Selective versus total insulin resistance: a pathogenic paradox.

Abstract

Mice with type 2 diabetes manifest selective hepatic insulin resistance: insulin fails to suppress gluconeogenesis but continues to activate lipogenesis, producing the deadly combination of hyperglycemia and hypertriglyceridemia. In this issue of Cell Metabolism, Biddinger et al. (2008) show that mice with total hepatic insulin resistance exhibit hyperglycemia without hypertriglyceridemia-a state paradoxically less severe than selective insulin resistance.