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Therefore, the down-regulation of SERCA is a beneficial adaptation mechanism that enables beta-cells to secrete more insulin to compensate for the loss of beta-cell mass in type I diabetes or to overcome insulin resistance in type II diabetes.
Decreased β-cell function and mass in type 2 diabetes involves the generation of β-cell stress [7], [8] resulting from chronic exposure to elevated glucose and free fatty acids [9], pro-inflammatory cytokines [10] and human islet amyloid polypeptide [11].
This may suggest that mTORC1 has a dual effect in the regulation of β-cell mass in type 2 diabetes: on one hand it is required for the adaptive increase in β-cell size and proliferation by stimulating protein synthesis; and on the other, it may increase ER stress and apoptosis in β-cells, e.g. in response to fatty acids.
Relative contributions of reversible β-cell dysfunction and true decrease in β-cell mass in type 2 diabetes remain unclear.
Chronic hyperglycemia causes a progressive decrease of β-cell function and mass in type 2 diabetic patients.
Chronic hyperglycemia is recognized as an important initiating factor for continuous deterioration of β-cell function and mass in type 2 diabetic patients.
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Cytokines mediate β-cell death by varying pathways and are instrumental in the reduction of β-cell mass in both type 1 and type 2 diabetes [ 49]. β-cell destruction is the result of islet infiltration and an inflammatory response elicited by secretion of pro-inflammatory cytokines and chemotactic factors leading to insulinopenia and hyperglycemia [ 50].
In addition to heterotic and type II constructions, we also realise the mass deformation in type I theory, thus leading to a natural way of uplifting the result to the instanton sector.
Endoplasmic reticulum (ER) stress plays an important role in the decline in pancreatic β cell function and mass observed in type 2 diabetes.
Present day cellular biology has provided us with insight into the mechanisms that may explain the loss of β-cell mass observed in type 2 diabetes.
Aepfelbacher et al [ 42] have described interventricular septal thickness decrease and left ventricular mass regression in type 1 diabetic patients with improved glycemic control.
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