Glucose metabolism
Glucose is stored in the body asglycogen. The liver is an important storage site for glycogen. Glycogen is mobilized and converted to glucose by gluconeogenesis when the blood glucose concentration is low. Glucose may also be produced from non-carbohydrate precursors, such as pyruvate, amino acids and glycerol, by gluconeogenesis. It is gluconeogenesis that maintains blood glucose concentrations, for example during starvation and intense exercise.
The pancreas has both endocrine and exocrine functions. The endocrine tissue is grouped together in the islets of Langerhans and consists of four different cell types each with its own function. Alpha cells produce glucagon. Beta cells produce proinsulin. Proinsulin is the inactive form of insulin that is converted to insulin in the circulation. Delta cells produce somatostatin. F or PP cells produce pancreatic polypeptide.
The growth hormone (GH) nadir during oral glucose tolerance test (OGTT) is the gold standard diagnostic test for acromegaly. The utility of OGTT-GH suppression test in patients with abnormal glucose metabolism (AGM) has not been well established.