Individuals with lipodystrophy exhibit severe insulin resistance because they lack fat tissue.

“you had these people that actually had no fat and you think okay if they're so thin if they're so skinny they must have no insulin resistance they had the worst insulin resistance you've ever seen like off-the-charts”

“so what your body is doing is taking all this fat and sort of storing it away so it doesn't cause a problem right so these these people with the lipodystrophy they couldn't store the fat so what happened is that the fat stored up in their liver and they had the highest insulin resistance you've ever measured because it's really a protective mechanism the fat is trying to suck away all this glucose so that it doesn't cause a problem”