Incretin and Pancreatic (3-Cell Function in Patients with Type 2 Diabetes

To maintain normal glucose homeostasis after a meal, it is essential to secrete an adequate amount of insulin from pancreatic (3-cells. However, if pancreatic (3-cells solely depended on the blood glucose level for insulin secretion, a surge in blood glucose levels would be inevitable after the ingestion of a large amount of carbohydrates. To avoid a deluge of glucose in the bloodstream after a large car-bohydrate-rich meal, enteroendocrine cells detect the amount of nutrient absorption from the gut lumen and secrete incretin hor-mones at scale. Since insulin secretion in response to incretin hormones occurs only in a hyperglycemic milieu, pancreatic (3-cells can secrete a "Goldilocks" amount of insulin (i.e., not too much and not too little) to keep the blood glucose level in the normal range. In this regard, pancreatic (3-cell sensitivity to glucose and incretin hormones is crucial for maintaining normal glucose homeo-stasis. In this Namgok lecture 2022, we review the effects of current anti-diabetic medications on pancreatic (3-cell sensitivity to glu-cose and incretin hormones.