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Diabetes Mellitus: Overview and Type I Subtype

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...

Insulin: Biosynthesis, Chemistry, and Preparation

Insulin: Biosynthesis, Chemistry, and Preparation

The endoplasmic reticulum (ER) of pancreatic β-cells synthesizes preproinsulin, which consists of a signal peptide, A and B chains, and a C-peptide. Preproinsulin is then cleaved and folded into proinsulin, which translocates to the Golgi apparatus for sorting and packaging into secretory granules. In these granules, enzymatic clipping generates insulin and C-peptide.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment primarily uses...

Insulin: Dosing Regimen and Adverse Effects

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...

Diabetes Mellitus: Introduction

Diabetes Mellitus: Introduction

Diabetes mellitus consists of chronic metabolic disorders characterized by persistent hyperglycemia. This elevated blood glucose results from defects in insulin secretion, impaired insulin action, or both. Insulin, produced by pancreatic β-cells, is essential for maintaining glucose homeostasis by facilitating cellular glucose uptake for energy or storage. Disruptions in insulin production or function lead to glucose accumulation in the bloodstream, causing the clinical features and long-term...

Type I Diabetes I: Introduction

Type I Diabetes I: Introduction

Type 1 diabetes mellitus is a chronic metabolic disorder characterized by an absolute deficiency of insulin resulting from the autoimmune destruction of pancreatic β-cells. Although it can occur at any age, it is most commonly diagnosed in childhood, adolescence, or early adulthood. The loss of insulin production impairs cellular glucose uptake, resulting in persistent hyperglycemia and necessitating lifelong insulin therapy.Autoimmune Destruction of β-CellsThe hallmark of type 1 diabetes is an...

Type I Diabetes II: Pathophysiology

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...

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Related Experiment Video

Updated: Jul 26, 2026

Isolation of Human Islets from Partially Pancreatectomized Patients

Isolation of Human Islets from Partially Pancreatectomized Patients

Published on: July 30, 2011

Insulinoma--experience from 1950 to 1995

M P Boukhman¹, J H Karam, J Shaver

¹Department of Surgery, University of California, San Francisco/Mt. Zion Medical Center 94115, USA.

The Western Journal of Medicine

|September 15, 1998

Summary

This study analyzed 67 insulinoma patients, finding intraoperative ultrasonography crucial for localization. For Multiple Endocrine Neoplasia type I (MEN 1) patients, subtotal pancreatectomy is recommended over simple enucleation.

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Isolation of Human Islets from Partially Pancreatectomized Patients

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Published on: July 30, 2011

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Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head

Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head

Published on: January 3, 2020

Area of Science:

Endocrinology
Surgical Oncology
Gastroenterology

Background:

Insulinomas are rare pancreatic islet cell tumors.
Management requires careful consideration of tumor location and patient factors.

Purpose of the Study:

To analyze institutional experience with insulinoma patients.
To present a comprehensive approach to diagnosis and surgical management.

Main Methods:

Retrospective review of 67 patients treated between 1954 and 1995.
Analysis of presenting symptoms, diagnostic studies, surgical outcomes, and complications.
Evaluation of localization techniques, including preoperative studies and intraoperative ultrasonography.

Main Results:

Surgical success rates varied: 96% for first operations (benign), 63% for reoperations (benign), and 50% for islet cell carcinoma.
Preoperative localization studies had limited utility (46% positive).
Intraoperative ultrasonography combined with palpation yielded the best localization results.

Conclusions:

Enucleation is curative for sporadic solitary tumors with low complication rates.
For MEN 1 patients, subtotal pancreatectomy with enucleation is preferred due to frequent multiple tumors.
Accurate localization, particularly intraoperative ultrasonography, is key to successful insulinoma management.