Fatty liver and fatty pancreas are both manifestations of hyperinsulinemia, suggesting a single underlying defect in type 2 diabetes.

“this is what I mean that's why I like the physics model which is like okay we have a theory now which now fits them the facts so much better than the old lock and key model”

“if you think about the sort of overflow paradigm again explains this paradox very easily because what happens is that and this is where you know if you look at a lot of the work on the twin cycles hypothesis fits in is that you're filling up your liver with all this glucose hyperinsulinemia you've got too much glucose in your liver your liver starts making fat and pumping it out then one of the organs that it accumulates in is the pancreas so now you've got fatty pancreas”