Excessive blood sugar, then insulin spikes, and over time type 2 diabetes. It used to take a life time to acquire type 2 diabetes and historically it was called adult onset diabetes.

The first case of type 2 diabetes in a child was only diagnosed in the 1983...now it’s common in children. Generally about 1/3 of the US is prediabetic, this population will generally also suffer from other chronic (metabolic) conditions like inflammation and obesity.