Understanding of basic mechanisms of b-cell function and survival. Prelude to new diabetes therapies

Type 1 and type 2 diabetes are both diseases of insulin insufficiency, although they develop by distinct pathways. The recent surge in the incidence of type 2 diabetes and the chronic ailments confronted by patients with either form of the disease highlight the need for better understanding of b-cell biology. In this review, we present recent work focused on this goal. Our hope is that basic research being conducted in this and other laboratories will ultimately contribute to the development of methods for enhancing b-cell function and survival in the context of both major forms of diabetes. Our strategy for understanding the b-cell involves a multidisciplinary approach in which tools from the traditional fields of biochemistry, enzymology, and physiology are teamed with newer technologies from the fields of molecular biology, gene discovery, cell and developmental biology, and biophysical chemistry. We have focused on two important aspects of b-cell biology in our studies: b-cell function, specifically the metabolic regulatory mechanisms involved in glucose-stimulated insulin secretion, and b-cell resistance to immune attack, with emphasis on resistance to inflammatory cytokines and reactive oxygen species.