This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The overall aim of this study is to evaluate molecular and genetic mechanisms of diabetes and insulin action in patients/subjects with a variety of unusual syndrome clusters of diabetes/insulin resistance or familial patterns of diabetes/insulin resistance/diabetes, in comparison to appropriate normative controls. One of the syndromes we are assessing is hyperinsulinemic hypoglycemia associated with nesideoblastosis following bariatric surgery. In these patient/subjects and in controls we are evaluating incretin and proteomic response to mixed meal to determine if excessive incretin or other hormone or metabolite production could underlie the rare case of beta cell hyperplasia seen following gastric bypass surgery. Furthermore, we are evaluating whether a familial predisposition to beta cell hyperplasia may underlie this conditi
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