes us feel sleepy and this regulates our circadian rhythm which is just our natural internal process of sleep awake cycles so our circadian rhythm repeats on each rotation of the earth which is roughly 24 hours so in daytime melatonin secretion will be low while we are awake and then as we are winding down for the night with the sun setting our melatonin secretion will ramp up which makes us feel sleepy and then we go to bed melatonin was first isolated by yale in 1958 yeah 1958 so like 60 years ago only 60 years ago like we've been talking about the pineal gland since the 17th century and we just recently figured it out so it wasn't until the 70s that we figured out its role with our circadian rhythm which is just mind-blowing to me because that means that there's only more to learn there's so much more sorry about that there's only so much more that is unknown and that is honestly very humbling i have endless fun facts about the pineal gland but another one for you is that the pineal gland is a highly vascular structure despite its small size the pineal gland is only second to the kidneys in terms of arterial supply which i think is really intriguing so the hormone melatonin has two important precursors and that's the amino acid tryptophan and the neurotransmitter serotonin so tryptophan can undergo a decarboxylation to form serotonin and then within the pineal gland serotonin is acetylated and then methylated to yield melatonin you've probably heard of people taking over-the-counter supplements of melatonin to help them sleep and while i can't give medical advice i would proceed with caution because that can just be like a slippery slope so because melatonin is a hormone supplementing with it regularly has some potentially iffy consequences long term so similar to how birth control pills shut down the production of those hormones in the brain melatonin pills can have a similar effect so if you're pumping yourself full of melatonin supplements every night then the pineal gland will just be like okay great look at all this melatonin i don't need to make it anymore so it shuts down its own production which i guess is technically fine but whenever you decide to stop that supplementation you're going to have much more difficulty falling asleep as the pineal gland readjusts and fires back up again so it's up to you and your doctor to discuss if that's the right path but remember that we just got started with this research in the 70s so there's still a lot of unknown short-term use seems to be okay long-term use may be a call for concern and i personally consider it to be a red flag i often cite in favor with beginning with more holistic approach like eating melatonin rich foods before bed like cherries or walnuts and then progressing to further intervention if needed there are so many tools in the toolbox for sleep like tryptophan magnesium calcium meditation avoidance of caffeine and alcohol proper timing of exercise and a regulation of blue light just to name a few so blue light is actually the last thing that i want to touch on with the in reference to the pineal gland because it's so prevalent in our modern world i'll keep it concise and that blue light blocks melatonin production and secretion so the bottom line is that staring at all these screens your phone your computer your tv your ipad your video games staring at all these screens before bed can make you feel less drowsy and in turn make it take longer for you to fall asleep if you don't believe me just try it do it as like a personal challenge for yourself to not look at any screens for at least two hours before bed for a week and i can almost guarantee that one you'll likely struggle to do it because we all look at our phone before bed and two if you do do it you'll feel a difference maybe not after the first night or the second night but as you commit to less screen time i am confident in these physiological impacts on the system if you don't want to be that extreme with it though just be sure to at least turn down the brightness at light at night we have blue light blocking glasses now that are a thing so that's an option it still doesn't have the same effect of just putting down the electronic devices putting them away picking up an actual book or engaging in a real life conversation and connection with your partner your family your roommate or whoever it is okay so on to the thyroid gland the thyroid gland is a butterfly shaped gland located on the anterior aspect of the trachea just inferior to the larynx so just below the adam's apple essentially and it has two lobes or two butterfly wings so to speak and those lateral lobes are connected in the middle by the isthmus looking at the microscopic anatomy with our histology side we can see the thyroid gland is composed of hollow spherical follicles and the walls of each follicle are formed by follicular cells and then the central lumen is filled with a jelly-like substance called colloid we can also see these parafollicular cells lying within the follicular epithelium so the prefix para is a greek derivative meaning at or to the side of so we can think of parafollicular cells as the ones to the side of our follicles so the thyroid produces two hormones thyroid hormone and calcitonin let's start with thyroid hormone this is the body's major metabolic hormone so when we say thyroid hormone the name actually applies to two similar molecules and that is thyroxine which we call t4 and then try iodithyramine which is t3 and the difference between the two between t3 and t4 is that t4 just has an extra iodine atom so t4 has four bound iodine atoms whereas t3 only has three thyroid hormone affects virtually every cell in the body so needless to say that is pretty important and though it is an amine thyroid hormone is a special exception to our plasma membrane rules because we have specific transporters there that allow us to get thyroid hormone inside of the cell where it combines the intracellular receptors within the cell's nucleus where it initiates transcription for protein synthesis so i've already mentioned it as a metabolic hormone so we can see how that relates to our basal metabolic rate our metabolism of carbohydrates lipids and proteins it impacts our temperature regulation so if someone has an excess of thyroid hormone they'll typically have a very high activity level they're typically very fidgety they'll feel warm a lot and they're often quite thin because their metabolism is like running like a racehorse whereas those who do not produce enough thyroid hormone often feel sluggish cold and tired they'll often put on weight because their metabolism is moving like a snail my fun fact for you about the thyroid gland is that the thyroid is the only endocrine gland that stores its hormones extracellularly in large quantities so it stores enough thyroid hormone to last two to three months which is pretty unique the other hormone that the thyroid gland is responsible for is calcitonin and this is released from the parafollicular cells so thyroid hormone is released from the follicular cells and then calcitonin is released from the parafollicular cells calcitonin's job is to lower blood calcium levels so when blood calcium is high the parafollicular cells will secrete calcitonin and calcitonin lowers it by inhibiting osteoclasts and by encouraging osteoblasts so to understand that let's just refresh our memory of osteoclast versus osteoblast osteoblasts are bone building cells so think of blast for building and then osteoclasts are bone crushing cells technically it's not as dramatic as crushing it's more like breaking down the bone but for the sake of the memory tool let's just think blast for bone building and then clast for bone crushing so if we inhibit osteoclast so if we stop the bone crushing then we can keep the calcium in the body and then by promoting our osteoblasts we can pull the calcium from the blood and deposit it into the bone effectively decreasing our blood calcium levels while we are on the topic of calcium let's talk about the parathyroid gland so the parathyroid glands are these very small glands located on the posterior aspect of the thyroid and there are usually four parathyroid glands two on each side like we see here but the number can vary as many of as many as eight parathyroid glands have been reported in some individuals which is kind of neat so parathyroid cells within the parathyroid gland secrete parathyroid hormone or pth so pth is the single most important hormone controlling our blood calcium balance because precise control of these calcium levels is critical because calcium homeostasis is essential for so many body functions like the transmission of nerve impulses for blood clotting we know that we have to have it for muscle contraction so maintaining a healthy balance or a healthy homeostatic range of blood calcium is very important to us so the parathyroid so parathyroid hormone increases calcium levels in the blood by targeting three organs the bone the kidneys and the intestine so let's start with the bones by stimulating osteoclasts so remember bone crushing cells we can break down some of that calcium-rich bony matrix so that it can be released into the blood thus increasing our blood calcium levels by way of the kidneys we can enhance calcium reabsorption or we can decrease calcium excretion thus again effectively raising the amount of calcium in our blood and then lastly through the intestines parathyroid hormone promotes the activation of vitamin d thereby increasing the absorption of calcium through our diet so we have to have vitamin d to be able to absorb calcium from our food so by parathyroid hormone playing a role in vitamin d activation we can achieve an increase in blood calcium in this way so let's just make sure we clarify this parathyroid hormone and calcitonin have opposite effects so they work as antagonists to one another parathyroid hormone is going to raise blood calcium levels whereas calcitonin is going to lower it my little tip as how to go about remembering this i think of calcitonin i just think of like the first two letters ca you know referring to the abbreviation for calcium and i think of it as toning up the bone like building up the bone so with calcitonin we have ca calcium toning up the bone with calcitonin and then i don't know you just have to remember that pth is the opposite of that i don't have a fun uh memory trick for that one okay so the adrenal glands are these pyramid-shaped organs that sit on top of the kidneys they are also sometimes referred to as the supra renal glands so the prefix supra meaning above so above renal supra-renal above the kidneys all the adrenal hormones help us cope with stressful circumstances in some way so within the adrenal glands we have two very distinct portions the adrenal medulla and the adrenal cortex the adrenal medulla is the innermost region and it functions as part of the sympathetic nervous system the cells here synthesize the catecholamines epinephrine and norepinephrine via a molecular sequence from tyrosine to dopamine to norepinephrine to epinephrine there are a few exceptions but in general epinephrine and norepinephrine exert the same effects so when a short-term stressor elevates the body to a fight-or-flight status the sympathetic nervous system is called to action and we will see the blood vessels constrict the heart rate increases both of those things together will increase the blood pressure blood glucose increases so we have plenty available for immediate energy the adrenal cortex on the other hand is the outer portion and here we'll have the release of over two dozen steroid hormones collectively called corticosteroids there are three different zones within the cortex and each zone has a unique function which you do need to know these zones with their unique function and hormones so starting at the outermost going inward first we have the zona glomerulosa and here we have the secretion of mineralocorticoids the main one being aldosterone to help control the balance of mineral and water in the blood the zona fasciculata is mainly responsible for glucocorticoids like cortisol the inner most stone so now we're deep in the cortex approaching the medulla we have the zona reticularis and here we'll see the gonadocorticoids being secreted so these are the sex hormones mostly weak antigens or male sex hormones such as dehydroepianddosterone or dhea and we can use these in the peripheral tissues to convert them to either testosterone or estrogen and the exact role of the adrenal sex hormones is still in question but we do know that they contribute to axillary and pubic hair formation and in women the adrenal antigens contribute to sex drive and once a woman hits menopause she'll be really thankful for these adrenal sex hormones because they largely account for the estrogen produced after menopause when the ovaries shut down that production all right last one the pancreas the pancreas is kind of neat and that it has both endocrine and exocrine functions and if you don't know the difference between the two all that means is that endocrine glands secrete their products directly into the bloodstream whereas exocrine glands secrete their products into ducts that go directly onto the surface of wherever they're intended to go so some examples of an exocrine gland would be like sebaceous glands that release oil to lubricate the skin or our hair or sudoriferous glands which is just a fancy way of saying sweat glands so the pancreas is exocrine function is with the digestive system and it'll secrete digestive enzymes to help break down food so we can absorb nutrients that's not our focus today though we want to learn about its endocrine function and responsibilities and we'll see its major role in the regulation of blood sugar levels so if we look at the histology slide we can see these little clusters let me get my mouse here's a little cluster right here here's another one over here so we can see these little clusters called pancreatic islets or the islets of langerhans and this is where we will have our two pancreatic hormones being produced so within the islets we have alpha cells that secrete the hormone glucagon and then we have beta cells that secrete the hormone insulin so glucagon is a hyperglycemic hormone so it works to raise our blood glucose levels it does this mainly by targeting the liver to break down glycogen to glucose and it also tells the liver to synthesize glucose from lactic acid and from other non-carbohydrate molecules so it's encouraging glycogenolysis and glyconeogenesis so we can ramp up the blood glucose insulin is the opposite insulin is a hypoglycemic hormone and so its job is to lower the blood glucose it also promotes the storage of fat but that is the topic for later so to lower the blood glucose insulin will enhance the membrane transport of glucose so we'll have the glucose being put into our cells especially our muscle cells and our fat cells so they can use this glucose as energy so after the glucose enters the target cell insulin binding triggers the oxidation of glucose for atp production it tells enzymes that it's time to build glycogen and it'll convert glucose to fat and it does so in this order so as a general rule of thumb the energy needs are met first and then if we have extra left over then we will make glycogen and then if we have even more left over after that the glucose will be converted to fat so let's just summarize so we have glucagon being released from alpha cells and its job is to raise blood glucose so as listed here on the slide hypoglycemia is a main activator of its release so hypoglycemia means that we have a low blood sugar hyperglycemia means that we have a high blood sugar so when blood sugar is low or we are hypoglycemic that signals to glucagon like hello i need more glucose and so we'll secrete glucagon and effectively raise the blood sugar so just the flip-flop of that for insulin then insulin works to lower our blood glucose so if we are hyperglycemic or our blood sugar is high then we will activate the release of insulin so we can bring the blood glucose back down okay so let's talk about this in relation to diabetes so most of you i'm assuming are at least vaguely familiar with diabetes so we know that individuals with diabetes aren't able to regulate their blood glucose very well so they typically end up with persistent hyperglycemia or an abnormally high blood sugar level think of insulin as the key that unlocks the doors to your cell to allow glucose to enter so every time you eat a meal insulin is released by your pancreas to help shuttle the glucose into your cells so without insulin your cells cannot accept glucose as a result the glucose builds up in your blood over time this extra sugar can be damaging to the blood vessels throughout the body and that's why diabetes can lead to blindness kidney failure heart attacks and stroke high blood sugar can also damage your nerves by creating a condition known as neuropathy that causes numbness tingling in pain because the damage to their blood vessels and nerves diabetics may also suffer from poor circulation and a lack of feeling in their legs and feet which can lead to poorly healing injuries that can in turn end as amputations diabetes also have a significantly increased risk for dementia as alzheimer's is developing a new catchy term sometimes referred to now as type 3 diabetes but that's a conversation for a different day so technically there are two main types of diabetes type 1 and type 2 and they are dramatically different from one another just as a side note there is i guess there's technically another type it's called gestational diabetes that can occur during pregnancy but we aren't going to get into that in this class in this class let's focus on type 1 and type 2. so type 1 diabetes is an autoimmune disorder and the immune system of someone with type 1 diabetes mistakenly destroys their beta cells which hormone is synthesized by the beta cells insulin right so without insulin their blood sugar just goes up and up and up to unsafe levels type 1 diabetes is therefore treated with injections of insulin a type of hormone replacement therapy to make up for that lack of production type 1 diabetes was previously referred to as adolescent onset diabetes because this autoimmunity often develops in childhood this is a very small proportion of the diabetic population so only about five percent of individuals with diabetes have type 1. the remaining 95 percent of the diabetic population has type 2 diabetes which has a very different developmental pathology so type 2 diabetes is often resulting from something that we call insulin resistance and it has strong ties to our diet and lifestyle so what we eat and how we exercise so with type 2 diabetes the beta cells are fine insulin is present but its effects are insufficient the body has become resistant to insulin so it doesn't work the way that it used to so what happens is when you continually bombard your body with carbohydrate-rich foods and foods high in saturated fats so like breads pastas refined processed food items like chips french fries sugary things like soda sweets things like that insulin is going to go sky high so that your body can process that rapid intake of calories and if you do this time and time again this just becomes your way of life that's just your normal diet then the pancreas is working overtime all the time constantly pumping out insulin well insulin loses its effect and over time the pancreas might not be able to keep up so in a clinical setting more often than not you'll see the use of pharmaceuticals like metformin being used as a treatment and i mean it works in the sense that metformin controls the blood sugar levels but it's not addressing the cause of the imbalance in the first place so it's basically like a band-aid over the wound the mentality of like if i can't see it then it's not there and that's clearly not the case metformin is proven to be less effective than lifestyle changes and it has a whole laundry list of potential side effects and interactions but swallowing a pill is much easier than changing your entire lifestyle and that's sad to say but it's also sadly true the bad news is that diabetes is the seventh leading cause of death in the united states but the good news is that type 2 diabetes is almost always preventable often treatable and sometimes even reversible through diet and lifestyle changes so if you take nothing else from my class i hope that i can share even a small piece of my energy and excitement about taking intentional care of our bodies and using these physiological mechanisms to understand how disease develops in the body and then also the appropriate steps towards prevention and treatment