Pathophysiology of Type 2 Diabetes Mellitus Genetic predisposition Obesity -Diet, inactivity Adipokines, ifree fatty acids inflammatory cytokines ↓ Activity of ghrelin l Beta cell mass and function Insulin resistance ↓ Activity of incretins t Demand for insulin synthesis ↓ Amylin Hypoinsulinemia Hyperinsulinemia t Glucagon- Tissue effects and Tissue effects without hyperglycemia hyperglycemia(insulin (type 2 diabetes resistance without diabetesPathophysiology of Type 2 Diabetes Mellitus