Beta cells in type 2 diabetes: Science explained


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

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

This overwork can lead to the loss of beta cells or to beta cells being unable to carry out their function effectively. As a result of 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 look at the role of beta cells, the impact of type 2 diabetes on insulin and beta cells, and how to prevent and manage the 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 blood sugar, or glucose, levels in the body.

When blood sugar increases — for example, 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 had high levels of glucose for a long time and is unable to make enough insulin or to use it effectively to reduce blood sugar.

Beta cells have to work harder to release and produce enough insulin to control high blood sugar levels. Research suggests that the overwork of 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 for 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 are not absorbing glucose for energy, which causes high levels of glucose to remain in the blood. Beta cells may then be unable to produce enough insulin to control blood sugar.

Learn what having high blood sugar levels can feel like here.

Amylin and C-peptide

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

C-peptide is a byproduct of insulin production. It also helps repair the walls of the arteries and prevent blood vessel issues and nerve damage.

Beta cells produce C-peptide at the same time as they do insulin and in equal amounts. This means doctors may 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 producing.

According to research, a person with type 2 diabetes may already have lost roughly 50% of beta cell function by the time they receive their diagnosis. This means that around half of their beta cells have died or are not able to function properly.

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

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

A 2019 study involved 40 people who had achieved remission from type 2 diabetes 2 years prior to the study from following a diet for weight loss.

After 2 years, 20 participants remained in remission, 13 participants gained weight and had a relapse, and seven participants were not available for a follow-up.

The researchers measured glucose levels before weight loss, after 5 months of weight loss, and at 1 and 2 years. Blood glucose below certain levels with no use of type 2 diabetes medication meant the participants were in remission.

The study authors found that remission of type 2 diabetes was sustainable over the course of 2 years as long as weight regain was minimal. This remission also meant a gradual return to proper beta cell function and mass.

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

The body releases half these levels after eating, due to a rise in blood glucose levels during digestion, and releases the remaining insulin in response to the body’s needs.

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

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

Incretin-based medications

Incretin-based medications help regulate blood glucose levels. 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 medications include:

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

Incretin-based medications can help improve beta cell function and keep people feeling fuller for longer after eating, which may help reduce food consumption.

Moreover, incretin-based medications regulate insulin production depending on how much glucose is present in the bloodstream. This prevents the overproduction of insulin and stops glucose levels from dropping too low, which can also damage beta cells.

SGLT2 inhibitors

SGLT2 inhibitors are another type of medication that can help treat type 2 diabetes and reduce the demand on beta cells.

SGLT2 inhibitors help increase the amount of glucose that the body removes through urine. SGLT2 inhibitors may also help with lowering body weight and reducing the risk of heart problems.

Learn more about diabetes medication here.

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

Individuals can reduce their food intake if necessary and make sure to get regular exercise. These factors help reduce the workload of beta cells and increase insulin sensitivity. Increased insulin sensitivity means the body can use insulin more effectively and better control blood sugar.

For people with type 2 diabetes, following a balanced diet and getting regular exercise are important in managing the condition and preventing it from progressing.

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

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

In people with type 2 diabetes, continuously high blood sugar levels can put extra pressure on beta cells, as 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 levels.

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

Certain medications can help control or prevent type 2 diabetes. However, the most effective steps a person can take to prevent or manage the condition are reaching or maintaining a moderate body weight and getting regular exercise.

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