Do oscillations in pancreatic islets require pacemaker cells?

The pancreatic islets of Langerhans are biomedically important because they are home to the beta cells that secrete insulin and are hence important for understanding diabetes. They are also an important case study for the mechanisms of bursting oscillations and how these oscillations emerge from the electrical coupling of highly heterogeneous cells. Early work has pointed to a voting/democratic paradigm, where the islet properties are a nonlinear average of the cell properties, with no 'conductor leading the orchestra'. Recent experimental work has uncovered new facets of this heterogeneity, and has identified small world networks dominated by a small subset of cells with a high degree of functional connectivity, assessed via correlations of calcium oscillations. It has also been suggested that these connectivity hubs act as pacemakers necessary for islet oscillations. We reviewed modeling studies that have confirmed the existence of small worldness, and we did not find evidence for obligatory pacemakers. We conclude that democracy rather than oligarchy remains the most likely organizing principle of the islets.