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[The endocrine pancreas]

L Cortesão1, A M Saraiva, L Guerreiro

  • 1Serviço de Endocrinologia Diabetes e Metabolismo, Hospital de Egas Moniz, Lisboa.

Acta Medica Portuguesa
|June 1, 1995
PubMed
Summary

The islets of Langerhans manage glucose and protect against hypoglycemia. Diabetes mellitus (IDDM and NIDDM) involves beta-cell issues, while pancreatic tumors like insulinoma and gastrinoma cause hypoglycemia and Zollinger-Ellison syndrome, respectively.

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Area of Science:

  • Endocrinology and Metabolism
  • Cell Biology
  • Oncology

Context:

  • The islets of Langerhans are crucial for glucose homeostasis and protection against hypoglycemia.
  • Insulin-dependent diabetes mellitus (IDDM) stems from autoimmune beta-cell destruction, while non-insulin dependent diabetes mellitus (NIDDM) results from beta-cell dysfunction.
  • Functional endocrine tumors (FETs) of the pancreas are rare neoplasms secreting hormones and peptides, often associated with Multiple Endocrine Neoplasia type 1 (MEN 1).

Purpose:

  • To review the diverse roles of pancreatic islet cells and associated pathologies.
  • To discuss the pathogenesis, prevention, and treatment strategies for IDDM and NIDDM.
  • To highlight the clinical significance of functional endocrine tumors, including insulinoma and gastrinoma, and their diagnostic challenges.

Summary:

  • IDDM prevention is advanced in animal models, with high-risk individual screening and treatment underway. Immunosuppression offers transient remission, and intensive insulin therapy slows long-term complications.
  • NIDDM management emphasizes diet and exercise. FETs, particularly insulinomas causing hypoglycemia and gastrinomas inducing Zollinger-Ellison syndrome, require careful diagnosis, often involving MEN 1 screening.
  • Hypoglycemia can be drug-induced or caused by insulinomas, whose symptoms may mimic neuropsychiatric disorders. Diagnosis relies on confirming hypoglycemia and hyperinsulinism.

Impact:

  • Understanding islet cell function and dysfunction is key to managing diabetes mellitus.
  • Early detection and management of pancreatic endocrine tumors can improve patient outcomes.
  • This review provides a comprehensive overview of islet cell disorders, aiding clinicians in diagnosis and treatment.

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