Impaired insulin clearance as a cause rather than a consequence of insulin resistance

Impaired insulin sensitivity and reduced β-cell function have been regarded as the two major physiological defects in type 2 diabetes mellitus. It is generally accepted that the initial defect in this disease is insulin resistance, which is typically elicited by overeating and decreased physical activity, both of which are tightly linked with obesity. β-Cells then compensate for insulin resistance by enhancing insulin secretion. However, the...