Compensatory Mechanisms of Pancreatic Beta Cells: Insights into the Therapeutic Perspectives for Diabetes

Diabetes is one of the leading causes of premature mortality worldwide and has become one of the major health challenges of the 21st century. Diabetes develops when insulin production is insufficient to compensate for the increased insulin requirements elicited by insulin resistance. Diabetes prevalence has risen dramatically during the last 20 years in parallel to the pandemic of obesity. Although obesity is the first diabetes risk factor, many obese and insulin resistant people do not suffer from diabetes. This situation is thought to result from the capacity of beta cell to adapt its mass and function in order to produce enough insulin to cover the needs of the organism. Beta cell adaptation is a physiological process that occurs efficiently from birth to early childhood periods and during pregnancy. Beta cell functional mass adaptation relies on both increased intrinsic insulin secretory capacity of the cell and beta cell mass expansion and preservation of cell survival against apoptosis. Deciphering the key mechanisms that account for such beta cell plasticity would help understanding the pathophysiology of diabetes, paving the way for the generation of innovative antidiabetic compounds aiming at preventing the development and the progression of the disease. In this respect, this special issue contains two regular articles and four reviews that highlight some of the mechanisms involved in the control of beta cell mass and function.