Table 1

Plausible etiological factors responsible for the increased propensity to develop T2DM

Genetic and acquired factors
 Genetic factors (familial aggregations)
 Ethnic susceptibility
 Adverse gene–environment interaction (i.e., epigenetics, metabolic maladaptations)
 Lower threshold for diabetogenic risk factors (i.e., age, BMI, central adiposity)
 Low muscle mass
 Increased insulin resistance
 Decreased β-cell compensation   disproportionate to insulin insensitivity
 Presence of metabolic obesity
 Increased inflammatory response
Environmental risk factors
 Urbanization and modernization
 Globalization and industrialization
 Unhealthy behavioral habits (sedentary  lifestyle, consumption of energy-  dense food, smoking, tobacco chewing,   and excessive alcohol consumption)
 Sleep disturbances
 Psychological stress
Societal factors
 Cultural and religious taboos
 Psychosocial factors
 Lack of universal health coverage