Pancreas

Abstract

Diabetes mellitus (DM), a clinical/biochemical entity characterized principally by increased blood glucose levels (hyperglycemia), and secondarily by multiple other metabolic abnormalities, is the result of insufficient or defective insulin secretion and/or insulin activity. Although the etiology/pathogenesis of DM can be multifactorial, most patients can be grouped together in two main types: DM type 1, typically resulting from direct, often immunologically-mediated destruction of the insulin producing β islet cells, and DM type 2 which is much more widespread in the general population, and results from peripheral resistance to insulin action complicated by an inadequate compensatory insulin secretory response or islet exhaustion [67]. Over time, due to the deranged metabolic processes, including increased protein glycosylation, patients with DM develop extensive microvascular pathology leading to renal failure, retinopathy, systemic neuropathy, etc. These chronic complications are not only associated with a marked increase in the morbidity and mortality, but also have significant impact on the patients' overall quality of life. In addition, patients with DM, particularly of type 1, may have acute life threatening complications such as diabetic ketoacidosis and severe hypoglycemia [67]. © 2011 Springer-Verlag Berlin Heidelberg.