Although it is agreed that autoimmune destruction of pancreatic islets in diabetic BB rats is rapid, reports of endocrine cell content of islets from BB diabetic rats at the time of onset of diabetes vary considerably. Because of the rapid onset of the disease (hours) and the attendant changes in islet morphology and insulin secretion, it was the aim of this study to compare islet β-cell numbers to other islet endocrine cells as close to the time of onset of hyperglycemia as possible (within 12 h). As it has been reported that hyperglycemia renders the β cell insensitive to glucose, the early effects of different levels of insulin therapy (well-controlled vs. poorly controlled glycemia) on islet morphology and insulin secretion were examined. When measured within 12 h of onset, insulin content of BB diabetic islets, measured by morphometric analysis or pancreatic extraction, was 60% of insulin content of control islets. Despite significant amounts of insulin remaining in the pancreas, 1-day diabetic rats exhibited fasting hyperglycemia and were glucose intolerant. The insulin response from the isolated perfused pancreas to glucose and the glucose-dependent insulinotropic hormone, gastric inhibitory polypeptide (GIP), was reduced by 95%. Islet content of other endocrine peptides, glucagon, somatostatin, and pancreatic polypeptide, was normal at onset and at 2 weeks post onset. A group of diabetic animals, maintained in a hyperglycemic state for 7 days with low doses of insulin, were compared with a group kept normoglycemic by appropriate insulin therapy. No insulin could be detected in islets of poorly controlled diabetics, while well-controlled animals had 30% of the normal islet insulin content. Well-controlled diabetic animals were more glucose tolerant and exhibited greater in vivo and in vitro insulin responses to glucose and GIP than poorly controlled animals. These studies indicate that at the onset of diabetes in the BB rat, significant amounts of insulin remain in the islet, although secretion in response to glucose and GIP is severely blunted. Adjusting insulin dosage to achieve normoglycemia has a significant β-cell sparing effect in diabetic animals, which is reflected in only a small increase in glucose-stimulated insulin secretion. These data suggest that impaired glucose recognition by the BB diabetic β cell occurs prior to autoimmune destruction of the islet and may contribute to the onset and severity of the diabetic state in these animals.Key words: diabetes, BB rat, islet endocrine cell content, insulin secretion.