ReviewDiabetes2020
The Peripheral Peril: Injected Insulin Induces Insulin Insensitivity in Type 1 Diabetes.
Review in Diabetes, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 68 citations in OpenAlex.
- Tirzepatide in Adults With Type 1 Diabetes: A Phase 2 Randomized Placebo-Controlled Clinical Trial.Diabetes care · 2026 · on this mapTrial
- Effect of metformin on insulin resistance in adults with type 1 diabetes: a 26-week randomized double-blind clinical trial.Nature communications · 2025 · on this mapTrial
- Insulin-mediated muscle microvascular perfusion and its phenotypic predictors in humans.Scientific reports · 2021 · on this mapTrial
- Continuous Intraperitoneal Insulin Infusion for People With Type 1 Diabetes: A Literature Review and International Position Statement.Diabetes, obesity & metabolism · 2026Review
- Type 1 diabetes and cardiovascular medicine.Cardiovascular diabetology. Endocrinology reports · 2026Review
- Article
- Interactive online calculator for estimation of muscle and hepatic insulin sensitivity in adults with Type 1 diabetes using clinical and research biomarkers.Diabetes, obesity & metabolism · 2026Article
- A one-week reduced-carbohydrate diet lowers insulin requirements and shifts the IGF axis with no detectable short-term change in endothelial function in a randomized, crossover trial of adults with type 1 diabetes.Cardiovascular diabetology. Endocrinology reports · 2026Article
- Myosteatosis in type 1 diabetes: immunometabolic mechanisms, biomarkers, and therapeutic targets.Frontiers in endocrinology · 2026Review
- Advancing Type 1 Diabetes Management: Integrating Novel Therapies, Technologies, and Adjunctive Approaches.Diabetes care · 2026Review
- Association between insulin resistance and sudomotor dysfunction in adults with type 1 diabetes.Endocrine connections · 2025Article
- No evidence from euglycaemic-hyperinsulinaemic clamp studies for greater insulin sensitivity in adults with type 1 diabetes using insulin pump versus multiple daily insulin injections-Post hoc meta-analysis.Diabetes, obesity & metabolism · 2025Article
- Sweeteners: erythritol, xylitol and cardiovascular risk-friend or foe?Cardiovascular research · 2025Review
- Metabolic Dysfunction-Associated Steatotic Liver Disease in People with Type 1 Diabetes.Journal of clinical medicine · 2025Review
- Insulin Resistance in Type 1 Diabetes: Pathophysiological, Clinical, and Therapeutic Relevance.Endocrine reviews · 2025Review
- CpG methylation changes associated with hyperglycemia in type 1 diabetes occur at angiogenic glomerular and retinal gene loci.Scientific reports · 2025Article
- Improved Afternoon Hepatic Glucose Disposal and Storage Requires Morning Engagement of Hepatic Insulin Receptors.Diabetes · 2025Article
- Unveiling the Therapeutic Potential of the Second-Generation Incretin Analogs Semaglutide and Tirzepatide in Type 1 Diabetes and Latent Autoimmune Diabetes in Adults.Journal of clinical medicine · 2025Review
- Case Report: Insulin resistance in type 1 diabetes mellitus: the role of genetic factors.Frontiers in endocrinology · 2025Article
- Mechanisms of insulin resistance in type 1 diabetes mellitus: A case of glucolipotoxicity in skeletal muscle.Journal of cellular physiology · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
Insulin resistance is an underappreciated facet of type 1 diabetes that occurs with remarkable consistency and considerable magnitude. Although therapeutic innovations are continuing to normalize dysglycemia, a sizable body of data suggests a second metabolic abnormality-iatrogenic hyperinsulinemia-principally drives insulin resistance and its consequences in this population and has not been addressed. We review this evidence to show that injecting insulin into the peripheral circulation bypasses first-pass hepatic insulin clearance, which leads to the unintended metabolic consequence of whole-body insulin resistance. We propose restructuring insulin therapy to restore the physiological insulin balance between the hepatic portal and peripheral circulations and thereby avoid the complications of life-long insulin resistance. As technology rapidly advances and our ability to ensure euglycemia improves, iatrogenic insulin resistance will become the final barrier to overcome to restore normal physiology, health, and life in type 1 diabetes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.