If glucose is an osmotically active agent and otherwise, can tonicity of blood change causing cell volume changes of intimal lining and of circulating cells effecting normal transcapillary movement of insulin? Why can't we consider insulin resistance as decreased exposure to target cells due to decreased transcapillary movement instead of insulin's decreased sensitivity?
Tonicity is a player only at very high glucose levels. There are many other factors that help to maintain near-normal blood tonicity in the face of hyperglycemia. You can actually study where insulin's effects are a problem. In clamp studies and other tissue culture models, the target is post-receptor.
Original posting 9 Jun 2007
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