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Gordon C. Weir, Susan Bonner-Weir
Published in Volume 117, Issue 1
J Clin Invest. 2007; 117(1):81–83 doi:10.1172/JCI30862
Abstract | Full text | PDF
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Figure 1
The pathway from glucose metabolism to increased β cell mass through enhanced β cell replication and survival.

Glucose enters the β cell via glucose transporter 2 (Glut2; also known as Slc2a2) and is phosphorylated to glucose-6-phosphate (G6P) by the rate-limiting enzyme of glycolysis, Gck. Further metabolism of glucose increases the expression of Irs2, possibly through CREB phosphorylation at residue Ser133 as a result of increased cytosolic calcium levels generated via voltage-dependent calcium channels (VDCCs), the ER, and mitochondria. The calcium effect is likely mediated by calmodulin-dependent protein kinases (CaMKs). Calcium can also increase cAMP levels in β cells. Increased Irs2 activity can then activate a signalling cascade that leads to β cell replication (via FoxO1 nuclear exclusion) and β cell survival (via PKB/Akt). This pathway can be augmented by cAMP signaling through GLP1 receptors (Glp1r). The contributions of the insulin and Igf1 receptors (Insr and Igf1r, respectively) are likely to be permissive. P, phosphate group.