Paracrine Interactions within the Pancreatic Islet Determine the Glycemic Set Point

Rayner Rodriguez-diaz, R. Damaris Molano, Jonathan R. Weitz, Midhat H. Abdulreda, Dora M. Berman, Barbara Leibiger, Ingo B. Leibiger, Norma S. Kenyon, Camillo Ricordi, Antonello Pileggi, Alejandro Caicedo, Per-olof Berggren

Research output: Contribution to journalArticlepeer-review

137 Citations (Scopus)


Every animal species has a signature blood glucose level or glycemic set point. These set points are different, and the normal glycemic levels (normoglycemia) of one species would be life threatening for other species. Mouse normoglycemia can be considered diabetic for humans. The biological determinants of the glycemic set point remain unclear. Here we show that the pancreatic islet imposes its glycemic set point on the organism, making it the bona fide glucostat in the body. Moreover, and in contrast to rodent islets, glucagon input from the alpha cell to the insulin-secreting beta cell is necessary to fine-tune the distinctive human set point. These findings affect transplantation and regenerative approaches to treat diabetes because restoring normoglycemia may require more than replacing only the beta cells. Furthermore, therapeutic strategies using glucagon receptor antagonists as hypoglycemic agents need to be reassessed, as they may reset the overall glucostat in the organism.
Original languageEnglish
Pages (from-to)549-558.E4
Number of pages10
JournalCell Metabolism
Issue number3
Early online date6 Mar 2018
Publication statusPublished (in print/issue) - 6 Mar 2018


  • glucose homeostasis
  • insulin secretion
  • beta cell
  • alpha cell
  • glucagon
  • paracrine signaling
  • human pancreatic islet
  • glycemic set point
  • glycemia
  • humanized mouse


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