The document discusses tools that can be used to assess beta-cell health and function in research and clinical settings. It notes that simply measuring insulin levels is not sufficient because insulin levels are determined by both beta-cell function and insulin resistance. The document argues that glucose levels better reflect beta-cell function and compensation for insulin resistance, as normal beta-cell function should maintain normal glucose levels even with varying degrees of insulin sensitivity. Failure of beta-cells to adequately compensate for insulin resistance results in elevated glucose levels over time.

1. Section 3 How Can We Assess  -Cell Health and Function?

2.  -Cell Adaptation and Failure: Opportunities for Prevention and Treatment of Type 2 Diabetes

6. Clinical Assessment of  -Cell Function: Why Not Just Measure Insulin? Same β -cell function, different insulin levels Same insulin levels, different function Insulin sensitivity Insulin level Normal Patient #2 Patient #1 Insulin sensitivity Insulin level Normal Impaired Patient #4 Patient #3

8. Falling  -Cell Function and Rising Glucose Levels Baseline Posttrial testing TRIPOD Study – Incident Diabetes Cases Minutes Plasma glucose (mg/dL) Acute insulin response IV glucose (  U/mL x min) Insulin sensitivity ( S i ) Xiang AH et al. J Clin Endocrinol Metab. 2004;89:2846-2851. 0 40 80 120 0 100 200 300 Buchanan TA et al. Diabetes . 2002;51:2796-2803. Baseline Posttrial 1,000 800 600 400 200 0 0 2 4 6