The Pathology of the Endocrine Pancreas in Diabetes

Diabetes mellitus represents one of the most frequent and serious clinical syn­ dromes in contemporary medicine. Since the end of the nineteenth century, the endocrine pancreas has been implicated in the pathogenesis of this disease. Several pathologists of the twentieth century detected various lesions and mor­ phologic alterations in the pancreatic islets of diabetic patients, but the patho­ physiologic basis of their findings remained long obscure. The systematic mi­ croscopic work of WILLY GEPTS clarified the views and related the variety in histopathology to differences in origin, duration and clinical expression of the disease. Over the past two decades, the concept of a multifactorial origin of diabetes has become widely accepted. Various agents and mechanisms have been identified which can lead to a quantitative or qualitative deficit in pancre­ atic B-cells. The purpose of this book is to bring an update on the many path­ ways which may induce an absolute or relative insufficiency in insulin release and hence a diabetic state. Rather than bringing a complete account on all re­ search relevant to the understanding of the pathology of the diabetic pancreas, the authors of the various chapters of this volume have focussed on selected processes which can impair B-cell function, survival or regeneration. Front Matter....Pages I-XI Clinical Forms of Diabetes Mellitus....Pages 1-16 The Diabetic Pancreas: A Pathologist’s View....Pages 17-40 Insulitis in the Human Pancreas....Pages 41-52 Circulating Signs of Autoimmune Islet Disease....Pages 53-70 Immune Interactions with Islet Cells: Implications for the Pathogenesis of Insulin-Dependent Diabetes Mellitus....Pages 71-84 Viral Interactions with Pancreatic B-Cells....Pages 85-105 Death of the Pancreatic B-Cell....Pages 106-124 Disturbed Growth of the Endocrine Pancreas....Pages 125-140 Islet Cell Replication and Diabetes....Pages 141-170 Islet Cell Tumors and Diabetes Mellitus....Pages 171-190 Insulin Secretion in Diabetes Mellitus....Pages 191-218 Possible Sites for Deficient Glucose Recognition in Islet Cells....Pages 219-232 Insulin Release and Islet Cell Junctions....Pages 233-248 Calcium Transport and Deficient Insulin Release....Pages 249-268 Autoimmune Diabetes in the BioBreeding/Worcester Rat....Pages 269-284 Rat Models of Non-Insulin-Dependent Diabetes Mellitus: Evidence that Mild Increases in Plasma Glucose Play an Important Role in Pathogenesis....Pages 285-309 Perspectives of Islet Cell Transplantation in Diabetes....Pages 310-328 Back Matter....Pages 329-336