In the simplest terms, diabetes mellitus results when pancreaticbeta cells are unable to maintain adequate insulin secretionto prevent hyperglycemia. A combination of genetic and environmentalfactors causes the underlying beta-cell failure. In type 1 diabetes,a T-cellmediated autoimmune response against beta cellsappears to be the main disease mechanism, whereas insulin resistanceis the key metabolic abnormality in type 2 diabetes. Yet theway in which insulin resistance triggers beta-cell failure remainsobscure. The report by Larsen et al. in this issue of the Journal(pages 15171526) provides insight into a shared mechanismof beta-cell dysfunction in type . . . [Full Text of this Article]
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Dr. Rother is an attending physician and principal investigator in the Clinical Endocrinology Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
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