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doi: 10.1016/S0140-6736(18)32203-7 10

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Peripheral IR primarily involves reduced insulin-mediated glucose uptake by skeletal muscle and adipose tissue, driven by defects in the insulin receptor substrate and downstream signaling pathways such as phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt), leading to diminished translocation of glucose transporter type 4 (SLC2A4/GLUT4) and glucose uptake [5]