There happened to be a one day diabetes conference near where I work, so I went there. Here are two interesting stories relevant to stuff we talk about here. Contact me if you want more specific info.
We talk a lot here about how type 2 is not a simple consequence of obesity. I heard a talk from a guy who used metabolomics to measure insulin resistance and thousands of metabolites in a bunch or normal and type 2 subjects. Then he did a statistical analysis (by pca) of what metabolites were associated with insulin resistence. There were six factors, of which the first two were already known (fatyy acids and one other). The third component was new--it had branched chain amino acids--leucine, isoleucine, and valine. He was able to show that there was a distinct group of type 2's with altered metabolisms for these substances leading to all muscle glucose coming these amino acids and none from the bloodstream. Only science, not medical, but a very specific way to get type 2 without a causal connection to obesity. Also relevent to ultra low carb approaches to type 2, where even protein gets reduced.
We talk a lot here about tired beta cells and honeymoons. Talked to a guy with a poster who was studying islets in a mutant mouse that gets very high glucose levels--diabetes--for a non-pancreas reason. He had fluorescence pix that showed insulin, glucagon, and cells; he also had hi-mag electron microscope pix of beta cells, each from normal and mutant mice. The normal islet cells had big black insulin vesicles (granules) ready for release. The islet cells from the diabetic mice had lots of vesicles under construction, almost no mature ones, and abnormally large amounts of ER and Golgi, which are thingies the cell uses to make more insulin vesicles for release. i.e, these beta cells were trying as hard as they could to make insulin to keep up with a high glucose stimulus, but they couldn't make enough insulin to keep up so they were exhausted. Then the guy put cultured islets from the diabetic mice into medium with normal glucose levels. The exhausted beta cells then recovered and became completely normal. So then the guy said to me, "I don't know if you've heard of the idea of 'tired beta cells', but this is histological proof that it really happens" I said I had heard of it, smiled, and thanked him for an interesting poster.