On the other hand, T2D is predominantly a disease of
insulin resistance in obese individuals, with insulin deficiency
developing as demand outstrips pancreatic insulin production, and insulin treatment may or may not be required to
maintain adequate control.31–33,35
While obesity contributes to
the risk of T2D via environmental factors including increased
caloric intake and sedentary time, genetic and epigenetic
factors also contribute to the genesis of T2D in children.
11,36
Furthermore, immune activation and inflammation associated
with obesity is an important driver of insulin resistance that
ultimately leads to diabetes.