How blood glucose level is maintained in our body?

Blood glucose regulation is the process by which the levels of blood  glucose is maintained by
the body within a narrow range. This tight regulation is referred to as glucose homeostasis. Too
low of blood glucose level is called hypoglycemia and too high of blood glucose level is called
hyperglycemia.

The standard measurement units for blood sugar levels are milligrams per deciliter (mg/dl). Ideal
blood sugar ranges are as follows:

1. Before breakfast (Person without diabetes): 100 mg/dL

2. Before breakfast (Person with diabetes): 70–132 hours

3. After a meal (Person without diabetes): Less than 140 mg/dL

4. After meal (Person with diabetes): Less than 180 mg/dL

5. Bed time (Person without diabetes): 120 mg/dL

6. Bed time (Person with diabetes): 90–150 mg/dL

So, we can say that normal BG levels should be between 60 and 140 mg/dL

The bloodstream carries glucose-a type of sugar. Blood glucose homeostasis condition is Mainly
controlled by insulin and glucagon and by the sympathetic nervous system. Other hormones also
have minor contribution in maintaining the homeostasis condition of blood glucose. There are
Amylin, Epinephrine, Somatostatin, Thyroxine, Cortisol, Asprosin, GIP and GLP-1.

 Main regulation and relation between Insulin and glucagon:

Insulin and glucagon work in a cycle. Glucagon interacts with the liver to increase blood sugar,
while insulin reduces blood sugar by helping the cells use glucose.

Normally, blood glucose levels increase after eating a meal. When blood sugar rises, beta cells in
the pancreas release insulin, Through the blood stream when insulin reaches to insulin-sensitive
cells like liver cells, red blood cells, fat cells, striated muscle and other cells, then insulin
stimulates them to take up and metabolize glucose. This hormone, insulin, causes the liver to
convert more glucose into glycogen (this process is called glycogenesis), and force about 2/3 of
body cells to take up glucose from the blood through the GLUT4 transporter, thus decreasing
blood sugar, having the net effct of lowering the high blood glucose level into normal range.

causing the body to absorb glucose from the blood and lowering the blood sugar level to normal.
On the contrary when blood sugar drops too low, the level of insulin declines and alpha cells in
the pancreas release glucagon, which instructs the liver to turn glycogen back into glucose and
release it into the blood. This brings blood sugar levels back up to normal.

Insulin , glucagon, and other hormone levels rise and fall to keep blood sugar in a normal range.

Islet cells in the pancreas.There are several different types of islet cell, including, which release
insulin, and, which release glucagon.

The liver stores glucose to power the cells during periods of low blood sugar. Skipping meals
and poor nutrition can lower blood sugar. By storing glucose, the liver makes sure that blood
glucose levels remain steady between meals and during sleep.

➡How insulin works??

👉Insulin gives glucose access to the cells. It attaches to the insulin receptors on cells throughout
the body, instructing the cells to open up and grant entry to glucose.

👉 A spike in insulin signals to the liver that blood glucose is also high. The liver absorbs
glucose then changes it into a storage molecule called glycogen.
Throughout the body, cells use glucose as a source of immediate energy. To keep the body
running smoothly, a continuous concentration of 60 to 100 mg/dL of glucose in blood plasma is
needed. During exercise or stress the body needs a higher concentration because muscles require
glucose for energy .

The concentration of glucose in the blood is determined by the balance between the rate of
glucose entering and the rate of glucose leaving the circulation. These signals are delivered
throughout the body by two pancreatic hormones, insulin and glucagon .The main hormones of
the pancreas that affect blood glucose include insulin, glucagon, somatostatin, and amylin.

👉blood to cell:

Although there is always a low level of insulin secreted by the pancreas, the amount secreted into
the blood increases as the blood glucose rises. Similarly, as blood glucose falls, the amount of
insulin secreted by the pancreatic islets goes down. 

After a meal, insulin is secreted into the bloodstream.

insulin turn on:Uptake and use of glucose by insulin-sensitive cells,Storage of glucose in the
form of glycogen in the liver and skeletal muscle tissue.
turn off:Breakdown of glycogen in liver cells,Gluconeogenesis

Glucose is brought into the cell through SLC2A1 channel proteins. For the glucose regulation
pathway the receptor autophosphorylates then causes insulin receptor substrate 1 (IRS-1) to be
phosphorated[2,3,4]. IRS-1 then phosphorylates Phosphatidylinositol 3-kinase (PI3K). PI3K
cleaves Phosphatidylinositol 4,5-bisphosphate (PIP2) leaving diacyl glycerol (DAG) in the cell
membrane and inositol 1,4,5-trisphosphate (IP3) in the cytosol. IP3 travels to the smooth
endoplasmic reticulum (SER) and cause calcium channels to open in the SER, releasing cations
into the cytosol. DAG activates a kinase named protein kinase C which also opens calcium
channels in the SER.[2,3] This ambient increase in calcium facilitates the binding of vesicles to
the membrane. These vesicles have Glut4 proteins imbedded in the membrane. Glut4 proteins
are channel proteins that allow glucose into the cell. Once these vesicles bind with the cell
membrane glucose flows through the Glut4 protein and into the cell, reducing blood glucose
levels.[2,3] When insulin binds to the receptors on the cell surface, vesicles containing the
GLUT4 transporters come to the plasma membrane and fuse together by the process of
endocytosis, thus enabling a facilitated diffusion of glucose into the cell. 

The process by which insulin is degraded and metabolized is poorly understood. However it is
known that the liver is responsible for the majority of insulin break down.The kidney is also key
in the break down of insulin. Peripheral tissue is thought to hold on to insulin perhaps reversibly
binding to membrane receptors.[6] These means it is possible for insulin to be removed from the
blood stream with out being broken down. 

👉liver to blood:glycogenolysis)

glucagon stimulates glycolysis, the breakdown of glycogen, and the export of glucose into the
circulation.

Glucagon is released from the alpha cells of the islets of Langerhans in the pancreas.When blood
glucose levels are low(such as between mill or during exercise), glucagon is released which
inhibits the break down of glucose, glycolysis and activates the formation of glucose,
gluconeogenesis. Gluconeogenesis creates glucose from such molecules as pyruvate, lactate,
glycerol, and glucogenic amino acids.
Glucagon is then released into the blood stream. Glucagon primarily operates on the liver.  it
binds to a transmembrane protein called a G protein coupled receptor(GPCR). The associated G
protein is phosphorylated with GTP and the alpha unit of the G protein moves to activate
adenylate cyclase (AC). AC converts ATP into cyclic AMP (cAMP). [8,9] Cyclic AMP activates
protein kinase A (PKA). PKA phosphorylates phosphofructokinase-2 (PFK-2) and fructose
bisphosphatase- 2(FBPase-2). Due to the addition of the phosphate PFK-2 becomes less active.
This in turn reduces the amount of fructose 2,6-bisphosphate (F-2,6-BP) being produce. High
levels of F-2,6-BP cause glycolysis or the break down of glucose.[8,9] So less active PFK-2
decreases the amount of F-2,6-BP. In addition FBPase-2 is activated which breaks downs F-2,6-
BP which also decreases the amount of F-2,6-BP. Low levels of F-2,6-BP cause the activation of
FBPase-1 which increase gluconeogenesis. In addition there is no activation of PFK-1, which is
involved in glycolysis both of these actions increase the amount of blood glucose.[9]

As a meal containing carbohydrates is eaten and digested, BG levels rise, and the pancreas turns
on insulin production and turns off glucagon production. Glucose from the bloodstream enters
liver cells, stimulating the action of several enzymes that convert the glucose to chains of
glycogen—so long as both insulin and glucose remain plentiful. 

BG levels begin to fall, insulin secretion drops and glycogen synthesis stops.

In a healthy liver, up to 10% of its total volume is used for glycogen stores. Skeletal muscle cells
store about 1% of glycogen. 

Your liver is amazing in that it knows how much to store and keep, or break down and release, to
maintain ideal plasma glucose levels. 

During extreme stimuli the sympathetic nervous system kicks into action. This is colloquially
known as the fight or flight response illustrated in figure 4. 

The brain sends signals to increase heart rate haptic glucose release. The brain also sends signals
to the adrenal glands. Epinephrine is released from the adrenal glands.Epinephrine travels
through the blood stream and causes the liver to release glucose thus increasing blood glucose
levels .

Epinephrine binds to a transmembrane receptor on the liver known as the beta-adrenergic

receptor protein. The receptor activates a G protein.Once activated the G protein diffuses along
the membrane. The G protein then binds with and activates adenylyl cyclase. Adenylyl cyclase
causes ATP to become cyclic AMP (cAMP).The molecule cAMP binds with protein kinase-A
which phosporalayts specific proteins. In this step phosphorylase is phosphorylated.[4,11]
Phosphorylase then cuts glucogen creating a glucose-1-phosphate. This is further refined into
glucose-6-phosphate by phosphoglucomutase. Glucose-6-phosphate can then be used for energy
requirements.

This hormone pathway is reversed when the parasympathetic nervous system takes priority.

👉Somatostatin is formed in the delta cells of the pancreas and acts as the “pancreatic
policeman,” balancing insulin and glucagon. It helps the pancreas alternate in turning on or
turning off each opposing hormone.

👉The Role of Amylin

Amylin is a peptide hormone that is secreted with insulin from the beta cells of the pancreas in a
1:100 ratio. Amylin inhibits glucagon secretion and therefore helps lower BG levels. It also
delays gastric emptying after a meal to decrease a sudden spike in plasma BG levels; further, it
increases brain satiety (satisfaction) to help someone feel full after a meal. This is a powerful
hormone in what has been called the brain–meal connection.

👉GLP-1[1]Intestinal L cells1) Enhances glucose-dependent insulin secretion; 2) Suppresses

glucagon secretion after eating; 3) Slows gastric emptying; 4) Reduces food intake. (Only works
while food is in the gut)
👉GIP (Intestinal K cells1) Induce insulin secretion 2) Inhibits apoptosis of the pancreatic beta
cells and promotes their proliferation 3) Stimulates glucagon secretion and fat accumulation

👉Asprosin[4]White adipose tissue1) Enhances release of liver glucose during

fasting.RaisesSomatostatinPancreatic δ Cells1) Suppresses glucagon release from α cells (acts
locally); 2) Suppresses release of Insulin, Pituitary tropic hormones, gastrin and secretin.

👉SomatostatinPancreatic δ Cells1) Suppresses glucagon release from α cells (acts locally); 2)

Suppresses release of Insulin,

👉EpinephrineAdrenal medulla1) Enhances release of glucose from glycogen

👉Cortisol Adrenal cortex1) Enhances gluconeogenesis; 2) Antagonizes insulin.

👉Thyroxine Thyroid1) Enhances release of glucose from glycogen; 2) Enhances absorption of

sugars from intestine.

👉When insulin binds to the receptors on the cell surface, vesicles containing the GLUT4
transporters come to the plasma membrane and fuse together by the process of endocytosis, thus
enabling a facilitated diffusion of glucose into the cell. 

https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=uf6060

https://microbewiki.kenyon.edu/index.php/Blood_Glucose_Regulation

https://www.medicalnewstoday.com/articles/316427
https://www.atrainceu.com/content/4-regulation-blood-glucose

https://www.atrainceu.com/content/4-regulation-blood-glucose (একটা পিক অাছে)

https://www.google.com/amp/s/www.endocrineweb.com/amp/26

https://en.m.wikipedia.org/wiki/Blood_sugar_regulation