Hormonal
Sustained hyperinsulinemia (elevated basal insulin levels) directly causes or sustains insulin resistance through homologous desensitization mechanisms, including receptor downregulation and post-receptor signaling defects.
High levels of insulin in your blood over time can make your body ignore insulin, leading to higher blood sugar. This happens whether the high insulin comes from your own body (due to obesity or genetics) or from external sources. Managing insulin levels, not just glucose, is key to improving sensitivity.
A sustained elevated level of insulin, immaterial of its origin, typically leads to generalized insulin resistance.
Why this rating
Supported by multiple animal models (transgenic mice, knockout mice) and human studies (insulinoma patients, clamp studies), though mostly observational or mechanistic rather than large-scale RCTs of intervention.
Source
Insulin Resistance and Hyperinsulinemia
Michael H. Shanik et al. · Diabetes Care · 2008
DOI 10.2337/dc08-s264
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