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The pancreas has 2 separate sections: the exocrine deals with digestion--the endocrine produces insulin in its Beta cells and glucagon in its Alpha cells.

Counterregulatory hormones have opposing effects to the actions of insulin. Where insulin, endogenous or exogenous, lowers blood glucose, one effect of these counterregulatory hormones is to raise it.

Adrenal Gland: The cortex, or outer area (shown at right), produces cortisol or cortisone; the center or medulla area (shown at left), produces adrenalin or epinephrine.

Cortisol,growth hormone, adrenalin AKA epinephrine, glucagon, progesterone and thyroid hormone are considered counter-regulatory hormones[1] as far as diabetes and blood glucose levels are concerned.

They need just as much consideration as insulin, because changes in their bloodstream levels, can mean a possible interference with insulin, or a need for more of it.

These changes can occur normally within the body to supply extra fuel when needed, or as symptoms of a disease state, or as a result of other medications, such as steroids.


Thyroid gland: an illustration of too much thyroid hormone being produced, or hyperthyroidism

The counter-regulatory hormones adrenalin/epinephrine, glucagon and cortisol/cortisone are released to provide extra energy to the body in various circumstances, or if the body believes it's threatened with hypoglycemia. In some cases this is part of the body's "self-defense" mechanism to counter the effects of too much insulin.

The following table lists counterregulatory hormones in roughly the order you're likely to encounter them in your diabetes research:

HormoneBody functionsProduced byOverproductionUnderproductionBG Effects
Glucagon[2] Stimulates liver to release glucose by glycogenolysis Alpha cells of the pancreas[3] hyperglycemia hypoglycemia, poor protection from excess insulin dose Raises BG
Cortisol[4][5][6] Increases blood glucose levels and blood pressure, suppresses the immune system. adrenal cortex[7] in response to stress, or given exogenously as steroids Cushing's Disease[8] Addison's disease[9] Raises BG
also see
Dawn phenomenon
epinephrine or adrenaline[10][11] Similar to cortisol but acts instantly -- used for fight-or-flight. Redirects body energy into heart & legs, forces fast glycogenolysis, reduces receptivity to insulin. adrenal medulla[12] See pheochromocytoma[13][14] epinephrine deficiency Raises BG very fast.
Thyroid hormone[15] Increases basal metabolic rate, heart rate, sensitivity to adrenaline thyroid gland[16] hyperthyroidism[17] hypothyroidism[18] Raises BG,Increases insulin resistance
Somatotropin or Growth hormone[19] Growth of bone & cartilage, insulin-like effects Anterior Pituitary[20] acromegaly[21] growth hormone deficiency Raises BG two ways - reduces liver's glucose uptake, and produces IGF-1 which competes with insulin for receptors.
progesterone Too many to list[22]. Partly responsible for gestational diabetes. Brain, gonads, adrenal glands, placenta See progesterone See progesterone increases insulin resistance

Further ReadingEdit


  1. Counter-Regulatory Hormones
  2. College of Veterinary Medicine-Colorado State-Glucagon
  3. Merck Veterinary Manual-Pancreas
  4. College of Veterinary Medicine-Colorado State-Adrenal Steroids
  5. College of Veterinary Medicine-Colorado State-Adrenal Steroids-Glucocorticoids
  6. College of Veterinary Medicine-Colorado State-Adrenal Steroids-Mineralcorticoids
  7. Merck Veterinary Manual-Adrenal Cortex Overview
  8. Merck Veterinary Manual-Hyperadrenocorticism-Cushing's Disease
  9. Merck Veterinary Manual-Hypoadrenocortisicm-Addison's Disease
  10. College of Veterinary Medicine-Colorado State-Adrenal Steroids
  11. College of Veterinary Medicine Colorado State-Adrenal Medullary Hormones--Epinephrine
  12. Merck Veterinary Manual-Adrenal Medulla
  13. OSU Endocrinology Symposium 2006-Unusual Endocrine Disorders in Dogs & Cats-Nelson-Page 44
  14. Endocrinology-an Integrated Approach--Pheochromocytoma
  15. Physiologic Effects of Thyroid Hormone-School of Veterinary Medicine-Colorado State
  16. Merck Veterinary Manual-Thyroid Gland Introduction
  17. Merck Veterinary Manual-Hyperthyroidism
  18. Merck Veterinary Manual-Hypothyroidism
  19. College of Veterinary Medicine-Colorado State-Somatotropin/Growth Hormone
  20. Merck Veterinary Manual-Adenohypophysis-Anterior Pituitary
  21. Merck Veterinary Manual-Feline Acromegaly
  22. Explanation of Progesterone's Functions-Veterinary Partner
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