Type II Diabetes begins with insulin resistance, a condition in which cells fail to respond to insulin properly. This was previously referred to as “non-insulin dependent diabetes mellitus”. The primary cause is excessive body weight and not enough exercise. This form of diabetes, which accounts for ∼90–95% of those with diabetes, (non-insulin-dependent diabetes) type II diabetes, or adult-onset diabetes, encompasses individuals who have insulin resistance and usually have relative (rather than absolute) insulin deficiency At least initially, and often throughout their lifetime, these individuals do not need insulin treatment to survive. Most patients with this form of diabetes are obese, and obesity itself causes some degree of insulin resistance. Patients who are not obese by traditional weight criteria may have an increased percentage of body fat distributed predominantly in the abdominal region. Ketoacidosis seldom occurs spontaneously in this type of diabetes; when seen, it usually arises in association with the stress of another illness such as infection. This form of diabetes frequently goes undiagnosed for many years because the hyperglycemia develops gradually and at earlier stages is often not severe enough for the patient to notice any of the classic symptoms of diabetes.