Insulin secretion from pancreatic beta cells is regulated by both nutrient and neural signals [1][2]. Vagal cholinergic signaling stimulates insulin release, mediated by muscarinic receptors on beta cells [2][6]. Gastrin and secretin also stimulate insulin secretion [1]. In contrast, sympathetic norepinephrine signaling inhibits insulin release via α2-adrenergic receptors [1][3]. Low blood glucose is sensed by glucose chemoreceptors that activate sympathetic outflow, inhibiting insulin release [4][5]. Hyperglycemia reverses this inhibition. Additionally, leptin signaling from adipose tissue to the hypothalamus modulates sympathetic drive to the pancreas [3]. Insulin controls its own secretion through negative feedback on beta cells [2]. Disruption of neural regulation contributes to dysregulated insulin secretion in diabetes [6].