Research
Hormonal
Selective insulin resistance occurs in the liver where insulin fails to suppress hepatic glucose production (gluconeogenesis) but continues to stimulate lipogenesis (fat creation), leading to hyperglycemia and hepatic steatosis.
Standard insulin therapy may not fix high blood sugar in liver disease because the liver's fat-making machinery is still overactive. Treatments need to target both glucose production and fat synthesis.
ModerateQualifiesMEDIUM confidence
In the case of hepatic insulin resistance, insulin fails to suppress HGP but stimulates lipogenesis, which results in hyperglycemia, hyperlipidemia, and hepatic steatosis
Why this rating
Supported by mechanistic studies and hypotheses, but the exact underlying mechanism is not fully established.
Source
Insulin Resistance: From Mechanisms to Therapeutic Strategies
Shin-Hae Lee et al. · Diabetes & Metabolism Journal · 2021
DOI 10.4093/dmj.2021.0280
narrative_reviewCited 1,003×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Ectopic lipid accumulation in the liver and skeletal muscle is a primary cause of insulin resistance, mediated by lipid metabolites like diacylglycerol (DAG) and ceramides which interfere with insulin signaling pathways.Good
- Diacylglycerol (DAG) accumulation at the plasma membrane, specifically the sn-1,2 stereoisomer, activates Protein Kinase C (PKC) isoforms (PKCε in liver, PKCθ in muscle), which inhibits insulin signaling.Good
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