2014
DOI: 10.2337/db13-1013
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Insulin Resistance Alters Islet Morphology in Nondiabetic Humans

Abstract: Type 2 diabetes is characterized by poor glucose uptake in metabolic tissues and manifests when insulin secretion fails to cope with worsening insulin resistance. In addition to its effects on skeletal muscle, liver, and adipose tissue metabolism, it is evident that insulin resistance also affects pancreatic β-cells. To directly examine the alterations that occur in islet morphology as part of an adaptive mechanism to insulin resistance, we evaluated pancreas samples obtained during pancreatoduodenectomy from … Show more

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Cited by 169 publications
(167 citation statements)
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“…We refer to a recent review article describing beta cell pathophysiology in type 2 diabetes [115], describing beta cell failure as a central mechanism in both type 1 and type 2 diabetes. Interestingly, in non-diabetic humans, insulin resistance has been reported to contribute to increased beta cell number and islet size [116]. Recently, in a mouse model, beta cell dedifferentiation rather than accelerated death has been suggested as a key driver of beta cell failure [117,118].…”
Section: Islet Structure-function and Diabetesmentioning
confidence: 99%
“…We refer to a recent review article describing beta cell pathophysiology in type 2 diabetes [115], describing beta cell failure as a central mechanism in both type 1 and type 2 diabetes. Interestingly, in non-diabetic humans, insulin resistance has been reported to contribute to increased beta cell number and islet size [116]. Recently, in a mouse model, beta cell dedifferentiation rather than accelerated death has been suggested as a key driver of beta cell failure [117,118].…”
Section: Islet Structure-function and Diabetesmentioning
confidence: 99%
“…Glucagon, insulin's counterregulatory hormone, plays a major role in maintaining glucose homeostasis by promoting glucose production via hepatic glycogenolysis and gluconeogenesis. Glucagon levels are elevated in insulin-resistant/nondiabetic T1D and T2D patients, leading to enhanced hepatic glucose output and thereby exacerbating hyperglycemia (1)(2)(3). On the contrary and much less understood is the failure of α cells to secrete glucagon in response to hypoglycemia.…”
Section: Introductionmentioning
confidence: 99%
“…Two processes have been implicated in islet compensation in response to obesity and insulin resistance: First, an increased functionality and insulin secretion rate of the individual b-cells, e.g., by enhancing glucose metabolism or insulin gene expression or translation (4)(5)(6). In addition, increased systemic insulin output can be achieved by a morphological enlargement of b-cell mass through proliferation (7,8), hypertrophy (5,8), or neogenesis (9,10). Whereas in rodents b-cell mass has been reported to increase substantially in response to insulin resistance (7,11), this seems to be less pronounced in humans (12)(13)(14).…”
mentioning
confidence: 99%