Islet Cell Function Its Role in the Onset and Progression of Type 2 Diabetes

Abstract

Studies of the natural history of type 2 diabetes have transformed views on the nature of the condition in the last two decades.The Belfast Study is one of the earliest and most complete studies to observe the change in blood glucose control during six years of best possible management by dietary means. After the rapid initial fall from presenting blood glucose levels over 11mM, mean fasting blood glucose was maintained around 8mM for only two years before an inexorable rise occurred. By six years after diagnosis mean plasma glucose was over 10mM.This work is all the more impressive as no oral agent therapy was used during the course of the study which truly observed natural history modified only by consistent and expert dietary advice. Calculated beta cell function revealed a fall from around 30% of normal function at diagnosis to around 22% after six years.