Pancreatic regeneration in type 1 diabetes: dreams on a deserted islet?

Excerpt

It is easy to see that Meier and colleagues have set out to gain our collective attention with their report in this issue of Diabetologia [1]. Many notions concerning the pathogenesis of type 1 diabetes have been repeated so often that they have hardened into dogma [2]. This list of unquestioned yet unconfirmed concepts might include the assumed autoimmune basis for the disorder, the notion that symptomatic onset is preceded by 85–90% loss of beta cells, and the belief that beta cell destruction is orchestrated by T lymphocytes. Yet another popular postulate maintains that beta cell mass is irrevocably lost in the months or years that follow initiation of insulin therapy, leaving the pancreas devoid of cells capable of insulin production. The proposal that this exocrine desert contains an oasis of insulin-producing cells would therefore be considered, at least by most, to represent a mirage. …