and insulin resistance (IR)/T2DM: High fat stores in ectopic compartments have been reported at the early stage of development of type 2 diabetes as well as in IR nondiabetic obese adolescents. Significant postprandial lipemia (PPL) in first-degree relatives of type 2 diabetes patients with NGT and IGT subjects indicates that it is an independent inherited defect in postprandial TG metabolism, which occurs prior to the development of T2DM. The most direct human evidence of the causal role of triglycerides (TGs) in T2DM comes from a case report of TG-induced diabetes, where very high TG levels resulted in IR and diabetes. Complete reversal of overt diabetes and near complete reversal of IR occurred when lipid malabsorption was induced by bilio-pancreatic diversion (BPD), which substantially lowered TG levels. Studies have suggested that there is significant PPL in diabetic and prediabetic patients with a strong association with IR.