Role of environmental factors in the development of noninsulin-dependent diabetes mellitus

Abstract Environmental factors, such as excessive caloric intake leading to obesity, altered dietary composition, physical inactivity, various forms of stress, hormonal imbalance, drugs, toxins, and the process of aging, may contribute to the development of noninsulin-dependent diabetes mellitus in the genetically predisposed subject but do not by themselves cause the disease. Both abnormal pancreatic betacell function and decreased sensitivity to insulin are present in most patients with noninsulin-dependent diabetes mellitus, and the degree of carbohyrate intolerance is dependent on the interaction between these two factors. Efforts to prevent or treat noninsulin-dependent diabetes mellitus should be aimed primarily towards eliminating factors associated with the development of insulin resistance and promoting those that increase insulin sensitivity. Obesity, the composition of the diet, and level of physical training are all important in this regard and are the major environmental factors discussed herein.