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Related Concept Videos

Chronic Pancreatitis I: Introduction01:24

Chronic Pancreatitis I: Introduction

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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
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Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
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Chronic Pancreatitis II: Collaborative Care01:29

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The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
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The pancreas, a vital organ within the abdominal cavity, plays dual roles in the digestive and endocrine systems, collaborating with exocrine and endocrine cells to maintain optimal digestion and blood sugar levels.
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Acute Pancreatitis I: Introduction01:27

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Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
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Pathophysiology of Diabetes01:20

Pathophysiology of Diabetes

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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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Islet cell dysfunction in patients with chronic pancreatitis.

Ayan Roy1, Jayaprakash Sahoo2, Sadishkumar Kamalanathan1

  • 1Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India.

World Journal of Diabetes
|August 27, 2020
PubMed
Summary

Chronic pancreatitis (CP) causes diabetes that is hard to manage. This is due to progressive beta cell loss and alpha cell dysfunction, impacting insulin and glucagon secretion.

Keywords:
Alpha cellBeta-cellChronic pancreatitisDiabetesIncretinsPancreatic diabetes

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Area of Science:

  • Endocrinology
  • Gastroenterology
  • Cell Biology

Background:

  • Chronic pancreatitis (CP) involves progressive pancreatic inflammation and fibrosis, leading to exocrine and endocrine insufficiency.
  • Diabetes in CP patients presents management challenges due to glycemic variability and malabsorption.
  • Beta cell loss causing insulin deficiency is the primary driver of diabetes in CP.

Purpose of the Study:

  • To review the multifactorial mechanisms of islet cell dysfunction in chronic pancreatitis.
  • To explore the role of alpha cell dysfunction and incretin hormone dysregulation.
  • To discuss the impact of inflammation, surgery, and medications on islet cell function in CP.

Main Methods:

  • Literature review of studies on islet cell function in chronic pancreatitis.
  • Analysis of factors contributing to hyperglycemia and glycemic variability in CP-associated diabetes.
  • Synthesis of evidence on alpha and beta cell interactions and incretin axis dysregulation.

Main Results:

  • Alpha cell dysfunction and altered glucagon secretion are observed in CP, though findings vary by study.
  • Loss of intra-islet alpha-beta cell regulation and dysregulated incretin hormone secretion (GLP-1, GIP) contribute to islet dysfunction.
  • Persistent inflammation, altered delta and PP cell function, surgical interventions, and anti-diabetic drugs further impact islet cell function.

Conclusions:

  • Islet cell dysfunction in CP is multifactorial, involving inflammation, hormonal imbalances, and external factors.
  • Targeting alpha cell function and promoting beta cell regeneration may offer future therapeutic strategies for CP-associated diabetes.