Pathogenesis of type 2 diabetes mellitus

Type 2 diabetes mellitus is a heterogeneous disorder with genetic and acqui red components. It is primarily due to impaired insulin secretion in that i ndividuals with genetically impaired beta cell function cannot increase the ir insulin release sufficiently to compensate for insulin resistance. The r esultant hyperglycemia is largely the consequence of excessive release of e ndogenous glucose due to increased gluconeogenesis. Nevertheless, clinical experience has demonstrated that therapies directed at improving beta cell function (sulfonylureas) and at improving hepatic (metformin) and muscle (t hiazolidinediones) insulin sensitivity are effective treatments for the con dition.