الفهرس 
Gestational diabetes mellitusOnly 14 pages are availabe for public view
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Abstract
The pancreas is a non-encapsulated, retroperitoneal organ that lies in the anterior pararenal space between the duodenal loop and splenic hilum over a length of 12.5-15 cm. various types of morphological changes in the pancreas have been described in patients with diabetes mellitus (DM). Pathologists have demonstrated islet cell pancreatic changes in DM such as hyalinization, fibrosis, hydropic degeneration, and hyperplasia. The term DM describes a chronic metabolic disorder of multiple etiology, characterized by hyperglycemia with disturbances of carbohydrate, fat, and protein metabolism, resulting from a relative or an absolute lack of insulin. Abdominal ultrasound is used in the hospital, radiology department and emergency department, as well as in physician offices for a number of clinical applications. It has a great advantage over plain radiography in that it does not predispose tissues to the hazard of ionizing radiation. Ultrasound is also generally far better than plain radiography at distinguishing the subtle variation of soft tissue structures and can be used in different modes and Doppler e.g. depending on the area of interest of the user. The pancreatic changes in DM and the advantages of ultrasonography compared to expensive methods, as well as its probable efficacy in predicting disease severity makes it a preferred first-line imaging modality. Sonographic evaluation of the pancreas shows that the size of the gland was significantly smaller in DM compared to that of the nondiabetics. This comparative cross-sectional study was carried out on 120 subjects over a 6 month period in Tanta University Hospitals to evaluate the ultra sonographic size of the pancreas and both the duration of the disease and type of treatment in type II Egyptian diabetic patients. The following groups were included in the present study: 1- group A: 100 patients with type II diabetes mellitus. A diagnosis of diabetes was established if a patient was already on oral hypoglycemic drugs or insulin, if fasting blood glucose was ≥ 126 mg/dl on 2 consecutive days, if 2-hours post prandial blood glucose ≥ 200 mg/dl or HbA1c levels were ≥ 6.5%. 2-group B: 20 non-diabetic patients (healthy controls). All subjects were submitted to careful history taking, thorough clinical examination, routine laboratory investigations, specific laboratory investigation (HbA1c) and pelvi-abdominal ultrasonography. In our study, there is no significant difference between diabetic group and control group as regard to age (years), HB (g/dl), bilirubin (mg/dl), ALT (u/l), AST (u/l), S. albumin (g/dl) and urea (mg/dl), P. value (0.053, 0.547, 0.173, 0.610, 0.610, 0.701 and 0.053). And there is a significant difference between diabetic group and control group as regard to creatinin (mg/dl), RBS (mg/dl), HbA1C (%),head (cm), body (cm),and tail (cm), P. value (0.001, 0.001, 0.001, 0.001, 0.001 and 0.001). Also, there is no a significant correlation between diabetic group and control group as regaed to sex. In our study, there was a comparison between oral hypoglycemic drugs and oral hypoglycemic drugs plus insulin in diabetic group as regard to pancreatic head, body and tail size and there are pancreatic head, body and tail size decrease more significantly in the group on oral hypoglycemic drugs than the group receiving oral hypoglycemic drugs plus insulin and this could be explained by better diabetic control by the compination treatment than oral hypoglycemic drugs alone. Also, there is a negative significant correlation of pancreatic head, body, and tail size with duration of DM in diabetic group.