Apoptosis, autophagy & endoplasmic reticulum stress in diabetes mellitus

The prevalence of diabetes mellitus (DM) is increasing secondary to increased consumption of food and decreased physical activity worldwide. Hyperglycaemia, insulin resistance and hypertrophy of pancreatic beta cellsoccur in the early phase of diabetes. However, with the progression of diabetes, dysfunction and loss of beta cellsoccur in both types 1 and 2 DM. Programmed cell deathalso named apoptosis is found to be associated with diabetes, and apoptosis of beta cellsmight be the main mechanism of relative insulin deficiency in DM. Autophagic cell death and apoptosis are not entirely distinct programmed cell deathmechanisms and share many of the regulator proteins. These processes can occur in both physiologic and pathologic conditions including DM. Besides these two important pathways, endoplasmic reticulum (ER) also acts as a cell sensor to monitor and maintain cellular homeostasis. ER stress has been found to be associated with autophagy and apoptosis. This review was aimed to describe the interactions between apoptosis, autophagy and ER stress pathways in DM.