Pancreas/beta cells can either be overused or underused in type 2 diabetes. How can its overuse and under use impact or damage it?

I prefer to think of type 2 diabetes to be associated with insulin resistance (overactive insulin secretion) and inappropriately low insulin secretion (underactive insulin secretion). Most people believe that both components exist coincidentally at the time of diagnosis. It is not that overuse or underused damages beta cells. It is that the abnormalities are already there at diagnosis. Many people have insulin resistance but only a few people have diabetes. It is thought that most of the genetic abnormalities determined to date reflect on impaired insulin secretion. Therefore, it is as if those pre-determined to have diabetes in the face of insulin resistance are going to be those with the genetic defects to ramp up insulin secretion.

JTL