Insulin, which is produced and secreted by pancreatic β-cells, is a critically important hormone. Insulin signaling allows nutrients, especially glucose, to be taken up by cells. When insulin — or the signaling pathways it activates — is impaired, food cannot enter cells efficiently. As a result, glucose accumulates in the bloodstream. The phenomenon of elevated blood glucose, therefore, is not the root cause of diabetes — it is a side effect of impaired insulin function.

Why Does Insulin Production Become Impaired?

There are many different causes of diabetes, but here we will focus on 2.5 of them:

1. Type 1 Diabetes (T1D, Juvenile Diabetes)

Type 1 diabetes is an autoimmune disease. For reasons not fully understood, the immune system in some individuals mistakenly targets their own tissues. In T1D, immune cells attack and destroy pancreatic β-cells. Once a critical number of β-cells is lost, insulin production drops below the threshold needed to regulate blood glucose — leading to the diabetic state.

2. Type 2 Diabetes (T2D)

First explanation:
There’s an old saying — “in every large person, there is a small man.” As we gain weight, our body increases in volume, especially through expanding fat tissue. However, internal organs do not scale up in the same way. Pancreatic β-cells are no exception.

Hormones like insulin exert their effect through concentration: a certain concentration is needed to activate receptors on target cells. Concentration is defined as the amount divided by volume. In larger individuals, the body’s volume increases, which means that higher amounts of insulin are required to reach the same effective concentration.

Because obesity is a chronic condition, pancreatic β-cells must produce elevated levels of insulin over extended periods. This chronic overproduction places them under considerable stress.

Second explanation:
Not all individuals with T2D are overweight. Some develop a condition known as insulin resistance — meaning their cells no longer respond to insulin as effectively. The reasons for insulin resistance are not fully understood, but it often worsens with age. To compensate, the body demands even more insulin to achieve the same effect, placing increasing pressure on β-cells.

In both scenarios, β-cells do not have time to rest. Some become exhausted and die. As the number of functioning β-cells declines, the remaining ones must work even harder — creating a vicious cycle of overwork and failure.

Our Goal: Regenerating β-Cells

In all of the examples above, diabetes ultimately results in β-cell loss. If we could regenerate these cells, we could move closer to a true cure for the disease. This is the focus of our lab: we study how β-cells are lost and explore strategies to regenerate them.