Mitochondria as Epigenetic Regulators of β-Cell Identity and Plasticity: A Metabolo-Epigenetic Perspective.

The progressive decline in functional β-cell mass in Type 2 Diabetes (T2D) is increasingly recognized not as a simple apoptotic loss, but as a complex erosion of cellular identity termed "dedifferentiation." Central to this phenotypic shift is the metabolo-epigenetic axis, where mitochondria act as the primary sensing hub, transducing nutrient flux into biochemical signals that govern the chromatin landscape. This review synthesizes current evidence on how mitochondrial metabolites-including Acetyl-CoA, α-ketoglutarate, and NAD+-serve as obligatory co-factors for the epigenetic machinery. We explore how chronic metabolic stress triggers a "Systemic epigenetic destabilization," leading to the loss of lineage-specific markers and the formation of persistent "metabolic scars." Furthermore, we discuss the clinical implications of these changes, specifically regarding the phenomenon of metabolic memory and the molecular limits of β-cell reversibility. By integrating foundational transcriptional studies with emerging epigenomic data, we propose that targeting the mitochondrial-epigenetic axis offers a strategic window for re-differentiating failing β-cells and restoring glycemic homeostasis.