ABSTRACT
Loss of b-cell mass is the critical convergence point in the development of both Type 1 and Type 2 diabetes. Consequently, restoration of b-cell mass is the fundamental underlying premise of many current therapeutic approaches to the treatment of both forms of the disease. Improvement in the success of islet transplantation procedures has provided critical proof of the principal that the restoration of b-cell mass can reverse diabetes and restore normal insulin secretion. Hence, many research laboratories worldwide are engaged in the development of new sources of insulin-producing cells, utilizing a broad range of molecular approaches. It is clear that in a healthy individual, a fine balance is constantly maintained between b-cell apoptosis and b-cell neogenesis. In patients with diabetes, this critical balance is lost, with the resultant decrease in b-cell mass contributing to the eventual loss of normoglycemic control. This chapter reviews our current understanding of the events regulating b-cell regeneration and neogenesis, with a view to potential therapeutic intervention for the improvement of b-cell mass and function in patients with diabetes.
