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Type 2 Diabetes-a Matter of ß-Cell Life and Death?
Christopher J. Rhodes
In type 2 diabetes, the ß cells of the pancreas failto produce enough insulin to meet the body's demand, in partbecause of an acquired decrease in ß-cell mass. Inadults, pancreatic ß-cell mass is controlled by severalmechanisms, including ß-cell replication, neogenesis,hypertrophy, and survival. Here, I discuss evidence supportingthe notion that increased ß-cell apoptosis is an importantfactor contributing to ß-cell loss and the onset oftype 2 diabetes. Interestingly, a key signaling molecule thatpromotes ß-cell growth and survival, insulin receptorsubstrate 2 (IRS-2), is a member of a family of proteins whoseinhibition contributes to the development of insulin resistancein the liver and other insulin-responsive tissues. Thus, theIRS-2 pathway appears to be a crucial participant in the tenuousbalance between effective pancreatic ß-cell mass andinsulin resistance.
The Pacific Northwest Research Institute, 720 Broadway, Seattle, WA 98122, USA, and Department of Pharmacology, University of Washington, Seattle, WA 98122, USA.
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