Islet amyloid polypeptide (IAPP) is a major component of amyloid deposition in pancreatic islets of patients with type 2 diabetes. It is known that IAPP can inhibit glucose-stimulated insulin secretion; however, the mechanisms of action have not yet been established. In the present work, using a rat pancreatic beta-cell line, INS1E, we have created an in vitro model that stably expressed human IAPP gene (hIAPP cells). These cells showed intracellular oligomers and a strong alteration of glucose-stimulated insulin and IAPP secretion. Taking advantage of this model, we investigated the mechanism by which IAPP altered beta-cell secretory response and contributed to the development of type 2 diabetes. We have measured the intracellular Ca 2؉ mobilization in response to different secretagogues as well as mitochondrial metabolism. The study of calcium signals in hIAPP cells demonstrated an absence of response to glucose and also to tolbutamide, indicating a defect in ATP-sensitive potassium (K ATP ) channels. Interestingly, hIAPP showed a greater maximal respiratory capacity than control cells. These data were confirmed by an increased mitochondrial membrane potential in hIAPP cells under glucose stimulation, leading to an elevated reactive oxygen species level as compared with control cells. We concluded that the hIAPP overexpression inhibits insulin and IAPP secretion in response to glucose affecting the activity of K ATP channels and that the increased mitochondrial metabolism is a compensatory response to counteract the secretory defect of beta-cells.Type 2 diabetes is characterized by impaired insulin secretion with a progressive decline in beta-cell mass and function (1, 2). A main characteristic of type 2 diabetes is the extracellular accumulation of amyloid fibrils in pancreatic islets (3, 4). The main component of these deposits is the islet amyloid polypeptide (IAPP).2 Specifically, human IAPP (hIAPP) but not rodent IAPP is amyloidogenic (5). Pancreatic beta-cells co-express and co-secrete IAPP and insulin in response to several secretagogue stimuli (6 -8). It is well established that IAPP is implicated in the pathogenesis of diabetes because it forms amyloid deposits leading to beta-cell death (9 -12). In addition, although different studies have demonstrated that IAPP can inhibit glucose-stimulated insulin secretion (GSIS) (13-15), the mechanisms of action have not been established. In pancreatic beta-cells, GSIS depends critically on the activity of ATP-sensitive potassium channels (K ATP ), which serve as a coupling factor between changes in glucose metabolism and membrane electrical activity (16,17). These channels are hetero-octameric complexes comprising four inward-rectifier potassium ion channels (Kir6.2) and four regulatory sulfonylurea receptors (SUR1) (18). Gain-of-function mutations of Kir6.2 are associated with defective GSIS and the development of type 2 diabetes (19,20), whereas loss of function mutations of Kir6.2 and SUR1 are the most common causes of congenital hyperinsulinism of infancy, ...