2.1.6. Origin of β-cell dysfunction
β-cell dysfunction is present at the early stages of the disease,i.e. IFG or IGT, and in normoglycaemic first-degree relatives
of patients with type 2 diabetes [17,41,42]. These results rule out the hypothesis of a hyperinsulinism state preceding
type 2 diabetes, which was evoked from results of studies with non-specific insulin assay (over-estimating “true” insulin concentrations), or from pseudolongitudinal studies describing the “Starling curve of the pancreas”. In fact, simultaneous plasma glucose levels, and insulin-sensitivity status were not taken into account in these studies. The phenomenon of compensation of insulin resistance by the β-cell has permitted to restore the correct sequence of events leading to the gradual decrease in insulin secretory capacities in type 2 diabetes [38].