Diabetes, notably late onset of type II diabetes, is linked to obesity and is now an alarming “epidemic” in the United States and the rest of the world. What is the difference between the two major types of diabetes and why are these diseases getting so much attention?

From a biochemical viewpoint, type I deals with the pancreatic β-cells’ inability to make insulin, while in type II, insulin can be made but the regulation of its activity is abnormal (Nelson and Cox, 2005, p. 909).

Diabetes is highly discussed in both research and news venues for reasons that include:

• In 2002, diabetes was the sixth highest cause of death in the United States.

• In 2005, there were about 1.5 million new cases of diabetes (both diagnosed and undiagnosed) in the United States in people older than 20 years (Figure 3).

• In 2002, the total financial impact of diabetes on the United States' economy was $132 billion (NDIC, 2005).

Since there is no cure for diabetes, only existing treatments and research to develop better therapeutic treatments provide hope to manage this disease. In particular, let’s focus here on exploring the regulation of glucose-stimulated insulin secretion (GSIS).

Now I will discuss a recent discovery that links a specific pyruvate cycling pathway to control of GSIS and that suggests possible new targets to improve treatment of type II diabetes (Ronnebaum et al., 2006).