The Genetic Basis of Type 2 Diabetes Mellitus: Impaired Insulin Secretion versus Impaired Insulin Sensitivity
John E. Gerich





I. Introduction
A. General considerations
B. Diabetogenic vs. diabetes-related genes
C. Secondary impairment of insulin secretion and insulin sensitivity
D. Insulin deficiency vs. impaired insulin secretion
E. Misinterpretation of the Oral Glucose Tolerance Test (OGTT)

II. Strategy

III. Studies in Genetically Predisposed Individuals with NGT
A. First-degree relatives (excluding twins)
B. Identical twins discordant for type 2 diabetes

IV. Prospective Studies of Individuals Before Development of Type 2 Diabetes

V. Studies of Normal Glucose-Tolerant Women with a History of Gestational Diabetes

VI. Reversibility of Insulin Resistance and Impaired Insulin Secretion by Therapeutic Interventions

VII. Are all Type 2 Diabetics Insulin Resistant?

VIII. Hypothesis for Pathogenesis of Type 2 Diabetes

IX. Summary and Conclusion

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