The α-cell in diabetes mellitus
Abstract
Findings from the past 10 years have placed the glucagon-secreting pancreatic α-cell centre stage in the development of diabetes mellitus, a disease affecting almost one in every ten adults worldwide. Glucagon secretion is reduced in patients with type 1 diabetes mellitus, increasing the risk of insulin-induced hypoglycaemia, but is enhanced in type 2 diabetes mellitus, exacerbating the effects of diminished insulin release and action on blood levels of glucose. A better understanding of the mechanisms underlying these changes is therefore an important goal. RNA sequencing reveals that, despite their opposing roles in the control of blood levels of glucose, α-cells and β-cells have remarkably similar patterns of gene expression. This similarity might explain the fairly facile interconversion between these cells and the ability of the α-cell compartment to serve as a source of new β-cells in models of extreme β-cell loss that mimic type 1 diabetes mellitus. Emerging data suggest that GABA might facilitate this interconversion, whereas the amino acid glutamine serves as a liver-derived factor to promote α-cell replication and maintenance of α-cell mass. Here, we survey these developments and their therapeutic implications for patients with diabetes mellitus.
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“As reviewed in (4), regulation of glucagon secretion is a complex phenomenon and involves endocrine/ paracrine mechanisms—the so-called “intra-islet interaction” (5, 6)—as well as intrinsic mechanisms in the alpha cell related to glucose sensing.”
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- Authors
- Gromada, J., Chabosseau, P., & Rutter, G. A.
- Affiliations
- Regeneron (United States) (US)
- Hammersmith Hospital (GB)
- Corresponding author
- Gromada, Jesper
- Rutter, Guy A.
- Venue
- Nature Reviews Endocrinology
- Published
- 2018-10-11
- Volume
- 14
- Issue
- 12
- Pages
- 694-704
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- OpenAlex
- W2897922438
- Cited by
- 143
- References
- 148
- Citations by year
- 2026: 19 · 2025: 12 · 2024: 17 · 2023: 21 · 2022: 24 · 2021: 27 · 2020: 12 · 2019: 11
- FWCI
- 2.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Regeneron Pharmaceuticals
- National Institute for Health and Care Research (CL-2017-21-002, ACF-2010-21-012)
- Academy of Medical Sciences (SGL019\1078)
- Servier
- Medical Research Council (MR/N00275X/1, MR/M012646/1, MR/K001981/1, MR/L020149/1, MR/R010676/1, MR/N020472/1, MR/R022259/1, MR/K023667/1, MR/R014329/1, MR/L02036X/1)
- Biotechnology and Biological Sciences Research Council (BB/J015873/1)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- alpha cells, glucagon secretion, type 1 diabetes, type 2 diabetes, hypoglycemia, GABA, glutamine, beta cell destruction, gene expression, diabetes treatment
- MeSH terms
- Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Glucagon, Humans, Insulin, Male, Role, Sensitivity and Specificity, Glucagon-Secreting Cells, Insulin-Secreting Cells
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