Four-Stage Evolution of Diabetes or Whole-Body Insulin Resistance

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Amity Island

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Relationship to Diabetes
Type 1
Insulin resistance (IR) would develop first preferentially in the muscle tissue with a relatively low cell turnover and then progress in sequence to the subcutaneous adipose tissue, then to the visceral adipose tissue, and then to the liver with higher cell turnovers. Moreover, metabolic disruptions due to IR would vary widely from tissue to tissue, contrary to the widespread notion that IR impairs merely glucose uptake in tissues. This warrants that IR be divided better into four distinct tissue-specific IRs: muscle insulin resistance (MIR), subcutaneous adipose insulin resistance (s-AIR), visceral adipose insulin resistance (v-AIR), and hepatic insulin resistance (HIR).

 
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