In people with obesity and prediabetes, losing weight through diet improves how the liver responds to insulin, but does not improve how muscles and other tissues respond to insulin.
Mechanism
Synthesis from 1 study
Losing weight by eating less helps the liver respond better to insulin, so it stops making too much sugar. But the muscles and fat tissue still don’t take up sugar well, so overall insulin sensitivity doesn’t improve everywhere — just in the liver.
Most probable mechanism
When someone loses weight by eating less, their liver gets better at responding to insulin, so it stops making too much sugar. This happens because there's less of a hormone called glucagon telling the liver to release sugar, and the liver becomes more sensitive to insulin's signal to stop producing sugar. Meanwhile, muscles and fat tissue don't get better at taking up sugar from the blood.
Diet-induced weight loss reduces circulating free fatty acids and ectopic lipid deposition in the liver
Reduced liver fat improves hepatic insulin receptor signaling and suppresses gluconeogenic enzyme activity
Glucagon secretion from pancreatic alpha cells is suppressed, reducing stimulation of hepatic glucose output
Improved hepatic insulin sensitivity lowers fasting and postprandial glucose levels, reducing compensatory hyperinsulinemia
Peripheral insulin sensitivity in skeletal muscle and adipose tissue remains unchanged due to persistent insulin resistance in these tissues despite weight loss
Evidence from Studies
Supporting (0)
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Contradicting (1)
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Weight Loss-Independent Effect of Liraglutide on Insulin Sensitivity in Individuals with Obesity and Pre-Diabetes.
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