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Type 2 diabetes mellitus: This is the most common form (80-90%). It is caused by a progressive impairment of insulin secretion in conditions of insulin resistance. Other pathogenetic mechanisms are also recognized, such as an increase in glucagon and the renal threshold for glucose excretion, or a decrease in the incretin effect. It may be genetically conditioned (most often polygenic inheritance), but age and environmental and lifestyle factors play a decisive role (excessive caloric intake and obesity [particularly abdominal], low physical activity and reduced lean body mass). Excess visceral fat has a significant influence on the development of diabetes, even in people without obesity defined by body mass index (BMI). An excess of free fatty acids released by adipose tissue is responsible for lip toxicity, which consists of an excess of fat oxidation that inhibits glycolysis (glucose metabolism) in the muscle, while in the liver it promotes gluconeogenesis and in the pancreas, it slows down insulin secretio levels. Once hyperglycemia is present, glucotoxicity occurs together with lip toxicity, and insulin secretory capacity and sensitivity are further impaired.n. To counteract these processes, a compensatory increase in insulin secretion is required, which in susceptible individuals can cause gradual depletion of β cells and elevated blood glucose