Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.

Obesity is the major risk factor for type 2 diabetes and appears to drive tissue insulin resistance in part via gain of ectopic fat, with the best-studied organ being the liver. However, ectopic fat in the pancreas may contribute to β-cell dysfunction. The majority of people who are obese will never develop type 2 diabetes – a fact that exposes the statement “obesity causes diabetes” as absurd.

People have different tolerance levels of fat in the liver and pancreas. It is only when a person has more fat than they can handle, while type 2 diabetes develops. In other words, once a person crosses your personal threshold of fat, sugar type 2 diabetes develops. After they successfully pass below their threshold personal fat in the liver and pancreas, diabetes disappears.

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. This explains why South Asian Indians are notoriously more prone to develop type 2 diabetes without obesity. South Asians are less able to store fat under the skin, so will accumulate fat a lot earlier on in their liver than white people.  The risk of  South Asian Indians and Nepalese developing type 2 diabetes at a BMI of 22 is the same as that for white people with a BMI of 30.