There were 2 recent BASIC SCIENCE articles in NEJM which should create a curiosity among young research oriented physicians and give clinicians some AAH moments .
NEJM Sept 18 -2014 Ectopic fat in insulin resistance Etc and NEJM Oct16 2014 The Target of Metformin in Type 2 DM.
I suggest any body curious why LEAN ASIAN INDIANS get Type 2DM read it.My AAH moment was this sentence.
“HEALTHY YOUNG LEAN ASIAN INDIAN MEN HAVE A MARKEDLY HIGHER PREVALANCE OF HEPATIC STEATOSIS ASSOCIATED WITH HEPATIC INSULIN RESISTANCE THAN HEALTHY LEAN YOUNG MEN OF OTHER RACES OR ETHNIC GROUPS’.
Polymorphisms of gene encoding APOLIPOPROTEIN C-3 have been shown to predispose such persons to non alcoholic fatty liver disease and insulin resistance—— and it goes on to say that it causes post-prandial HYPERTRIGLYCERIDEMIA.
The article is long and detailed and may put many doctors off but worth reading if involved with Diabetic patients and have a WHY Bug in your brain.

Looks like we are dealing with age related decrease of MITOCHONDRIAL function as the cause.It does fit clinically.