Intracellular fat accumulation in muscle cells interrupts insulin signaling, requiring more insulin for glucose transport.

“as the intramuscular fat increases and I by intramuscular I mean intracellular fat uh triasil and disoglycerides accumulate in a muscle cell that signal gets interrupted and all of a sudden I'm making these numbers up if you used to need two units of insulin to trigger the little transporter now you need three and then you need four and then you need five you need more and more insulin to get the thing up”