When cells do not respond to insulin as they should, the pancreas compensates by secreting higher than normal levels of insulin. This period of impaired glucose tolerance/impaired fasting glucose is known as prediabetes: glucose levels are normal or slightly elevated to levels below the criteria for diabetes and insulin levels are increased. Over time, chronic hyperinsulinemia leads to a decrease in the number of insulin receptors on the cells and a further reduction in tissue sensitivity to insulin. Insulin production progressively falls to a deficient level, and frank type2 diabetes develop. Because hyperglycemia develops gradually in type2 diabetes and is often not severe enough for patients to recognize any of the classic diabetes symptoms, type2 diabetes may go undiagnosed for years. Many patients will have already developed complications by the time of diagnosis (Ahmad and Crandall, 2010)