How is natural history of T2DM?

First we have normal glucose tolerance w/ diabetes genes, increased obesity, lipogenesis, waist cirumference, atherogenesis, hyperinsulinemia, insulin resistance, arterial HTN and increased TG w/decreased HDL Then we get impaired glucose tolerance (insulin secretion deficiency, decreased glucose transport, increased glucose prodcution, postprandial plasma glucose increase) These lead to macroangiopathy and microangiopathy leading finally to T2DM.