Many patients with type 2 diabetes wonder how their blood sugar levels can be high when they have not eaten anything. The answer to this counterintuitive phenomenon lies in what is known as insulin resistance.

Insulin resistance prevents cells from taking up glucose properly, but it also causes the liver to continue producing it. Here, we will look at how this happens, and at what current research is being carried out to treat this condition.

Generally speaking, our blood glucose levels are regulated by a balance between the intake of this type of sugar from food and its uptake by tissues. This balance mainly depends on the hormone insulin.

After a meal, a rise in blood glucose causes the beta cells of the pancreas to secrete insulin. This hormone facilitates the absorption, utilisation and storage of glucose by body tissue, ensuring that the body has energy available when it needs it.

However, if we go many hours without eating, the body still has to maintain a minimum level of blood glucose. This is to prevent hypoglycaemia (low blood sugar), and to ensure that energy is supplied to the tissues – particularly the brain, which depends almost exclusively on glucose.

In the first few........

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