![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhD2or8yh8dbSJTkE5c6Y7X48pPUe85Dm68G6hZCndB4AKBbaNiI3g04_jMUuKzsagjnXk6YUnCmhKhtKe7pOsGgN2ZWeK2r1iW-dRJVRLYRrbws1bIjZmJdZCm25pH3DWMSWdePpEYVIUb/s320/DM+type+2+%2528a%2529.png)
(1) insulin resistance and
(2) β-cell dysfunction: inadequate insulin secretion in the face of insulin resistance and hyperglycemia
Sedentary lifestyle, obesity and insulin resistance
Among identical twins, the concordance rate is 50% to 90%, showing some genetic component also.
Loss-of-function abnormalities of either the insulin receptor or its down-stream signaling molecules cause insulin resistance
β cell dysfunction
hyperinsulinemic state is a compensation for peripheral resistance and can often maintain normal plasma glucose for years, but after some years the β cells are overwhelmed and can no longer secrete adequate insulin
adverse effects of high circulating FFAs ("lipotoxicity") or chronic hyperglycemia ("glucotoxicity") on β cells
decrease in β-cell mass, islet degeneration, and deposition of islet amyloid.
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhquLYt0joiDI0_GML0TPV0kzRx-4LbVAdDJOaFlur-zbRPUz39Q16zTBRJxPJ2WpozH5oBuJPlG47pHWnTtjtCBMN9SFDQTO657t0R_EECWdbrskwSAQpTUK0tGVH1IxwrUyo5SCOoHXLo/s320/DM+type+2.png)
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