Progenitor cells may aid successful islet compensation in metabolically healthy obese individuals.

Obesity is associated with insulin resistance and type 2 diabetes. Fortunately most obese, insulin-resistant individuals do not develop type 2 diabetes as they can overcome reduced efficiency of insulin action by increasing the functional β-cell mass. Compelling evidences suggest β-cells neogenesis through progenitor/stem cells residing in pancreatic ductal cells and islets, but the role of β-cell regeneration in obesity/insulin resistance from progenitor/stem cells is not clear. Based on many indirect evidences in human studies such as unchanged β-cell replication, apoptosis and size during compensation in insulin resistance in humans, we suggest successful β-cells mass compensation in metabolically healthy obesity is contributed by neoformation of β-cells, through expansion of progenitor cells/stem cells in synergy with β-cell replication.