There are also certain hereditary, i.e. congenital, factors in Type 2 diabetes that play a major role. There can be variations in how resilient the insulin-producing cells are. It varies from person to person how long the insulin-producing beta cells can compensate for insensitivity to insulin.

It is not uncommon for the insulin-producing cells to compensate by increasing production 10 times normal to bring down blood glucose in insulin resistance compared to a person who is normally sensitive to insulin.

This can be illustrated in the difference between a patient who has Type 1 diabetes where one has normal insulin sensitivity but has lost the ability to produce insulin. Then you might need 4-6 units of insulin for a meal. With type 2 diabetes, it is not unusual to need 40 units of insulin with meals, if you need to be treated with insulin.