Micronutrients & recovery
Thiazolidinediones (TZDs) improve insulin sensitivity primarily by reducing intramyocellular lipids and diacylglycerol, thereby reducing PKC activation, rather than directly enhancing insulin signaling pathways like PI3K/Akt in all patients.
TZDs (like rosiglitazone) help manage type 2 diabetes by improving how muscles handle glucose. While they may enhance insulin signaling in some cases, their primary benefit likely comes from reducing fat accumulation in muscles (specifically diacylglycerol), which removes a block on insulin signaling. This makes them effective even when direct signaling enhancement is not observed.
This raises the possibility that decreases in plasma lipid concentrations with TZD treatment could lead to a reduction of diacylglycerol in muscle, reducing PKC activation, resulting in an improvement of the insulin signaling cascade.
Why this rating
The paper highlights conflicting human data regarding direct signaling enhancement, relying on mechanistic hypotheses about lipid reduction.
Source
Molecular Mechanism of Insulin Resistance in Obesity and Type 2 Diabetes
Kang‐Duk Choi et al. · The Korean Journal of Internal Medicine · 2010
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