Hormonal
Obesity and Type 2 Diabetes impair the insulin-induced suppression of hepatic glycogenolysis and gluconeogenesis, leading to excessive endogenous glucose production.
In obesity and Type 2 Diabetes, the liver fails to stop producing glucose even when insulin signals it to. This is not just about high glucagon; the insulin signal itself is ignored. Managing this requires addressing the underlying insulin resistance and free fatty acid levels, rather than just targeting glucagon.
We concluded that defects in the regulation of glycogenolysis as well as gluconeogenesis cause hepatic insulin resistance in obese nondiabetic and type 2 diabetic humans.
Why this rating
Randomized controlled trial using hyperinsulinemic-euglycemic clamps and stable isotopes (gold standard methodology).
Source
Obesity and Type 2 Diabetes Impair Insulin-Induced Suppression of Glycogenolysis as Well as Gluconeogenesis
Rita Basu et al. · Diabetes · 2005
DOI 10.2337/diabetes.54.7.1942
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