Is it true that impaired glucose, due to obesity (weight 100 kg [220 pounds]), can neither have beta cells dysfunction/damage nor low insulin production but a problem of insulin utilization? Are there pathology tests to confirm that beta cells are in order and insulin production is also in order? Can this situation can be reversed by reducing weight?

Impaired glucose tolerance is associated with decreased insulin response in the target tissues. In addition, even as blood glucose levels become mildly elevated, it has been noted that there is also inappropriate insulin secretion for the degree of elevated glucose. Losing weight will help improve the target tissues’ response to the insulin and improve glucose utilization. However, not all people who are heavy have diabetes. They appear to be able to compensate for the insulin resistance by increasing insulin secretion. It appears there are genetic determinants that mark people for the development of diabetes that are not clearly understood. If individuals are at risk for developing diabetes or if they have pre-diabetes, it is very important to lose excess weight and exercise regularly.

JTL