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Sarah J Richardson Islet Biology Group, Exeter Centre for Excellence in Diabetes (EXCEED), Institute of Biomedical and Clinical Sciences (IBCS), University of Exeter, RILD Level 4, Exeter, UK

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Alberto Pugliese Division of Diabetes Endocrinology and Metabolism, Departments of Medicine, Microbiology and Immunology, Diabetes Research Institute, Leonard Miller School of Medicine, University of Miami, Miami, Florida, USA

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1D pancreas Additional pancreatic pathological abnormalities have been described and appear to contribute to the disease pathogenesis. Inflammation, beta cell stress, and dysfunction Islet inflammation induces stress, protein misfolding

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Pieter-Jan Martens Clinical and Experimental Endocrinology (CEE), KU Leuven, Belgium

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Conny Gysemans Clinical and Experimental Endocrinology (CEE), KU Leuven, Belgium

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Chantal Mathieu Clinical and Experimental Endocrinology (CEE), KU Leuven, Belgium

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, clear signs of beta cell stress can be detected in those on their way to develop T1D, as illustrated by an increased proinsulin-to-insulin ratio ( Wasserfall et al. 2017 ). This increased ratio suggests abnormalities in insulin processing and vesicular

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James Cantley School of Medicine, University of Dundee, Dundee, Scotland, UK

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Decio Eizirik ULB Center for Diabetes Research, Medical Faculty, Université Libre De Bruxelles, Brussels, Belgium

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autoimmunity, which has important implications for efforts to protect, regenerate and restore endogenous beta-cell function. A timely review of the histological evidence for inflammation, viral infection and endoplasmic reticulum (ER stress in the aetiology of

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Jennifer M Ikle Division of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA

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Anna L Gloyn Division of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
Stanford Diabetes Research Center, Stanford University, Stanford, California, USA

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stress ( INS , EIF2AK3 ), and transcriptional regulation ( HNF1A , HNF1B , HNF4A , NEUROD1 , PDX1 ). Created with BioRender.com. Recognition of autosomal dominantly inherited diabetes Maturity-onset diabetes of the young (MODY) is

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Jennifer Chen The Westmead Institute for Medical Research, The University of Sydney Westmead Hospital, New South Wales, Australia

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Jenny E Gunton The Westmead Institute for Medical Research, The University of Sydney Westmead Hospital, New South Wales, Australia
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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found to have 49% greater sympathetic nerve density than their lean littermate counterparts. Islets undergoing chronic sympathetic stress are postulated to accelerate β-cell degeneration ( Chien et al. 2016 ). In contrast, human islets have

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