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Hyalinization of islets of Langerhans is generally a characteristic finding in non-insulin dependent diabetes mellitus. However, hyaline material/amyloid is sometimes found in elderly nondiabetic patients and also in patients with endstage renal failure on dialysis treatment and in patients after gastrectomy, which are known as states of impaired glucose tolerance. Glucose intolerance also occurs in patients with cirrhosis of the liver, showing enlarged/swollen islets of Langerhans accompanied with B cells, and decrease in insulin-secreting cells, and in patients with hemochromatosis which consists of hemosiderin deposition in B cells.

Copyright © 2007 S. Karger AG, Basel

The islets of Langerhans of the pancreas are a representative component of the endocrine pancreas, related to glucose metabolism. Abnormal glucose metabolism, or impaired glucose tolerance, occur in various diseases.

Hyalinization of the islets of Langerhans is generally a characteristic feature of patients with type 2 (non-insulin dependent) diabetes mellitus. Prevalence of islet amyloid in type 2 diabetic patients ranges up to 87%, while in elderly non-diabetic subjects it ranges between 0 and 17% [1-4]. These hyalinized islets demonstrate amyloid with nonbranching, randomly distributed 100- to 120-Ä thick fibrils and are immunostained positive for anti-amylin (or islet amyloid polypeptide), which is a major component of hyaline replacement [6, 7]. According to the studies in a group of spontaneously diabetic monkeys, amyloid development precedes glucose intolerance [5].

Fig. 1. Hyaline replacement in an islet of Langerhans in an autopsied endstage renal failure patient who had received dialysis treatment for 5 years. HE. X200.

In this chapter, various diseases related to impaired glucose tolerance are described.

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