BETA-CELL BEHAVIOR DURING THE PREDIABETIC STAGE - PART II - NON-INSULIN-DEPENDENT AND INSULIN-DEPENDENT DIABETES-MELLITUS

The pathogenesis of autoimmune insulin-dependent (Type 1) diabetes mel litus (IDDM) is far from being resolved, despite extensive genetic and immunological research. However, recent experimental data from immune and endocrine studies using spontaneous or transgenic models of the d isease have emphasized the role of the Islet of Langerhans, and partic ularly beta cells, in IDDM pathogenesis. Parr: I oi this review (Diabe tes Metab, 1997, 23, 181-194) considered the various ways normal beta cells cope with increased demands on their resources in different mode ls of hyperglycaemia in order to provide a better delineation and comp arison of the mechanisms implicating these cells in the pathogenesis o f IDDM and non:insulin-dependent (Type 2) diabetes mellitus (NIDDM). P art II attempts to improve our understanding of the various mechanisms through which beta cells, and perhaps the entire islet of Langerhans, may influence the immune system from the perinatal period to adulthoo d. Genetics and P-cell behaviour are considered during prediabetes in human and experimental models of IDDM and NIDDM. Attention is focused on the spontaneous model of the disease, the non-obese diabetic (NOD) mouse, which in addition to providing genetic data, appears to be usef ul for sequential study of the early developmental, immune and endocri ne events that occur in IDDM pathophysiology.