[sjf911]

Type 2 diabetes is a very complex disorder with a strong but highly varied genetic component. The simple fact is that type 2 diabetics are born insulin resistant. It simply takes more insulin to achieve normal glucose control from birth. A number of things add to this. There is a correlation with circulating FFA's (free fatty acids) and insulin resistance. The more fat you carry, the more FFA's you have in circulation and the more insulin resistant you are. Also, skeletal muscle is a big player in insulin sensitivity. The less exercise you get and the lower you are on the fitness curve, the more insulin resistant you will be. There also seems to be a large degree of variability in individuals in pancreatic insulin production and durability leading to a concept of "pancreatic fatigue". This means, the more you stress your sugar/insulin pathway (simple carbs, excess calories, HFCS, etc.), the more you fatigue your pancreas resulting in declining insulin production. At some point your pancreas is just not able to produce enough insulin to overcome you insulin resistance and you become diabetic.