The pancreatic beta-cell in human Type 2 diabetes

Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
Piero MarchettiSilvia Del Guerra

Abstract

There is growing evidence that the beta-cell is central to the development of Type 2 diabetes. In this brief review we discuss the factors predisposing to beta-cell dysfunction and some characteristics of islet cells in Type 2 diabetes. Several genes have been associated with islet cell dysfunction in Type 2 diabetes, including those encoding for transcription factors, glucose metabolism proteins, molecules of the insulin signaling pathways, and several others. On the other hand, many environmental factors can directly or indirectly affect pancreatic islet cells, and possibly contribute to the development and/or progression of Type 2 diabetes. In this regard, the role of prolonged exposure to high glucose (glucotoxicity) and high fatty acid (lipotoxicity) concentrations seems to be of particular relevance. More recently, it has been possible to directly evaluate some properties of pancreatic islets prepared from Type 2 diabetic donors. Consistently, a marked decrease in insulin secretion during glucose stimulation has been found, although the secretory response to amino acids or sulphonylurea is usually less severely affected. In addition, increased beta-cell apoptosis in Type 2 diabetes islets has been reported. Interestingly,...Continue Reading

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