Diabetes and beta cell function: from mechanisms to evaluation and clinical implications.

Area of Science:

• Endocrinology
• Metabolic Diseases
• Cell Biology

Background:

• Diabetes mellitus is characterized by pancreatic beta cell dysfunction.
• Multiple factors including hyperglycemia, lipotoxicity, inflammation, and insulin resistance impact beta cell function.
• Chronic hyperglycemia and lipotoxicity induce detrimental effects on insulin synthesis, secretion, and cell survival.

Purpose of the Study:

• To provide a comprehensive overview of mechanisms influencing pancreatic beta cell function in diabetes.
• To discuss current methods for assessing beta cell function.
• To explore therapeutic strategies for protecting beta cell function and mass.

Main Methods:

• Literature review of factors affecting beta cell function.
• Discussion of pathogenetic mechanisms in diabetes.
• Analysis of beta cell function assessment methods.
• Review of therapeutic options targeting beta cell health.

Main Results:

• Identified key factors influencing beta cell function: hyperglycemia, lipotoxicity, autoimmunity, inflammation, adipokines, islet amyloid, incretins, and insulin resistance.
• Detailed mechanisms of beta cell damage, including endoplasmic reticulum stress, oxidative stress, mitochondrial dysfunction, and calcium homeostasis disruption.
• Emphasized the need for simultaneous assessment of insulin secretion and sensitivity for accurate beta cell evaluation.

Conclusions:

• Beta cell dysfunction is central to diabetes, driven by complex interactions.
• Accurate assessment requires evaluating both insulin secretion and sensitivity.
• Targeting underlying mechanisms offers potential for protective therapies to preserve beta cell function and mass.