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Near Infrared Optical Projection Tomography for Assessments of β-cell Mass Distribution in Diabetes Research
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Beta cells in type 1 diabetes: mass and function; sleeping or dead?

Richard A Oram1,2,3, Emily K Sims4,5, Carmella Evans-Molina6,7,8,9

  • 1RILD Level 3, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Royal Devon and Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK. R.Oram@exeter.ac.uk.

Diabetologia
|February 16, 2019
PubMed
Summary

Type 1 diabetes may not destroy all insulin-producing beta cells. Residual beta cells persist, but evidence for their significant regeneration or functional recovery in long-standing disease is limited, requiring further research.

Keywords:
Beta cell functionBeta cell massC-peptideNetwork for Pancreatic Organ Donors with DiabetesProinsulinReviewType 1 diabetes

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Area of Science:

  • Endocrinology
  • Immunology
  • Cell Biology

Background:

  • Type 1 diabetes (T1D) is characterized by autoimmune destruction of insulin-producing beta cells.
  • However, evidence suggests some beta cells may persist even after disease onset.

Purpose of the Study:

  • To review histological and in vivo evidence of persistent beta cells in T1D.
  • To discuss the limitations in assessing beta cell mass versus function.
  • To explore potential for beta cell rejuvenation and growth in T1D.

Main Methods:

  • Histological analysis of donor pancreases.
  • Measurement of serum C-peptide in clinical cohorts.
  • Review of existing literature on beta cell persistence and function in T1D.

Main Results:

  • Histological and clinical data challenge the notion of complete beta cell destruction in T1D.
  • Evidence for significant new beta cell growth in long-duration T1D is limited.
  • Functional recovery of beta cells is observed in recent-onset T1D but not in long-duration cases.

Conclusions:

  • Residual beta cells persist in some individuals with T1D, raising questions about their survival mechanisms.
  • Current methods have limitations in differentiating beta cell mass from function.
  • Further research is needed to understand the source, phenotype, and potential for recovery of these residual beta cells.