Diabetes mellitus is the most common metabolic disorder worldwide. In industrialized countries it is the leading cause of blindness, renal failure and lower limb amputations and is a major risk factor for cardiovascular disease and stroke. Due to population ageing and increasing trends towards obesity and sedentary lifestyles, the number of affected individuals is expected to double within the next two decades. Insulin secretion from pancreatic beta cells plays an essential role in the control of blood glucose levels and diabetes mellitus develops if insulin production is insufficient to cover the metabolic demand. Insulin exocytosis is a highly regulated process that is finely tuned by nutrients, hormones and neurotransmitters. This process is impaired under conditions predisposing to the development of diabetes, such as chronic exposure of beta cells to elevated levels of glucose or free fatty acids. Thus, a better knowledge of the mechanisms controlling insulin exocytosis is essential to determine the causes of the disease and to favour the development of new strategies for the treatment of diabetic patients. Moreover, since the secretory apparatus of pancreatic beta cells is very similar to that of neuronal cells, the elucidation of the mechanisms regulating insulin secretion will probably help clarifying the events governing neurotrasmitter release and aid the design of new pharmacological principles for the treatment of neurological disorders.

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