Pancreatic beta-cell loss and preservation in type 2 diabetes.
Pancreatic beta-cell loss and preservation in type 2 diabetes.
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DOI：
10.1016/s0149-2918(03)80241-2
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发表时间：
2003-01-01
影响因子：
3.2
通讯作者：
Buchanan, Thomas A.
中科院分区：
文献类型：
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作者：
Buchanan, Thomas A.
背景：在大多数个体中，对胰岛素抵抗进展状态的反应需要通过增加胰岛素产生来满足。然而，对于胰岛素抵抗患者，胰岛素供应和需求之间的平衡可能会因胰腺β细胞功能的逐渐丧失而失败，最终导致2型糖尿病。目的：本综述的目的是讨论目前的概念潜在的胰腺β细胞衰竭的进展为2型糖尿病和治疗，可能会改变这一进程。方法：通过MEDLINE检索1966年至2003年4月发表的文章，确定本综述中包含的数据。使用的检索词为β细胞、糖尿病、胰岛素抵抗、肥胖、心血管疾病、噻唑烷二酮类和二甲双胍。结果如下：β细胞功能进行性丧失的证据可能包括胰岛素原转化为胰岛素的改变、脉冲和振荡胰岛素分泌的变化以及胰岛素释放的定量减少。潜在的潜在机制是葡萄糖毒性、脂毒性、对增加的分泌需求的耐受性差和β细胞质量减少。结论：目前2型糖尿病的临床管理重点是治疗晚期疾病的体征和症状，而不是解决潜在的根本原因，基于对现有数据、实践经验和理性的广泛理解，这可能适合当前可用的疗法。推测。
Background: In most individuals, the need to respond to progressive states of insulin resistance is met by increasing insulin production. For insulin-resistant patients, however, the balance between insulin supply and demand may fail from the progressive loss of pancreatic beta-cell function, eventually leading to type 2 diabetes mellitus. Objective: The aim of this review was to discuss the current concepts underlying potential pancreatic beta-cell failure in the progression toward type 2 diabetes and therapies that may alter the process. Methods: Data included in this review were identified through a MEDLINE search for articles published from 1966 to April 2003. Search terms used were beta cell, diabetes, insulin resistance, obesity, cardiovascular disease, thiazolidinediones, and metformin. Results: Evidence of the progressive loss of beta-cell function may include altered conversion of proinsulin to insulin, changes in pulsed and oscillatory insulin secretion, and quantitative reductions in insulin release. Potential underlying mechanisms are glucose toxicity, lipotoxicity, poor tolerance of increased secretory demand, and a reduction in beta-cell mass. Conclusion: Current clinical management of type 2 diabetes is focused on treatment of the signs and symptoms of late-stage disease rather than addressing potential underlying causes, which may be amenable to currently available therapies, based on a broad understanding of existing data, practice experience, and rational speculation.