Pathogenesis of type II diabetes:: are there common causes for insulin resistance and secretion failure?

Insulin resistance of major target tissues and insulin secretion abnormalities play a pivotal role in the pathogenesis of type 2-diabetes. Population studies have demonstrated that both insulin resistance and insulin secretion defects are already detected in a prediabetic state and contribute to the development of overt type 2-diabetes. Major factors causing insulin resistance are obesity, physical activity and the genetic background. Since insulin resistance and insulin secretion abnormalities are often confounded, it can be speculated that a common defect exists for both conditions. Several candidate genes have been studied including insulin signaling elements as well as genes which are important for insulin secretion. A link between defects in the insulin signaling chain and insulin secretion processes was suggested by some of these studies.