The making of insulin in health and disease

Diabetologia. 2020 Oct;63(10):1981-1989. doi: 10.1007/s00125-020-05192-7. Epub 2020 Sep 7.

Abstract

The discovery of insulin in 1921 has been one of greatest scientific achievements of the 20th century. Since then, the availability of insulin has shifted the focus of diabetes treatment from trying to keep patients alive to saving and improving the life of millions. Throughout this time, basic and clinical research has advanced our understanding of insulin synthesis and action, both in healthy and pathological conditions. Yet, multiple aspects of insulin production remain unknown. In this review, we focus on the most recent findings on insulin synthesis, highlighting their relevance in diabetes. Graphical abstract.

Keywords: Beta cell; Insulin biosynthesis; Insulin maturation; Post-transcriptional regulation; Proinsulin conversion; Review; Type 1 diabetes; Type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Crystallization
  • Diabetes Mellitus, Type 1 / metabolism*
  • Diabetes Mellitus, Type 2 / metabolism*
  • Gene Expression Regulation
  • Glucose / metabolism
  • Humans
  • Insulin / biosynthesis*
  • Insulin / genetics
  • Insulin / metabolism
  • Insulin Secretion*
  • Proinsulin / biosynthesis
  • Proinsulin / genetics
  • Proinsulin / metabolism*
  • Protein Biosynthesis
  • Protein Folding
  • Protein Precursors / biosynthesis
  • Protein Precursors / genetics
  • Protein Precursors / metabolism*
  • RNA Processing, Post-Transcriptional
  • RNA, Messenger / metabolism*
  • Secretory Vesicles / metabolism*

Substances

  • Insulin
  • Protein Precursors
  • RNA, Messenger
  • preproinsulin
  • Proinsulin
  • Glucose