Role of β-cell Failure in the Pathogenesis of Type 2 Diabetes Mellitus and Therapeutic Choice

There is a progressive deterioration in β-cell function and mass in type 2 diabetes.The reduction of β-cell mass is attributable to accelerated apoptosis.The major factors for progressive loss of β-cell function and mass are glucotoxicity,lipotoxicity,proinflammatory cytokines,leptin,and islet cell amyloid.The hypoglycemic drugs such as insulin,thiazolidinediones(TZDs),incretin mimetics,and dipeptidyl peptidase(DPP)-IV inhibitors may delay the rate and extent of β-cell failure.