beta-cell turnover: its assessment and implications.

The pancreatic beta-cells are responsible for the maintenance of the body's glucose levels within a very narrow range; their population is dynamic and undergoes compensatory changes to maintain euglycemia. The structural parameters that allow mass changes (replication, neogenesis, cell volume changes, and cell death) can now be assessed and have proved to be powerful tools. Changes in one parameter can dramatically affect the beta-cell mass. Unfortunately, conclusions are often drawn on measurements that do not assess beta-cell mass but only relative volumes. Throughout the lifetime of a mammal, low levels of beta-cell replication and apoptosis are balanced and result in a slowly increasing mass. The balance allows gradual replacement of the beta-cell population; thus, beta-cells should be considered a slowly renewed tissue. Two major implications of beta-cell turnover are that 1) at any time, the beta-cells would be at different ages and 2) any limitation on replacement could have dire consequences for glucose homeostasis.