Scientists have long known that the pancreas plays a central role in diabetes, but a landmark NIH-funded study has now revealed just how much the internal makeup of this organ varies from person to person — and why that variation matters enormously for disease risk.
Researchers analyzed pancreatic islet cells from 299 donors collected through the Integrated Islet Distribution Program (IIDP) at City of Hope in California, the largest human islet research resource in the country. The donor pool reflected the full demographic diversity of the United States, spanning different ages, sexes, races, ethnicities, and body types, making the findings broadly applicable to real-world populations.
Islets are tiny clusters of cells scattered throughout the pancreas that regulate blood sugar by releasing hormones. They include beta cells that produce insulin to lower blood sugar, alpha cells that produce glucagon to raise it, and delta cells that produce somatostatin to regulate both. On average, islets were comprised of 58% beta cells, 34% alpha cells, and 8% delta cells — but the researchers detected broad variability in the percentage of alpha and beta cells across the study population.
That variability turned out to be the key finding. Islets with a higher proportion of insulin-producing beta cells showed stronger insulin secretion, while higher levels of alpha and delta cells were generally linked to reduced insulin output. In other words, the cellular recipe inside your pancreas directly influences how well your body handles blood sugar.
The study also uncovered biological differences tied to sex and ancestry. Cells from female donors tended to have a higher percentage of alpha cells and a lower percentage of beta cells, and differences in beta cell proportions were also observed across ancestry groups.
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Taken together, the findings move science meaningfully closer to understanding why certain people are predisposed to diabetes — and open the door to more personalized prevention and treatment strategies in the years ahead. As study co-lead author Dr. Carmella Evans-Molina noted, this dataset is just the tip of the iceberg, with far greater discoveries still to come as the broader research community digs into the data.
