Prohormone convertase 2 (PC2) plays an essential role in the processing of proglucagon to mature active glucagon in pancreatic ␣-cells (J Biol Chem 276:27197-27202, 2001). Mice lacking PC2 demonstrate multiple defects, including chronic mild hypoglycemia and dramatic hyperplasia of the pancreatic ␣-cells. To define the contribution of mature glucagon deficiency to the hypoglycemia and ␣-cell hyperplasia, we have attempted to correct the defects by delivery of exogenous glucagon by micro-osmotic pumps. Intraperitoneal delivery of 0.5 g glucagon/h in PC2 ؊/؊ mice resulted in the normalization of blood glucose concentrations. Islet remodeling through the loss of hyperplastic ␣-cells was evident by day 11 after pump implantation; by 25 days postimplantation, PC2؊/؊ islets were indistinguishable from wildtype islets. These rapid changes were brought about by induction of apoptosis in the ␣-cell population. Morphological normalization of islets was also accompanied by marked downregulation of endogenous preproglucagon gene expression, but with little or no change in the level of preproinsulin gene expression. Exogenous glucagon delivery also normalized hepatic expression of the gluconeogenic enzyme PEPCK. These results demonstrate that the lack of mature glucagon in PC2 ؊/؊ mice is responsible for the aberrant blood glucose levels, islet morphology, and gene expression, and they confirm the role of glucagon as a tonic insulin antagonist in regulating glycemia. Diabetes 51:398 -405, 2002 S ubtilisin-like prohormone convertases (PCs) proteolytically process many precursor proteins in the secretory pathway, including the maturation of active hormones from inactive prohormones in the regulated secretory pathway (1). PC1/3 and PC2 are thought to be the major convertases, acting on prohormones in multiple neuroendocrine tissues throughout the body. PC2 Ϫ/Ϫ mice have both islet and central nervous system (CNS) processing defects (1,2), including a block in the conversion of preproglucagon to mature glucagon in the pancreatic ␣-cells. This observation is consistent with earlier findings that PC2 is the predominant convertase in the ␣-cells and that PC2 is capable of independently processing proglucagon to mature glucagon (3,4).The pancreatic islet is a dynamic structure that acts to control energy homeostasis. Changes in demand for islet hormones lead to alterations in the size and activity of islet cell populations. This is most generally noted for the -cell population, where increased demand for insulin because of obesity, peripheral insulin resistance, or gestation leads to an enlarged -cell population and increased activity of the -cells (rev. in 5,6). When the increased demand is relieved, the -cell population returns to normal levels. This ability to increase and decrease both activity and cell populations allows for a highly dynamic structure that is finely attuned to normal metabolic demands, but which may be disturbed in diabetes and other disorders. PC2 Ϫ/Ϫ mice exhibit marked hyperplasia and hypertrophy of the ...