can address only the current understanding
T2DM is a genetic disease. There are many
genes involved, most of which have not as
yet been identified. These genes con
a
number of chemical steps in
B cell action
insulin secretion
insulin action at the cell
level, insulin receptor production by the cell
and insulin action inside the cell. A differ
ent gene controls enzyme production for each
step in this process. A defect in any one
of these genes can prevent enzyme produc
tion and block the action of insulin. This
block can interfere with glucose uptake by
the cell, increase glucose production by the
liver, prevent uptake of glucose and fatty by the fat cells, increase breakdown of the
triglycerides, and cause many other metabolic
defects. Thus, it is difficult to understand
the pathophysiology of such a multifactoral
disease