The answer to this question may be in glucose toxicity leading to a biphasic response, thereby preventing neoplastic effects of dynamical compensation by mutant takeover.

pubmed.ncbi.nlm.nih.gov/286522

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Therefore, the non-increased and, in many cases, even reduced beta cell function in metabolic syndrome may not mirror an "either-or" question but be part of continuous evolution. It may be a source of prediabetes and diabetes but also prevent insulinoma.

pubmed.ncbi.nlm.nih.gov/381691

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