Why I [Still] Love my Pancreas

Many major media outlets have covered the recent news about closed-loop systems in development that are being called the “bionic pancreas” or the “artificial pancreas.” While I love the concept of the technology, the names bother me. Although familiarity with diabetes elevates awareness of the pancreas, it’s still a pretty mysterious organ. (In my mind, the pancreas might as well be in the company of the gallbladder and spleen. After all, where is the spleen? And what does it do? I dunno.)

Among the type 1 diabetes community, I think we know enough about the pancreas to make it the scapegoat of our jokes. We throw around phrases like “pancreatically challenged,*” “busted pancreas,” “lazy pancreas,” etc. I’ve even seen rumors of a t-shirt with “a velociraptor ate my pancreas” on it. Not bad, huh? But similar to the media-friendly names of the closed-loop system, it may be a little misleading. Because here’s the catch: Insulin production is only about 5% of what a healthy pancreas does.

So this leaves the other 95% of the pancreas to perform some pretty important functions, such as producing the other stuff we need to process foods. This includes enzymes in the form of digestive juices to break down fats, carbs and proteins. The pancreas also makes the stuff (technically called nucleic acids) needed to help our body interpret our own DNA. This really isn’t anything to scoff at – apparently the pancreas produces approximately 1 liter of enzymes each day, so a pump system to replace all the functions of the pancreas would not likely fit in your pocket.

Fortunately for people who don’t actually have a pancreas (which is rare, but happens), they don’t require a mega-sized pump. From what I understand, they need the same insulin and blood glucose monitoring as people with type 1 diabetes, but they can take the other enzymes in the form of pills. That said, some those enzymes do help us level out our blood glucose to some degree, so the ups and downs of blood glucose control for people who don’t have a pancreas are actually even more acute.

Sure, yes, your pancreas may not be achieving at the top of its class and it may be reasonable to call it broken, but at least it’s not useless. So go ahead, give your imperfect pancreas a hug (or, you know, squish your stomach toward your small intestine to give it a hug-like squeeze, like you do). Sure, it’s fallen down on the insulin part of the job, but it’s still working away at the other elements. I know it seems like the bad guy, and if you’re like me, you’ve probably been blaming it for its shortcomings for years. But much like the most complex and loved villains, it’s still trying its best.

 

* Thanks to spell check wanting to change the word “pancreatically” to “pancreatic alley,” I am now imagining a dark and shadow-lined street where the lazy bum pancreases hang out. Thanks, spell check.