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Taking all this data together it seems logical or appropriate to conclude that, because IGF1-R has a different signalling pathway that can maintain lipid oxidation in the liver, FFA uptake in muscle, and activates mTORC1 could reactivate IR through tyrosine kinase activity on IRS, thus displacing serine phosphorylation, reinstituting insulin signalling

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[DOI] [PubMed] [Google Scholar] 8.Bikman BT, Summers SA

They've been taking them months and months, or maybe even years