Clinical Approaches to Preserving β-Cell Mass and Function in the Management of Type 2 Diabetes

Kuo-Bin Tseng

《E-Da Medical Journal》 9卷2期 (2022/06) Pp. 21-37

https://doi.org/10.6966/EDMJ.202206_9(2).0003

摘要

Type 2 diabetes (T2D) is a chronic disease characterized by insulin resistance (IR) and impaired insulin secretion by β-cells, leading to persistent hyperglycemia. T2D is essentially caused by a progressive decline in β-cell mass and function. Disruption in the balance between β-cell growth and death may result in rapid and marked changes in β-cell mass. In autopsy studies, patients with T2D showed a 40% - 60% reduction in β-cell mass despite a normal capacity of β-cell neogenesis and replication. The observation that the degree of β-cell dysfunction is associated with a combination of metabolic, genetic, and environmental factors highlights the necessity of better understanding β-cell dysfunction in T2D development. These factors include glucolipotoxicity, cholesterol accumulation, islet amyloid deposition, inflammation, autoimmunity, incretins, and IR. The goal of T2D treatment is to not only reduce the glucose concentration but also prevent progressive decline in β-cells and delay disease progression. Therefore, developing new therapeutic strategies to preserve β-cells has become central in the management of T2D. This review presents the evidence on the efficacy of currently available clinical approaches to preserve β-cells in the management of T2D.

關鍵字

β-cell function ； β-cell mass ； type 2 diabetes ； clinical approaches

參考文獻

Brooks-Worrell B, Palmer JP. Is diabetes mellitus a continuous spectrum? Clin Chem 2011; 57: 158-61.

Butler AE, Janson J, Bonner-Weir S, Ritzel R, Rizza RA, Butler PC. β-cell deficit and increased β-cell apoptosis in humans with type 2 diabetes. Diabetes 2003; 52: 102-10.

Schofield CJ, Sutherland C. Disordered insulin secretion in the development of insulin resistance and Type 2 diabetes. Diabet Med 2012; 29: 972-9.

Rahier J, Guiot Y, Goebbels RM, Sempoux C, Henquin JC. Pancreatic β‐cell mass in European subjects with type 2 diabetes. Diabetes Obes Metab 2008; 10: 32-42.

Kendall DM, Cuddihy RM, Bergenstal RM. Clinical application of incretin-based therapy: therapeutic potential, patient selection and clinical use. Eur J Intern Med 2009; 20: S329-39.