Paul Saladino· MD
but these cells are not as responsive to the actions of insulin probably coming from mitochondrial signaling telling them to refuse the actions of insulin but when we get systemic insulin resistance during times of inflammation or during times of again I guess if we're talking about diabetes it would be metabolic dysfunction then cells are not responding to insulin as well and the signaling from insulin at the level of the cell specifically in this case at the level of immune cells is significantly impaired