Insulin oscillation the oscillations become synchronized by electrical coupling between closely located beta cells that are connected by gap junctions, and the periodicity is more uniform (3-6 min). Pulsatile insulin release from the entire pancreas requires that secretion is synchronized between 1 million islets within a 25 cm long organ. Much like the cardiac pacemaker, the pancreas is connected to cranial nerve 10, and others, but the oscillations are accomplished by intrapancreatic neurons and do not require neural input from the brain. It is not entirely clear which neural factors account for this synchronization but ATP as well as the gasses NO
Insulin resistance the β-cells to produce sufficient insulin in a condition of hyperglycemia is what characterizes the transition from insulin resistance to T2DM. Various disease states make body tissues more resistant to the actions of insulin. Examples include infection (mediated by the cytokine TNFα) and acidosis. Recent research is investigating the roles of adipokines (the cytokines produced by adipose tissue) in insulin resistance. TNF-α has been found in increased amounts in obese patients. Due to its effects on adipocytes it is possible that excessive TNF-α is one of several factors that leads to insulin resistance. TNF-α can inhibit lipogenesis, promote lipolysis, disrupt