Many people with type 2 diabetes (T2D) are resistant to the effects of insulin. Their insulin-producing beta cells therefore need to work hard to produce enough insulin to overcome this resistance and maintain normal blood sugar or glucose levels. The work to produce insulin involves producing, folding, and cutting precursors of the insulin molecule. If the body cannot keep up with the demand for more of this work, it makes less insulin than is needed to prevent glucose from rising. That is when diabetes develops.
This process is similar to what happens when a small bakery is asked to increase its usual output of loaves of bread ten times. Mistakes multiply, quality checks can no longer keep up, and defective loaves pile up. Unlike a bakery that can close for the night, beta cells have no off switch. As long as blood sugar remains elevated, the demand continues. This unrelenting stress places strain on the cell’s internal systems and pushes its coping mechanisms to their limits.
Scientists have made significant progress in understanding how beta cells respond to stress. While responding to the stress of folding the insulin molecule, beta cells may also make molecules that damage them. These processes reinforce each other, creating a vicious cycle that leads to insufficient insulin.
However, many aspects remain unclear. Key questions include how different stress types interact over time, how cells regulate their responses under prolonged pressure, and what determines whether a cell dies or loses function. Recent studies also suggest that not all beta cells respond to stress in the same way. This suggests that some cells behave differently than others when under pressure. Understanding these differences is helping identify new targets for treatments that may protect beta cells, restore their function, or prevent their loss.
About the author
Isaac Lo
Isaac is a first year M. Sc student from YCC lab at the University of Saskatchewan. His research focuses on proinsulin biosynthesis heterogeneity during type 2 diabetes development.
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