Beta cells in type 2 diabetes: the science explained

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Beta cells are cells in the pancreas that produce and release insulin in response to blood sugar. In people with type 2 diabetes, beta cells have to work harder to make enough insulin to control high blood sugar levels. This can prevent beta cells from working properly to regulate blood sugar.

In people with type 2 diabetes, prolonged high blood sugar requires beta cells to work harder so they can produce enough insulin to lower blood sugar.

This overwork can lead to the loss of beta cells or the inability of beta cells to perform their function effectively. Due to this cycle of loss of beta cell function, the body may not be able to produce enough insulin to control blood sugar.

In this article, we take a look at the role of beta cells, the impact of type 2 diabetes on insulin and beta cells, and how to prevent and manage loss of beta cell function in type 2 diabetes.

Beta cells are cells in the pancreas that produce and release the hormone insulin. Insulin helps control the levels of blood sugar, or glucose, in the body.

When blood sugar levels rise, such as after eating, beta cells respond by releasing stored insulin and continuing to make more of it.

In people with type 2 diabetes, the body has long had high levels of glucose and is unable to produce enough insulin or use it effectively to lower blood sugar.

Beta cells have to work harder to release and produce enough insulin to control high blood sugar levels. Research suggests that overworking beta cells could cause them to stop working properly or die.

This reduces the number of beta cells available to produce and release insulin, which increases the workload on the remaining beta cells and can lead to further loss of beta cells.

Insulin resistance develops early in type 2 diabetes. Insulin resistance occurs when tissues and cells in the body do not absorb glucose for energy, resulting in maintenance high levels of glucose in the blood. Beta cells may then be unable to produce enough insulin to control blood sugar.

Find out what high blood sugar can feel like here.

Amylin and C-peptide

Beta cells also produce a hormone called amylin. Amylin helps control blood sugar by slowing the rate at which glucose enters the bloodstream.

Peptide C is a by-product of insulin production. It also helps repair the walls of the arteries and prevent blood vessel problems and nerve damage.

Beta cells produce C peptide along with insulin and in equal amounts. This means that doctors can use a C peptide test to monitor people with diabetes. The blood test measures C peptide levels, which can indicate how much insulin the body is making.

Research shows that a person with type 2 diabetes may already have lost about 50% of beta cell function by the time they are diagnosed. This means that about half of their beta cells are dead or cannot function properly.

This loss is irreversible and beta cells are not able to produce enough insulin to regulate healthy blood sugar. Without treatment, type 2 diabetes can progress and further loss of beta cells can occur.

However, research from 2019 has shown that loss of beta cell function is reversible in the early stages of type 2 diabetes and does not cause permanent damage. Losing excess fat from cells can lead to a return to healthy beta cell function and remission in type 2 diabetes.

A 2019 study looked at 40 people who went into remission from type 2 diabetes 2 years before the study after dieting to lose weight.

After 2 years, 20 participants remained in remission, 13 participants gained weight and relapsed, and seven participants were unavailable for follow-up.

The researchers measured glucose levels before weight loss, after 5 months of weight loss, and at ages 1 and 2. Blood sugar below certain levels without the use of type 2 diabetes medications meant participants were in remission.

The study authors found that remission from type 2 diabetes was durable over a period of 2 years as long as weight gain was minimal. This remission also meant a gradual return to beta cell function and mass.

Depending on body weight, in adults beta cells usually release about 30-70 international units (IU) of insulin each day.

The body releases half of these levels after eating, due to an increase in blood sugar during digestion, and releases the remaining insulin in response to the body’s needs.

During stressful events, the body releases hormones such as adrenaline which prevent the release of insulin. This increases the blood sugar to help the body deal with the stressful situation.

Certain drugs, including incretin drugs and SGLT2 inhibitors, can help treat type 2 diabetes and improve beta cell function.

Incretin-based drugs

Incretin drugs help regulate blood sugar. Incretin is a hormone that triggers the production of insulin and helps reduce the rate at which glucose from food enters the bloodstream.

Incretin-based drugs understand:

  • dipeptidyl peptidase-4 inhibitors, such as alogliptin, linagliptin, saxagliptin and sitagliptin
  • glucagon-like peptide-1 analogs, such as albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide and semaglutide

Incretin-based drugs can help improve beta cell function and allows people to feel full longer after eating, which may help reduce food intake.

In addition, drugs containing incretin regulate the production of insulin based on the amount of glucose present in the blood. This prevents the overproduction of insulin and keeps glucose levels from dropping too low, which can also damage beta cells.

SGLT2 inhibitors

Another type of medicine that can help treat type 2 diabetes and reduce the demand for beta cells is SGLT2 inhibitors.

SGLT2 inhibitors help increase the amount of glucose that the body excretes in the urine. SGLT2 inhibitors may also help reduce body weight and reduce the risk of heart problems.

Learn more about diabetes medications here.

While medication can help, lifestyle changes can also be important steps a person can take to prevent or manage type 2 diabetes.

Individuals can reduce their food intake when necessary and ensure that they exercise regularly. These factors help reduce beta cell workload and increase insulin sensitivity. Increased sensitivity to insulin means the body can use insulin more efficiently and better control blood sugar.

For people with type 2 diabetes, eating a balanced diet and exercising regularly are important for managing the disease and preventing it from progressing.

Achieving or maintaining moderate body weight through changes in diet and exercise can also lead to remission of type 2 diabetes and the return of proper beta cell function.

Beta cells are cells in the pancreas that produce and release the hormone insulin to regulate blood sugar.

In people with type 2 diabetes, continuously high blood sugar levels can put extra strain on beta cells because they have to work harder to produce enough insulin to control glucose levels.

Beta cells may eventually be unable to produce enough insulin to control blood sugar.

In the early stages of type 2 diabetes, the loss of beta cell function may be reversible through weight loss and reduced blood sugar.

Certain drugs can help control or prevent type 2 diabetes. However, the most effective steps a person can take to prevent or manage the disease are to achieve or maintain a moderate body weight and to exercise. ‘exercise regularly.


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