Morphopathology of Pancreas in Diabetes Mellitus- A Prospective Study Done in 50 Autopsy Cases

Abstract

The pancreas comprises exocrine and endocrine compartments, with the latter comprising the pancreatic islet with its endocrine cells. In both type1 and type2 diabetes, several morphological changes occur in the pancreas, but the predominant feature of beta cell loss. Our aim of this study is to find out of histopathological changes in pancreas due to diabetes and correlate it with clinical findings. Methods: A prospective study was done on 50 autopsy specimens of pancreas. Specimens were fixed in formalin and tissue was adequately processed. The sections were stained with routine haematoxylene and eosin stain. Results: In our study 86% cases were of T1DM and 14% of T2DM. Most common age group was between 40-60 years (62% cases). 68% cases had duration of DM of 10-20 years. On histopathological examination, 85% Cases of T1DM revealed cytolysis and inflammation in exocrine pancreas. In cases of T2DM cytolysis was seen in 32% cases, inflammation in 25% and fibrosis in 16% cases.. Fibrosis was present in 14% cases of T1DM and 25% cases of T2DM in endocrine pancreas. Insulitis in endocrine pancreas was seen in 85% cases of T1DM and 34% cases of T2DM. Thus, the most common finding was reduced beta cell mass in T2DM and insulitis in T1DM. Findings were correlated with age, sex and duration of diabetes. Conclusion: With increasing incidence of diabetes knowledge of pathogenesis of changes due to diabetes in pancreas may lead to research of further targeted therapy in better management of diabetes in future. Changes that occur in pancreas due to diabetes are more evident in long standing diabetes and early changes are not evident in routine histopathological sections.