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In summary, the pathogenesis of Type 2 diabetes involves the inheritance of diabetes susceptibility genes. The risk of developing the disease is first manifested by insulin resistance. Insulin resistance is worsened by a number of factors including obesity and physical inactivity. If insulin resistance is severe enough, IGT will appear. When IGT is present, the risk of progressing to Type 2 diabetes is very high in all populations. A major factor in determining progression from IGT to diabetes is the inability of the beta-cell to secrete enough insulin to compensate sufficiently for the level of insulin resistance. Its capacity and ability to do so is further decreased by persistent and increasing glycemia.