Can non-equilibrium thermodynamics explain skeletal muscle insulin resistance due to low mitochondrial content?

Insulin resistance plays a crucial part in the development of type 2 diabetes and metabolic syndrome. A defect in insulin secretion characterises the natural history of hyperglycaemia and type 2 diabetes, 1 DeFronzo RA Lilly lecture 1987. The triumvirate: β-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes. 1988; 37: 667-687 Crossref PubMed Google Scholar usually occurring in the context of insulin resistance. Insulin resistance is present in many tissues in type 2 diabetes, but skeletal muscle and the liver are the two most important sites quantitatively for regulation of blood glucose. Insulin resistance in both of these tissues is essential for the development of hyperglycaemia; however, for the purpose of this Comment, we focus on skeletal muscle insulin resistance only. Although there is evidence for the involvement of a panoply of factors in the pathogenesis of insulin resistance in skeletal muscle, the underlying mechanisms remain unresolved.