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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #129: Beta-Cell Mass and Function in Human Type 2 Diabetes Part 5

Loss of beta-cell functional identity: The dominance of beta-cell functional impairment in T2DM implies that beta-cells have lost, at least in part, their normal insulin secretory phenotype. The associated molecular features have been discussed in a number of insightful reviews and research articles, and the role of genetic, epigenetic, transcriptomic and proteomic changes has been described extensively. At the cellular level, beta-cell insulin degranulation and the recently hypothesized beta-cell dedifferentiation phenomenon could play key roles. Insulin granules can be easily identified by electron microscopy on the basis of their typical morphology, characterized by a dense core and a more or less clearly visible halo. In addition, secretory granules can be subdivided into mature and immature, based on distinct ultrastructural, biochemical, and functional, with a relative ratio of 6 to 10 in normal human beta-cells.

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