Pathogenesis of Diabetes
Elucidation of the pathogenesis of a disease prompts a rational search for the most appropriate therapy. In the majority of patients with diabetes mellitus, the pathogenesis has not been established, but significant contributory factors have been demonstrated in some instances.
Decreased Insulin Secretion.
—A marked decrease in pancreatic islet tissue, whether produced by carcinomatosis, pancreatitis, extirpation, or in other ways, has been found to cause diabetes. But in the majority of patients, apparently there is insufficient morphologic abnormality to account for the development of this disorder. It could be postulated that a biochemical defect in the β-cells is associated with a decreased insulin synthesis and/or release. Such a concept deserves notation in considering the possible mechanisms of action of sulfonylureas, discussed later.
Relative Insufficiency of Insulin Secretion.
—There are many conditions that are associated with the development of diabetes in which there is reason for assuming that
WILLIAMS RH, HENLEY ED. Recent Studies Relative to the Treatment of Diabetes: Special Reference to New Oral Antidiabetic Drugs. AMA Arch Intern Med. 1957;99(4):501–518. doi:10.1001/archinte.1957.00260040001001
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