The pathophysiologic defects of type 2 diabetes. Abnormal insulin action and impaired insulin secretion.

Normal glucose metabolism is dependent on tight interplay among the pancreas, the liver, muscle, and adipose tissue. If this interplay is disturbed by decreased insulin secretion or decreased insulin effectiveness, glucose intolerance and type 2 diabetes ensue. Therapeutic approaches currently available and those under development target the pathophysiologic defects of type 2 diabetes, and treatment must be selected with this in mind, a major goal being to ensure adequate availability of insulin to the tissues.