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Diabetes for 1 last update 02 Jun 2020 mellitusDiabetes mellitus
Non insulin dependent diabetes mellitus


Topic Completed: 1 August 2012

Minor changes: 6 March 2020

Copyright: 2002-2020, PathologyOutlines.com, Inc.

PubMed Search: Non insulin dependent diabetes mellitus[TI] pancreas[TIAB]

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Table of Contents
Definition / general | Pathophysiology | Clinical features | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Videos
Cite this page: Jain D. Non insulin dependent diabetes mellitus. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/pancreasNIDDM.html. Accessed May 11th, 2020.
Definition / general
  • Also called adult onset, non insulin dependent diabetes mellitus / NIDDM, type 2
  • 80 - 90% of cases of diabetes (Wikipedia: Diabetes Mellitus Type 2 [Accessed 8 December 2017])
  • Usually > 30 years old, obese (80% of cases, abdominal obesity more important than subcutaneous obesity), normal or increased blood insulin, rare diabetic ketoacidosis, no anti-islet antibodies
Pathophysiology
Early:
  • Normal insulin secretion and plasma levels but loss of pulsatile, oscillating pattern of secretion
  • Also loss of rapid first phase of insulin secretion triggered by glucose
  • NO insulinitis is present

Later:
  • Mild / moderate insulin deficiency, may be due to beta cell damage
  • Beta cells may be "" due to chronic hyperglycemia and persistent beta cell stimulation

Amylin:
  • 37 amino acid peptide, normally produced by beta cells, packaged and cosecreted with insulin
  • In NIDDM patients, tends to accumulate outside beta cells and resembles amyloid
Clinical features
  • 90%+ concordance in twins, apparently due to multiple genetic polymorphisms (no HLA association)
  • Due to insulin resistance (associated with obesity and pregnancy) or derangement in beta cell secretion of insulin
  • Associated with amyloid deposits in islets (amyloid associated with basement membrane heparan sulfate proteoglycan, Arch Pathol Lab Med 1992;116:951) and pituitary (Arch Pathol Lab Med 1995;119:1055)
Treatment
Microscopic (histologic) description
  • Amyloid in the islets of Langerhans is the uniform pathologic feature
Microscopic (histologic) images

Images hosted on other servers:

Amyloid for 1 last update 02 Jun 2020 deposition in isletsAmyloid deposition in islets

Islet amyloid
polypeptide and
insulin expressing
cells in islets

Videos

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