Excessive lipid accumulation in adipose tissue triggers hypertrophy and stress of adipocytes, leading to infiltration of proinflammatory immune cells, fibrosis and adipocyte cell death, collectively referred to as adipose tissue dysfunction. As consequence, adipocytes capacity to store lipids is impaired and fat is ectopically accumulated in organs such as muscle, liver and pancreas, a condition that promotes organ dysfunction and insulin resistance, contributing to the pathogenesis of type 2 diabetes (T2D).

Although fat accumulation in human pancreas was described decades ago, it has for long remained an underexplored facet of ectopic fat distribution. Pancreatic fat has been associated with improved insulin secretion in normoglycaemic subjects, but with impaired insulin secretion in patients at increased risk of T2D. Furthermore, T2D diabetes remission, i.e. recovery of beta cell function was accompanied by reduction of pancreatic fat. These clinical observations point to the controversial role of pancreatic fat in insulin secretion, and emphasize the need for experimental evidence demonstrating plausible lipolysis derived fatty acids-/secretome-mediated effects of pancreatic adipocytes in islets. To date, detailed studies on the mechanistic interactions between pancreatic adipocytes and insulin secretion remain sparse, as reliable in vitro models replicating the unique properties of these cells have been lacking.

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