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In the simplest terms, diabetes mellitus results when pancreatic beta cells are unable to maintain adequate insulin secretion to prevent hyperglycemia. A combination of genetic and environmental factors causes the underlying beta-cell failure. In type 1 diabetes, a T-cell–mediated autoimmune response against beta cells appears to be the main disease mechanism, whereas insulin resistance is the key metabolic abnormality in type 2 diabetes. Yet the way in which insulin resistance triggers beta-cell failure remains obscure. The report by Larsen et al. in this issue of the Journal (pages 1517–1526) provides insight into a shared mechanism of beta-cell dysfunction in type . . .
Kristina I. Rother (Wed,) studied this question.