The diminished insulin secretion of type 2 diabetes might result from abnormal regulation of the potassium permeability which leads to beta-cell depolarization. The possibility of a generalized defect has been investigated in vitro by the stimulation of 86Rb efflux from red cells of type 2 diabetic patients by calcium ionophore and its inhibition by quinine. Diabetic subjects and control subjects had identical 86Rb efflux stimulated by 0.2-0.6 microM calcium ionophore A23187 and identical inhibition by quinine with mean Ki 6 microM and 4 microM quinine respectively for 0.2 microM ionophore and mean Ki 38 microM and 37 microM quinine respectively for 0.6 microM ionophore.
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