Volume 2 Issue 5, May 2006

Although pancreatic islet transplantation can restore normal β-cell function to patients with diabetes, success is limited by tissue availability. An alternative strategy is to stimulate development of the patients' own β cells; however, the postnatal origin of new β cells remains controversial. This Viewpoint proposes that progenitor cells could exist in the pancreatic ducts.

New insulin-producing β cells are produced throughout adult life and could potentially be exploited in regenerative therapies for diabetes. Although pancreatic progenitor cell differentiation has been proposed to drivede novoβ-cell generation, this Viewpoint argues that new β cells arise from the proliferation of pre-existing β cells.

Biosynthetic human growth hormone (GH) is now used to treat GH deficiency and promote growth in conditions such as Turner syndrome, intrauterine growth restriction, chronic renal failure and idiopathic short stature. The net effect in these conditions is less than in GH deficiency. Vigilance for long-term complications of GH use is essential.

This article describes the different conditions that embrace the diagnosis of diabetic neuropathies—the Cinderella complication of diabetes. Distinction between the proximal and distal large and small fiber, focal mononeuritides and entrapments is essential since each has a unique presentation and requires specific therapeutic intervention for a successful outcome.

Genetic disorders of ACTH action lead to rare syndromes of glucocorticoid deficiency. Many common disorders are accompanied by disturbance of the pituitary-adrenal axis, which may contribute to their morbidity. This Review describes the evidence that in some circumstances—septic shock and depressive illness—disturbed ACTH responsiveness may contribute to the disease.