Pancreas
Diabetes mellitus
General

Author: Deepali Jain, M.D. (see Authors page)

Revised: 8 December 2017, last major update August 2012

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Cite this page: Jain, D. Diabetes mellitus - general. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/pancreasdmgeneral.html. Accessed August 15th, 2018.
Definition / general
Epidemiology
Etiology
  • Destruction of islets due to drugs (steroids, thiazides, pentamidine), hemochromatosis ("bronze diabetes" due to hemosiderin deposition in pancreas), hereditary ceruloplasmin deficiency (Hum Pathol 1997;28:499), infections (congenital rubella, CMV, coxsackievirus [Arch Pathol Lab Med 1980;104:438], enteroviruses [Diabetologia 2004;47:225]), pancreatitis, surgery, tumors, endocrinopathies (pituitary, adrenal, pregnancy) or idiopathic
Diagnosis
  • High fasting glucose or impaired glucose tolerance (without diabetes, oral glucose loads cause only slight rise in blood glucose due to brisk insulin response; with diabetes, blood glucose rises markedly for a sustained period)
Microscopic (histologic) description
  • Type 1: inconsistent reduction in number and size of islets, uneven insulinitis (T lymphocytes)
  • Type 2: subtle reduction in islet cell mass, amyloid replacement of islets due to amylin fibrils (also seen in aging nondiabetics); associated with marked fatty replacement
  • Gestational diabetes: lower total insulin+ area due to smaller islets (Islets 2011;3:231)
  • Infants of diabetic mothers: islet cell hypertrophy / hyperplasia