β cells uniquely produce and secrete insulin under the control of several, integrated signals, to maintain blood glucose concentrations within a narrow physiological interval. β cell failure is key to the onset and progression of type 2 diabetes, due to impaired function and reduced mass. In this review we focus on several features of human β cell dysfunction and pathology in type 2 diabetes, as revealed by direct assessment of isolated islet traits and examination of pancreatic tissue from organ donors, surgical samples or autoptic specimens. Insulin secretion defects and pathology findings are discussed in relation to some of the major underlying mechanisms, to also provide clues for conceiving better prevention and treatment of type 2 diabetes by targeting the pancreatic β cells.

β细胞在几种综合信号的控制下独特地产生和分泌胰岛素，以将血糖浓度维持在狭窄的生理区间内。由于功能受损和体重减少，β细胞衰竭是2型糖尿病发作和进展的关键。在本综述中，我们重点研究2型糖尿病中人β细胞功能异常和病理学的几个特征，这些特征通过直接评估孤立的胰岛特征和检查器官供体，手术样本或尸体标本中的胰腺组织揭示。讨论了有关胰岛素分泌缺陷和病理学发现的一些主要潜在机制，以通过靶向胰腺β细胞为更好地预防和治疗2型糖尿病提供线索。