Adults normally secrete approximately 50 units of insulin each day from the β cells of the islets of Langerhans in the pancreas. The rate of insulin secretion is primarily determined by the plasma glucose concentration. Insulin, the most important anabolic hormone, has multiple metabolic effects, including facilitating glucose and potassium entry into adipose and muscle cells; increasing glycogen, protein, and fatty acid synthesis; and decreasing gly-cogenolysis, gluconeogenesis, ketogenesis, lipolysis, and protein catabolism.
In general, insulin stimulates anabolism, whereas lack of insulin is associated with catabolism and a negative nitrogen balance ( Table 34–1).
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