Содержание
- 2. ENDOCRINE PANCREAS
- 3. ENDOCRINE PANCREAS The pancreas consists of two functionally distinct components: The exocrine pancreas, which secretes digestive
- 4. CELL TYPES IN THE ISLETS OF LANGERHANS
- 5. DIABETES MELLITUS Abnormal metabolic state characterised by glucose intolerance due to inadequate insulin action Type 1
- 6. Diagnosis is based on the clinical demonstration of glucose intolerance Insulin is unique, in that it
- 7. PATHOGENESIS The actions of insulin are all anabolic, that is, they promote the laying down of
- 8. In hyperglycaemia the renal threshold for glucose conservation is exceeded, so that there is osmotic diuresis
- 9. The combined result of severe ketosis, acidosis, hyperglycaemia, hyperosmolarity and electrolyte disturbance is to impair cerebral
- 10. CLASSIFICATION Type 1 (juvenile-onset, insulin-dependent diabetes) Typically presents in childhood. The patient usually shows the catabolic
- 11. Postmortem examination of the pancreas in patients who had recently developed type 1 diabetes but died
- 12. Autoimmune destruction. The majority of patients have circulatory antibodies to several different types of islet cell.
- 13. Type 2 (maturity-onset, non-insulin-dependent diabetes) is more common than type 1 and usually presents in middle
- 14. Type 2 (maturity-onset, non-insulin-dependent diabetes) Genetic factors clearly play an important part in the aetiology of
- 15. Secondary diabetes Hypersecretion of any of the hormones that tend to exert a hyperglycaemic effect may
- 16. COMPLICATIONS The commonest complications are seen in blood vessels. Atheroma, often ultimately severe and extensive, develops
- 17. TUMOURS Less common than pancreatic adenocarcinoma Present with endocrine effects and may be malignant Insulinoma: causes
- 18. Insulinoma Insulinoma is the commonest islet cell tumour and produces hypoglycaemia through hypersecretion of insulin. During
- 19. Gastrinomas : Although gastrin is usually produced in the G-cells of the stomach, tumours of the
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