It has been possible to work out the basic mechanisms which lead to type 2 diabetes. Too much fat within liver and pancreas prevents normal insulin action and prevents normal insulin secretion. Both defects are reversible by substantial weight loss.
A crucial point is that individuals have different levels of tolerance of fat within liver and pancreas. Only when a person has more fat than they can cope with does type 2 diabetes develop. In other words, once a person crosses their personal fat threshold, type 2 diabetes develops. Once they successfully lose weight and go below their personal fat threshold, diabetes will disappear.
Some people can tolerate a BMI of 40 or more without getting diabetes. Others cannot tolerate a BMI of 22 without diabetes appearing, as their bodies are set to function normally at a BMI of, say 19.
If diabetes is because of morbid obesity getting rid of that obesity can reverse diabetes. But it's very difficult to burn visceral fats by diet control and exercise. We may or may not like but the Role of bariatric surgeries come into play for them.
there are many diabetics who are slim and have no fat or obesity issues, like me. So this theory is only one possible explanation. And there are many who are obese beyond measure but they do not have or do not develop diabetes, so once again, the theory centered on obesity is questionable.
If you familiar with Ayurveda, there are as many as 7-10 pathways/causes for the genesis of diabetes and each one is given a specific name to indicate the pathway. Some of these pathways are rooted in the dysfunction of the intestinal system. Very interestingly, recent empirical research has validated this Ayurvedic perspective - hmm, a nice convergence between Eastern & Western medicine.
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