In 1893, William Osler described diabetes with the following words "hereditary influences play an important role. It is a disease of adult life, a majority of cases occur from the third to the sixth decade ... in a considerable proportion of these cases of diabetes the subjects have been excessively fat at the beginning of, or prior to the onset of the disease . . . The combination of over-indulgence in food and drink, with sedentary life, seem particularly prone to induce the disease". This description summarizes the basic elements of type 2 diabetes (22). The precise reasons for racial disparities in the prevalence of diabetes are not entirely clear, but the balance of available evidence indicates that the higher propensity for developing diabetes in ethnic minority populations is driven by an interaction between a heritable genetic predisposition and environmental precipitants. Some postulated explanations for this disparity would be examined below.
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