Decreased beta-cell mass in diabetes: significance, mechanisms and therapeutic implications

Diabetologia. 2004 Mar;47(3):581-589. doi: 10.1007/s00125-004-1336-4. Epub 2004 Feb 7.

Abstract

Increasing evidence indicates that decreased functional beta-cell mass is the hallmark of both Type 1 and Type 2 diabetes. This underlies the absolute or relative insulin insufficiency in both conditions. In this For Debate, we consider the possible mechanisms responsible for beta-cell death and impaired function and their relative contribution to insulin insufficiency in diabetes. Beta-cell apoptosis and impaired proliferation consequent to hyperglycaemia is one pathway that could be operating in all forms of diabetes. Autoimmunity and other routes to beta-cell death are also considered. Recognition of decreased functional beta-cell mass and its overlapping multifactorial aetiology in diabetic states, leads us to propose a unifying classification of diabetes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cell Death
  • Diabetes Mellitus / pathology*
  • Diabetes Mellitus, Type 2 / pathology
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Humans
  • Insulin / metabolism
  • Insulin Secretion
  • Islets of Langerhans / anatomy & histology*
  • Islets of Langerhans / pathology

Substances

  • Insulin