The mechanism of impaired insulin secretion in type 2 diabetes (TTDM) is poorly understood. In health, approximately 75 percent of secreted insulin is released in discrete pulses with a periodicity of approximately 6 minutes, and modulation of the magnitude of these pulses serves to regulate the insulin secretion rate. In patients with TTDM, the rate of insulin secretion is impaired by a selective reduction of the pulse mass (amount of insulin released during a pulse), not pulse frequency. In addition, in TTDM first phase insulin secretion in response to a glucose bolus is impaired. These deficits are present even though there appears to be abundant stored insulin in the islets of patients with TTDM. The incretin hormone glucagon-like peptide-1 restores pulsatility and first phase secretion. Taken together these observations suggest that the number of insulin granules available for rapid discharge in a discrete insulin pulse or first phase secretion is deficient in TTDM. Our overall hypothesis for the present studies is that the mechanisms of impaired insulin secretion in TTDM is a decrease in the readily releasable pool of insulin granules.
Three specific aims test this overall hypothesis:
Aim 1 : Test the hypothesis that impaired insulin secretion in TTDM is due to a reduction in the size of the readily releasable pool of insulin granules.
Aim 2 : Test the hypothesis that the mechanism leading to this deficit is insufficient docking of granules from the reserve pool.
Aim 3 : Test the hypothesis that the readily releasable pool and insulin secretion can be restored by agents that enhance granules docking and/or inhibit undocking. We will use the method of total internal reflection fluorescence microscopy (TIRFM), a method that enables the visualization of individual granules near the plasma membrane within living secretory cells. We are well positioned to address these hypotheses with the following resources: (1) A fully established apparatus for TIRFM. (2) Access to a number of rodent models of TTDM, including GK and ZDF rats and a transgenic rat model in which human IAPP is expressed. (3) Access to human islets. (4) The support of the USC Diabetes Research Center.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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Metabolism Study Section (MET)
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Laughlin, Maren R
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University of Southern California
Schools of Medicine
Los Angeles
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