Glucocorticoids pancreas

Uncommon causes of diabetes (1% to 2% of cases) include endocrine disorders (e.g., acromegaly, Cushing s syndrome), gestational diabetes mellitus (GDM), diseases of the exocrine pancreas (e.g., pancreatitis), and medications (e.g., glucocorticoids, pentamidine, niacin, and a-interferon). 

Cortical hormones include glucocorticoids (cortisol/corticosterone) and mineralocorticoids (aldosterone) medullar hormones are adrenaline and noradrenaline Pancreas Regulates glucose in blood via production of the hormones glucagon and insulin... 

Pancreatitis and altered pancreatic secretion can occur at any time during long-term glucocorticoid treatment (SED-12, 986 SEDA-14, 339 160). Necrosis of the pancreas during glucocorticoid treatment has been described and can be lethal. Impairment of pancreatic function can predispose to glucocorticoid-induced pancreatitis. Two other cases of glucocorticoid-induced pancreatitis have been reported (161). 

Clinical Use. Cyclosporine (Neoral, Sandimmune) is one of the primary medications used to suppress immune function following organ transplantation.14 21 69 This medication can be used alone or combined with glucocorticoids, azathioprine, and other immunosuppressants to prevent the rejection of a kidney, lung, liver, heart, pancreas, and other organ transplants. 

Islet cell and whole pancreas transplantation are occasionally used in patients, nsually renal transplants, who reqnire immunosnp-pressive therapy for other reasons. There has been considerable interest in islet cell transplantation since investigators in Edmonton reported snccess without using glucocorticoids as immunosuppressive agents. Some of these patients are able to come off insnlin altogether. 

Answer D. Drugs that decrease extracellular potassium such as the thiazide and loop diuretics and adrenal glucocorticoids will lead to an increased requirement for insulin by making it more difficult to release the hormone from the B cells of the pancreas. Spironolactone is K sparing, tends to cause hyperkalemia, and does not interfere with the release of insulin. Stress conditions such as examinations also increase insulin requirement. 

---