What is the most common cause of elevated fasting plasma glucose in type 2 diabetes?

Insulin resistance is recognized as the most common cause of elevated fasting plasma glucose levels in type 2 diabetes. In this condition, the body's cells become less responsive to insulin, a hormone crucial for enabling glucose uptake from the bloodstream into muscle and fat cells. As a result, glucose remains elevated in the blood, leading to hyperglycemia.

In type 2 diabetes, the pancreas initially compensates for this resistance by producing more insulin. However, over time, the pancreatic beta cells may become exhausted and can also diminish in insulin production. This is why, while inadequate insulin production can be a factor as the disease progresses, the primary driver of elevated fasting plasma glucose is the underlying insulin resistance that characterizes the early stages of type 2 diabetes.

Other options, such as liver dysfunction and increased glucagon secretion, do play roles in glucose metabolism but are not the main contributors to elevated fasting plasma glucose in the context of type 2 diabetes. Liver dysfunction could result in impaired gluconeogenesis or glycogen storage, but it is not the most frequent underlying cause of fasting hyperglycemia. Similarly, while increased glucagon secretion can contribute to hyperglycemia, especially in the context of insulin resistance, it is not the primary mechanism at play in most cases