Intensive insulin therapy and microvascular disease) is central to the development of complications of diabetes mellitus. This evidence convinced most physicians who specialize in diabetes care that an important goal of treatment is to make the biochemical profile of the diabetic patient (blood lipids, HbA1c, etc.) as close to the values of non-diabetic people as possible. This is especially true for young patients with many decades of life ahead. A working pancreas continually secretes small amounts of insulin into the blood to maintain normal glucose levels, which would otherwise rise from glucose release by the liver, especially during the early morning dawn phenomenon.
Lifestyle causes of diabetes mellitus type 2 that "produce fewer and smaller mitochondria than is normal," and are thus prone to insulin resistance. Fat tissue has also been shown to be involved in managing much of the body's response to insulin and control of uptake of sugar. It secretes RBP4 which increases insulin resistance by blocking the action of insulin in muscle and liver. Fat cells also secrete adiponectin which acts in an opposite way to RBP4 by improving the action of insulin, however, engorged fat cells secrete it in lower amount than normal fat cells. The obese therefore may have higher level of RBP4 but lower