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Figure 2 The Role of the PPP in Insulin Secretion Insulin is stored in granules and released via exocytosis from pancreatic islet cells in response to glucose in a biphasic manner, which is known as the triggering pathway and the amplifying pathway ( NADPH is one key modulator of the amplifying pathway because it converts GSSG to GSH which elicits insulin granule exocytosis via sentrin/SUMO-specific protease-1 (SENP1) (Figure 3)