[Heterogeneity in pathogenesis of NIDDM and recent advances in research of diabetogenic genes].

Impaired insulin secretion and/or insulin resistance are the primary defect(s) in the pathogenesis of non-insulin-dependent diabetes mellitus (NIDDM). Both seem to be regulated by the genetic factors in addition to environmental factors. Recent Advances are revealing the molecular mechanism how insulin is secreted in response to glucose and how insulin acts on the target tissues. Several genes including glucokinase and mitochondria have been shown to be responsible for the development of NIDDM, but NIDDM is the polygenic disease and most of NIDDM patients may have still-uncharacterized diabetogenic factors.