Starling's curve of the pancreas

Insulin secretion in the body follows and inverted U pattern, during the natural history of type 2 diabetes mellitus, which is termed the ‘Starling’s curve of the pancreas’. Insulin concentration in blood initially increases as the sensitivity to insulin decreases as a consequence of situations like obesity. But when the glucose tolerance deteriorates as in impaired glucose tolerance or overt type 2 diabetes mellitus, the insulin levels come down.