while the mechanism of altered glucose tolerance may involve mechanical , neural , humoral , or vascular events , our data clearly support the conclusion that pancreatic ductal stenosis with resultant pancreatic fibrosis and chronic pancreatitis is associated with abnormal islet responsiveness leading to circulating insulin deficiency and glucose intolerance , despite histologic and ultrastructural evidence of intact islets of langerhans .
C0021641
insulin
C0022131
of