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‘hyperinsulinise’ the peripheral tissues to reach physiological levels of the hormone in the portal system. Therefore, new disease-modifying therapies to protect and restore beta-cell function are urgently needed ( Martens et al. 2021 ). A final point to note at
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Department of Endocrinology and Diabetes, Westmead Hospital, Sydney, New South Wales, Australia
Garvan Institute of Medical Research, Sydney, New South Wales, Australia
St Vincent’s Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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pancreatic islets. Although they consist of only 1–2% of the adult pancreas, islets are critical for regulating glucose homeostasis. The hormone insulin is secreted solely by islet β-cells. When blood glucose levels rise, insulin is released. Diabetes occurs
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Stanford Diabetes Research Center, Stanford University, Stanford, California, USA
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secretion across the phenotypic spectrum of diabetes and provided a model for precision medicine in diabetes. Figure 1 Timeline indicating key genetic discoveries in the context of our understanding of the hormone insulin and its use therapeutically
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, and evidence of impaired proinsulin hormone processing within the remaining beta cells. In these patients, proinsulin is found in mature granules, colocalizing with the processed insulin. Similar observations in terms of proinsulin were made in the
