Type 2 Diabetes: The Pathologic Basis of Reversible β-Cell Dysfunction

The reversible nature of early type 2 diabetes has been demonstrated in in vivo human studies. Recent in vivo and in vitro studies of β-cell biology have established that the β-cell loses differentiated characteristics, including glucose-mediated insulin secretion, under metabolic stress. Critically...

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Published inDiabetes care Vol. 39; no. 11; pp. 2080 - 2088
Main Authors White, Michael G., Shaw, James A.M., Taylor, Roy
Format Journal Article
LanguageEnglish
Published United States 01.11.2016
Subjects
Animals
Blood Glucose - metabolism
Cell Differentiation
Diabetes Mellitus, Type 2 - physiopathology
Disease Models, Animal
Disease Progression
Humans
Insulin - metabolism
Insulin Secretion
Insulin-Secreting Cells - pathology
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Summary:The reversible nature of early type 2 diabetes has been demonstrated in in vivo human studies. Recent in vivo and in vitro studies of β-cell biology have established that the β-cell loses differentiated characteristics, including glucose-mediated insulin secretion, under metabolic stress. Critically, the β-cell dedifferentiation produced by long-term excess nutrient supply is reversible. Weight loss in humans permits restoration of first-phase insulin secretion associated with the return to normal of the elevated intrapancreatic triglyceride content. However, in type 2 diabetes of duration greater than 10 years, the cellular changes appear to pass a point of no return. This review summarizes the evidence that early type 2 diabetes can be regarded as a reversible β-cell response to chronic positive calorie balance.
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ISSN:0149-5992
1935-5548
1935-5548
DOI:10.2337/dc16-0619