This heterogeneous disease is usually divided into two major groups: the autoimmune type 1 diabetes with a destruction of the insulin-producing b-cells, and type 2 diabetes characterized by insulin resistance and a relative insulin insufficiency.
In long-standing type 1 diabetes, the lack of local anabolic effects of insulin within the pancreas leads to a slight exocrine dysfunction, but this has rarely been studied. Since the remaining islets are few and mainly consist of glucagon-and somatostatin-producing cells, they are difficult to find, and no studies on their microcirculation have been published. In the spontaneously diabetic NOD mouse we have observed that as the islet volume decreases due to the autoimmune assault, the remaining islets initially become hyperperfused to try to cope with the increased functional demands. However, as the disease progresses blood perfusion decreases.
In type 2 diabetes there are no major changes in total pancreatic blood flow. However, islet blood flow is markedly affected. Thus, in the prediabetic and early phases of the disease an increased islet blood flow is consistently seen in all models studied so far. This increased blood flow is, at least in GK rats, associated with an islet capillary hypertension. To what extent the hyperperfusion of blood alleviates or aggravates the impaired islet endocrine function is at present unknown. It is tempting to speculate that increased shear stress on islet endothelial cells changes their expression and production of different vasoactive mediators, such as nitric oxide and endothelins, which may affect also the endocrine functions.
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All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.