Abstract
Insulin-dependent diabetes is the clinical definition for a condition of absolute insulin deficiency which leads to ketosis when no exogenous insulin is administered (Lefèbvre, this volume). The syndrome was attributed to an insufficient number of pancreatic B-cells after it became clear that newly diagnosed cases contained at least a five-fold smaller B-cell mass than normal controls [1-5]. Little is known about the events which lead to such quantitative deficit. Clarification of the underlying mechanisms has been hindered by two major obstacles. The first is the inability to measure the pancreatic B-cell mass in vivo, which prevents the detection of the disease at an earlier stage and hence its follow-up in the light of extrapancreatic events. Secondly, it has been impossible so far to screen for agents which impair the growth or survival of the pancreatic B-cells or their precursor cells. During recent years, both issues have been investigated in man and in rodents with a genetic predisposition for insulin-dependent diabetes. It was shown that abnormal glucose tolerance curves can precede the onset of clinical diabetes and may thus serve as a more sensitive parameter for a reduced B-cell mass [6-8]. It remains nevertheless questionable whether this functional test can be employed as a reliable index for the actual number of pancreatic B-cells. Observations in recent-onset diabetic patients also suggested a heterogeneous origin of the disease, but succeeded only in exceptional cases in identifying an agent which was primarily responsible for the killing of B-cells [9-11].
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The authors’ experimental work has been supported by grants from the Belgian Fonds Geneeskunding Wetenschappelijk Onderzoek (3.0066.84 and 3.0059.86) and the Belgian Ministerie voor Wetenschapsbeleid (gekonc. aktie 86/91-102).
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Pipeleers, D.G., In’t Veld, P.A., Van De Winkel, M. (1988). Death of the Pancreatic B-Cell. In: Lefèbvre, P.J., Pipeleers, D.G. (eds) The Pathology of the Endocrine Pancreas in Diabetes. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72691-0_7
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DOI: https://doi.org/10.1007/978-3-642-72691-0_7
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