T2D is mainly characterized by defective insulin secretion and peripheral insulin resistance. It develops chronically over years to decades before it becomes apparent. Early in the disease progression, pancreatic beta cells respond to initial insulin resistance by increasing insulin secretion to preserve a near-normal glucose level. Over time the beta cell mass reduces gradually, leading to a decline in insulin secretion causing hyperglycemia. Beta cell failure is dependent on several factors like genetic predisposition, poor dietary control, glucotoxicity and lipotoxicity, liver steatosis and therapy itself.