The 'lock and key' model of insulin resistance, where receptors are normal but glucose entry is impaired, is an incorrect paradigm.

“this is the sort of lock and key paradigm that we talked about so insulin is a hormone it acts on the insulin receptor which is on the cell surface and the insulin receptor is like a gate so there's a door there's a lock insulin is like the key so it opens the door and therefore the glucose can go from the blood into the cell the cell has energy to use so we can measure insulin we can also look at insulin receptors you can sequencing and you can tell there's actually nothing wrong with them so insulin receptors are completely normal insulin is completely normal so we say is that well there must be something that's gumming up the system so like a piece of gum that's sort of stuck in that lock it's gumming up the things you have a normal key you have a normal lock but when you put the key in the lock it doesn't really work and then therefore the glucose can't get into the cell and the cell is now facing a internal starvation”

“that's our current thinking or at least what I was taught and what most people still think about insulin resistance but it's almost completely incorrect and there's no possible way it can be correct because there's a central paradox of insulin resistance”