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We have called our research approach the metabolic epidemiology of type 2 diabetes. By this we mean an intensive multifaceted approach to the longitudinal epidemiologic study of type 2 diabetes mellitus that takes into account a fuller understanding of etiology and pathogenesis of the disease. It includes lifestyle (culture, customs, habits, diet, and physical activity), genetics (family diabetes history, genetic markers), adiposity (body fat distribution), insulin resistance and islet beta-cell function (islet beta-cell lesion).