Ndei Beta Cell Slide Kit Biology

Slideshow Transcript

1. Slide 1: Section 1 Normal Biology of Pancreatic -Cells and Insulin Secretion This slide can be downloaded free of charge from www.ndei.org, the website of the National Diabetes Education Initiative
2. Slide 2: -Cell Adaptation and Failure: Opportunities for Prevention and Treatment of Type 2 Diabetes
3. Slide 3: Disclosure This slide kit is intended to provide current  information on issues concerning -cells in patients with type 2 diabetes. Some of the information and agents mentioned may  include discussions of off-label, non–FDA- approved, or investigational uses. Please refer to each manufacturer’s full prescribing information before prescribing any of the agents mentioned in this program. Slides that include discussion of off-label uses are  identified with the symbol . This slide can be downloaded free of charge from www.ndei.org, the website of the National Diabetes Education Initiative
4. Slide 4: Normal Islet Function: Glucose Regulation  Insulin secretion (-cell) High  Glucagon secretion (-cell) Detect changes in blood glucose  Insulin secretion (-cell) Low  Glucagon secretion (-cell) This slide can be downloaded free of charge Adapted from Matschinsky FM, Bedoya FJ. In: Endocrinology. from www.ndei.org, the website of the Vol 2. 2nd ed. 1989:1290-1303. National Diabetes Education Initiative
5. Slide 5: Regulation of Insulin Secretion Drugs • Sulfonylureas • Meglitanides • Diazoxide Nutrients • Amino acids • Glucose Hormones Neurotransmitters • GIP • Norepinephrine • GLP-1 This slide can be downloaded free of charge from www.ndei.org, the website of the National Diabetes Education Initiative Adapted from Fajans SS et al. N Engl J Med. 2001;345:971-980.
6. Slide 6: -Cells Maintain Normal Glucose Levels in the Face of Varying Insulin Needs Acute response  – increased insulin secretion per -cell (eg, response to meals)  Chronic response (eg, insulin resistance) – enhanced function of individual cells and increased -cell mass This slide can be downloaded free of charge from www.ndei.org, the website of the National Diabetes Education Initiative
7. Slide 7: -Cell Adaptation to Chronic Insulin Resistance in Obesity Meals Meals Normal (acute) Normal (acute) 160 Obese (chronic) Obese (chronic) 160 140 150 130 Glucose (mg/dL) Insulin (U/mL) 140 100 130 80 120 60 110 40 100 20 90 0 80 8 AM 12 PM 4 PM 8 PM 12 AM 4 AM 8 AM 12 PM 4 PM 8 PM 12 AM 4 AM Clock time Clock time (hours) (hours) This slide can be downloaded free of charge from www.ndei.org, the website of the Polonsky KS et al. J Clin Invest. 1988;81:442-448. National Diabetes Education Initiative
8. Slide 8: What Methods Do -Cells Use to Adapt to Changing Insulin Sensitivity? Change the function of individual -cells  Change -cell mass  This slide can be downloaded free of charge from www.ndei.org, the website of the National Diabetes Education Initiative
9. Slide 9: Normal Relationship Between Insulin Sensitivity and Response: The Disposition Index 6,000 4,000 Insulin response Insulin sensitivity x insulin response = constant 2,000 0 0 1 2 3 4 Insulin sensitivity This slide can be downloaded free of charge from www.ndei.org, the website of the Bergman RN et al. Diabetes. 2002;51(suppl 1):S212-S220. National Diabetes Education Initiative
10. Slide 10: -Cell Adaptation to Insulin Resistance: Cross-sectional Data 300 250 Males (n=55 ) Females (n=38) 200 Fasting insulin 150 (pmol/L) 100 50 50th 0 25 0 5 10 15 20 r=-0.73; P<0.0001 Insulin sensitivity index (x10-5 min-1/pmol/L) This slide can be downloaded free of charge from www.ndei.org, the website of the Kahn SE et al. Diabetes. 1993;42:1663-1672. National Diabetes Education Initiative
11. Slide 11: -Cell Adaptation to Insulin Resistance: Longitudinal Data in Normal Women 1,000 Nonpregnant postpartum 800 3rd trimester Insulin 600 secretion rate 400 (pmol/min) 200 0 0 0.1 0.3 0.4 0.2 Insulin sensitivity index (mol/kg/min per pmol/L) This slide can be downloaded free of charge from www.ndei.org, the website of the Buchanan TA. J Clin Endocrinol Metab. 2001;86:989-993. National Diabetes Education Initiative
12. Slide 12: Regulation of -Cell Mass: A Dynamic Process Replication Neogenesis Hypertrophy Increased -cell mass -Cell mass Decreased -cell mass Apoptosis Necrosis This slide can be downloaded free of charge from www.ndei.org, the website of the National Diabetes Education Initiative
13. Slide 13: -Cell Mass in Lean and Obese People: Autopsy Studies 4.0 0.5 -Cell volume (mL) 0.4 3.0 -Cell volume (%) 0.3 2.0 0.2 1.0 0.1 0 0 Lean Obese Lean Obese Klöppel G et al. Surv Synth Pathol Res. Butler AE et al. Diabetes. This slide 1985;4:110-125. of charge 2003;52:102-110. can be downloaded free from www.ndei.org, the website of the National Diabetes Education Initiative
14. Slide 14: Alteration in -Cell Mass Is a Consequence of Increased Insulin Demand Increased -cell mass in obese vs lean  individuals has been described in several autopsy studies Increase in  – numbers of islets and -cells – size of -cells In animal models of insulin resistance, there  is both replication (of existing -cells) and neogenesis (new cells) from ductal precursor cells This slide can be downloaded free of charge from www.ndei.org, the website of the National Diabetes Education Initiative
15. Slide 15: Plasticity of Islets: Experimental Increase in -Cell Mass in Response to IR Experimental overfeeding results in increased -cell numbers (hyperplasia) and increased -cell size (hypertrophy) H and E Insulin Glucagon/somatostatin SC HF -Cell size -/-Cell size Islet area This slide can be downloaded free of charge SC=standard chow from www.ndei.org, the website of the National Diabetes (diet) HF=high-fat Education Initiative Lingohr MK et al. Trends in Mol Med. 2002;8:375-384.
16. Slide 16: Effect of High-Fat Diet on Islet Size and -Cell Hypertrophy 34.4% 47.5% * 3 200 200 * (% total pancreatic area) -/-Cell diameter (M) -Cell diameter (M) 2 Islet area 100 100 1 0 0 0 SC HF SC HF SC HF *P<0.001 This slide can be downloaded free of charge from www.ndei.org, chow SC=standard the website of the Lingohr MK et al. Trends in Mol Med. 2002;8:375-384. National Diabetes (diet) HF=high-fat Education Initiative
17. Slide 17: Neogenesis May Contribute to Increased Islet Mass in Obese Humans This slide can be downloaded free of charge Section of pancreas stained for insulin from www.ndei.org, the website of the Butler AE et al. Diabetes. 2003;52:102-110. National Diabetes Education Initiative