Diabetes is defined by the presence of a chronically elevated blood glucose levels. It reflects an insufficiency in insulin, a hormone that maintains this sugar’s concentrations between a physiological range. Insulin is produced by beta cells which are located in the pancreas. There are two major forms of diabetes, differing in origin :
Type 1 diabetes is caused by a depletion in beta cells following an autoimmune disease process in the pancreas. It is the major form when diagnosed in children, adolescents and adults under 40 years but can occur at all ages. This form requires life-long administration of insulin. It was previously named insulin-dependent diabetes mellitus or juvenile diabetes.
Type 2 diabetes is caused by an inadequate metabolic control by the pancreatic beta cell population, resulting from a combination of its dysfunctional state and a lower sensitivity of the body to released insulin. Its occurrence is linked to lifestyle and obesity. It represents the major form when diagnosed after age 40 but can occur at younger age. This form can require daily supplements of insulin. It was previously named non insulin-dependent diabetes mellitus or adult-onset diabetes.
Both forms of diabetes expose patients to the risks of chronically elevated glucose concentrations leading to a higher incidence of cardiovascular disease, kidney failure, blindness. Both also affect quality of life, and more significantly so in patients with difficult glucose control. Improvements in daily insulin administration have led to marked benefits for many patients but have not eliminated the burden of the disease and the associated risk for acute complications. Restoration of an adequate endogenous insulin production by a physiologically regulated beta cell population is since long considered as treatment of choice, capable of curing the disease. Strategies for Beta Cell Replacement are in the first place developed for type 1 diabetes where beta cell depletion is severe and often present since young age. They are expected to subsequently translate to subgroups of type 2 diabetes patients.
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The normal human pancreas contains clusters of insulin-producing beta cells (shown in red). They are surrounded by other endocrine cells such as glucagon-producing alpha cells (labeled in green), forming microscopic structures that were described as islets of Langerhans