Studies by Kahn and Porte, (1988) established that the
degree of impaired beta-cell responsiveness to glucose
is closely related to the degree of fasting hyperglycemia
but in a curvilinear fashion. Decreased insulin secretion
and defective cellular insulin action also compromises
efficient glucose uptake by peripheral tissues. This
derangement gets more predominant as the islet
dysfunction declines. Management interventions
improve islet function and raise plasma insulin levels,
reduce hepatic gluconeogenesis, or improve the
efficiency of tissue glucose uptake.