The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux.

@article{Samuel2016ThePO,
  title={The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux.},
  author={Varman T Samuel and Gerald I Shulman},
  journal={The Journal of clinical investigation},
  year={2016},
  volume={126 1},
  pages={12-22}
}
Insulin resistance arises when the nutrient storage pathways evolved to maximize efficient energy utilization are exposed to chronic energy surplus. Ectopic lipid accumulation in liver and skeletal muscle triggers pathways that impair insulin signaling, leading to reduced muscle glucose uptake and decreased hepatic glycogen synthesis. Muscle insulin resistance, due to ectopic lipid, precedes liver insulin resistance and diverts ingested glucose to the liver, resulting in increased hepatic de… CONTINUE READING
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