Nearly 25 years ago, one of us wrote a collaborative review entitled “Obesity and Diabetes, the Odd Couple” [1]. At that time we pointed out that obesity was a risk factor for diabetes mellitus, despite the fact that most obese people do not have and never will develop diabetes. We also pointed out that obesity is associated with insulin resistance and hyperinsulinaemia, whereas in the non-obese, diabetes is characterized by hypoinsulinaemia and hyperglycaemia. We asked, how is it that such different syndromes interact so closely? We concluded that while these two syndromes are likely to have independent risk factors and mechanisms, their known interactions made it likely that shared metabolic defects are involved in their pathogenesis. We concluded that further studies into the pathophysiology of these syndromes were needed to explain this apparently paradoxical asso