Another potential key action for IRE-1 in diabetes arises in pancreatic beta cells. These cells synthesize insulin in the ER, and the ER may be placed under stress if it produces high level of the hormone while trying to handle insulin resistance or a type 1 diabetes autoimmune attack. "Beta cells then would rely on IRE-1 to protect the ER, and this could have a negative effect on antioxidant defenses," Dr. Blackwell says.