The Pancreas: Anatomy, Function, and Connection to Diabetes

Your pancreas is an organ that’s part of both the digestive system and the endocrine system.

The digestive system, which breaks down food into tiny components that are then absorbed into the body, is made up of numerous organs in addition to the pancreas, including the mouth, esophagus, stomach, and small and large intestines.

The endocrine system is a collection of many different endocrine glands, such as the thyroid gland, testes, and pituitary gland, which secrete hormones directly into the bloodstream.

Anatomy of Your Pancreas

Your pancreas is located in the upper left area of your abdomen, behind your stomach, and near your duodenum, the first section of your small intestine.

The organ measures about 6 inches long and weighs about one-fifth of a pound.

Looking somewhat like a sweet potato, the pancreas is made up of a bulbous head and neck, a tubular body, and a narrow, pointy tail.

The pancreas contains a tubelike structure called the main pancreatic duct, which runs from the tail to the head of the organ.

The gallbladder’s bile duct enters at the top of the pancreas head to connect to the main pancreatic duct. The joined ducts exit from the pancreas head and connect to the duodenum.

Some people also have an additional pancreatic duct, sometimes known as the duct of Santorini, which connects to another part of the duodenum.

RELATED: 9 Common Digestive Conditions From Top to Bottom

What Does the Pancreas Do?

Your pancreas has two main responsibilities: It helps the body digest food, and it helps regulate blood sugar.

More than 95 percent of the pancreas’s mass is made up of cells and tissues that produce pancreatic juices containing digestive enzymes such as amylase, lipase, elastase, and nucleases. (1)

Each of these enzymes breaks down a specific type of substance; for instance, amylase breaks down carbohydrates, lipase breaks down fats, and elastase breaks down proteins.

The pancreatic juices, along with bile from the gallbladder, empty into the small intestine at the duodenum, where they assist in digesting food.

Clusters of cells called the islets of Langerhans make up much of the rest of the pancreas. These cell clusters release insulin, glucagon, and other hormones directly into the bloodstream, helping control the body’s blood sugar level.

Can You Live Without a Pancreas? 

Yes, it’s possible, but uncommon. Only those with pancreatic cancer, severe cases of pancreatitis, or other diseases of the pancreas face the possibility of having to live without one.

In those cases, the entire pancreas would be removed, and you’d be prescribed drugs that could help your body carry out the functions previously handled by the pancreas (without a pancreas, for example, you would develop diabetes and become dependent on insulin shots to regulate your blood sugar level). You would also be prescribed digestive enzymes to help break down your food.

But this procedure, called a pancreatectomy, is rarely done, and more often than not, only part of the pancreas is removed.

What Is the Relationship Between Diabetes and the Pancreas? 

The pancreas releases insulin into the bloodstream after you eat. This hormone helps your body absorb sugar from your bloodstream into your cells so you can use it for energy.

Diabetes develops because there are problems either with your body developing a resistance to insulin or the pancreas’s ability to produce insulin.

In type 1 diabetes, your body’s immune system starts attacking the cells in the pancreas that make insulin, which means that you can’t make the hormone. Type 1 diabetes often develops in childhood. In type 2 diabetes, which usually develops in people in their forties or fifties, your body develops a resistance to insulin and the pancreas is not able to keep up with the increased demand to overcome the resistance.

With both types of diabetes, blood sugar can’t enter into the cells to be used for energy. As a result, the sugar stays in the bloodstream and can cause damage to certain tissues, which may lead to damage of the nerves and kidneys and even blindness.

Diabetes can be managed with insulin injections or medications that improve the sensitivity to insulin. Exercise, weight loss, and a healthier diet can help manage your blood sugar level.

It’s not clear what exactly causes type 1 diabetes, but researchers think that genetics, environment, and perhaps even viruses may play a role. Being overweight or obese and sedentary, and having diabetes in the family, are some of the risk factors for type 2 diabetes.

RELATED: The Best and Worst Foods to Eat in a Type 2 Diabetes Diet

Does Diabetes Cause Pancreatic Cancer?

Having diabetes does not automatically cause pancreatic cancer, but there are cases in which there may be a relationship between the two.

Some research has found that having type 2 diabetes for five or more years has been associated with a two-fold increase in the risk for pancreatic cancer. (2) Other research suggests that if you develop diabetes for the first time after age 50, it may be a symptom of the disease. (3)

Scientists are still trying to confirm whether diabetes leads to cancer or whether cancer leads to diabetes. It may be that in some people, the cancer interferes with the functioning of the pancreas and therefore creates diabetes, (4) and in others, the diabetes may be creating inflammatory conditions that eventually become carcinogenic. (5)

But the number of people who have both diabetes and cancer is rare: Studies have estimated that only 1 to 2 percent of people with recently developed diabetes will develop cancer in three years. (6) In contrast, 20 to 30 percent of pancreatic cancers are caused by smoking. (7)

Pancreatic cancer itself is rare, according to the National Cancer Institute (NCI), which estimates that it represents 3.2 percent of all new cancer cases in the United States. In 2022, the NCI estimates that 62,000 Americans will develop pancreatic cancer and about 50,000 will die from the disease. (8)

Pancreatic cancer causes a number of symptoms:

• Upper abdominal pain
• Jaundice (yellowed skin and eyes)
• Dark urine and pale stool
• Loss of appetite
• Weakness or extreme fatigue

Treatment options for pancreatic cancer include surgery, chemotherapy, targeted cancer therapy with drugs, and radiation therapy.

What Causes Pancreatitis? 

Pancreatitis occurs when the pancreas becomes inflamed. Small gallstones that get stuck in the pancreatic duct and chronic heavy alcohol use are the two most common causes of pancreatitis.

Pancreatitis often causes symptoms, such as abdominal pain, fever, weakness, and nausea, and generally resolves within a few days with hospital treatment.

Additional reporting by Carlene Bauer.