Case Report:

A 12-year-old boy presents to the emergency department with complaints of weight loss, fatigue, polydipsia, polyphagia, and polyuria. The patient has no medical problems but has many family members with diabetes and hypertension. On examination, the patient is a thin ill-appearing male in no acute distress with normal vital signs. His examination is unremarkable. A urinalysis reveals glucosuria and a markedly elevated fasting blood sugar. The patient is diagnosed with type I diabetes mellitus (insulin-dependent), and is advised by the physician to start insulin therapy. The patient’s parents ask whether oral agents such as sulfonylurea tablets can be used instead of insulin.
• What is the major factor that regulates insulin secretion?
• What hormones do the delta cells of the pancreas produce?
• How do sulfonylurea drugs increase insulin secretion?

ANSWERS : Pancreatic Islet Cells
Summary: A 12-year-old boy with weight loss, fatigue, polydipsia, polyphagia, polyuria, and elevated fasting blood sugar is diagnosed with type I diabetes mellitus.

• Major regulating factor: Serum sugar levels.
• Delta cells produce: Somatostatin and gastrin.
• Sulfonylurea medications: Close the KATP potassium channels in the beta cells, resulting in insulin secretion.