Beta-cell rejuvenation with thiazolidinediones.
Type 2 diabetes mellitus manifests in an insulin-resistant individual when pancreatic beta-cells are unable to produce sufficient insulin to overcome insulin resistance in the muscles and liver. There is a growing body of evidence that the thiazolidinedione (TZD) class of antidiabetic agents rejuvenates beta-cells and improves their function. When combination therapy with a sulfonylurea drug and metformin fails, treatment with a TZD increases C-peptide concentrations, reflecting improvement in beta-cell function. Further evidence of TZD-induced preservation of beta-cell function is documented by the findings of several recent trials in diabetes prevention. This apparent ability of TZDs to rejuvenate beta-cells, in addition to improving insulin resistance and glycemic control, is a compelling reason to use these agents as initial therapy for type 2 diabetes.
Bell
David S H
DS
Division of Endocrinology, Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama 35294, USA.
D017209:Apoptosis / Q000187:drug effects / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000503:physiopathology; D005230:Fatty Acids, Nonesterified / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D007515:Islets of Langerhans / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D015227:Lipid Peroxidation / Q000187:drug effects / Q000502:physiology; D019001:Nitric Oxide Synthase / Q000096:biosynthesis / Q000187:drug effects; D012060:Rejuvenation; D013577:Syndrome; D045162:Thiazolidinediones / Q000627:therapeutic use*
D005230:Fatty Acids, Nonesterified; D045162:Thiazolidinediones; C089946:2,4-thiazolidinedione; D019001:Nitric Oxide Synthase