Glucose homeostasis dependency on acini–islet–acinar (AIA) axis communication: a new possible pathophysiological hypothesis regarding diabetes mellitus

a Balanced Acini–islet–acinar (AIA) feedback maintains sustainable glucose utilization by insulin-independent (muscle, fat, etc.) and amylase-dependent glucose assimilation (gut tissues, gut bacteria). b The overstimulation of the pancreas enlarges the AIA defensive mechanism against the hyperglycaemic condition; c exhaustion of the acinar cells leads to the development of functional exocrine pancreatic insufficiency and hyperglycemia as a consequenc