Targeting beta-cell function early in the course of therapy for type 2 diabetes mellitus.
OBJECTIVE
This report examines current perspectives regarding likely mechanisms of beta-cell failure in type 2 diabetes and their clinical implications for protecting or sparing beta-cells early in the disease progression. In addition, it considers translation strategies to incorporate relevant scientific findings into educational initiatives targeting clinical practice behavior.


METHODS
On January 10, 2009, a working group of basic researchers, clinical endocrinologists, and primary care physicians met to consider whether current knowledge regarding pancreatic beta-cell defects justifies retargeting and retiming treatment for clinical practice. Based on this meeting, a writing group comprised of four meeting participants subsequently prepared this consensus statement. The conference was convened by The Endocrine Society and funded by an unrestricted educational grant from Novo Nordisk.


METHODS
Participants reviewed and discussed published literature, plus their own unpublished data.


METHODS
The summary and recommendations were supported unanimously by the writing group as representing the consensus opinions of the working group.


CONCLUSIONS
Workshop participants strongly advocated developing new systems to address common barriers to glycemic control and recommended several initial steps toward this goal. These recommendations included further studies to establish the clinical value of pharmacological therapies, continuing basic research to elucidate the nature and mechanisms of beta-cell failure in type 2 diabetes mellitus, and exploring new educational approaches to promote pathophysiology-based clinical practices. The Endocrine Society has launched a new website to continue the discussion between endocrinologists and primary care physicians on beta-cell pathophysiology in type 2 diabetes and its clinical implications. Join the conversation at http://www.betacellsindiabetes.org
Leahy
Jack L
JL
Endocrine Unit, University of Vermont College of Medicine Colchester Research Facility, 208 South Park Drive, Colchester, Vermont 05446, USA. jleahy@uvm.edu
Hirsch
Irl B
IB
Peterson
Kevin A
KA
Schneider
Doron
D
D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D016503:Drug Delivery Systems / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D050417:Insulin-Secreting Cells / Q000187:drug effects* / Q000473:pathology / Q000502:physiology; D008954:Models, Biological; D013997:Time Factors
D007004:Hypoglycemic Agents