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In small intestinal mucosa insulin resistance, a defect in these insulin receptors causes insulin to be less effective than it normally would be. Thus, the pancreas must produce more insulin than normal in order to maintain normal blood glucose levels. Initially in this process, the increased insulin levels are sufficient to maintain normal blood glucose. In these patients, however, although the blood glucose is normal, the condition of being overweight or obesity are still clues that they are insulin resistant. At this small intestinal mucosa juncture, only sophisticated blood tests (such as the small intestinal mucosa euglycemic clamp test) can detect insulin resistance at the biochemical level. As the insulin resistance progresses, even very high levels of insulin become ineffective. This degree of insulin resistance leads to elevated blood sugars and diabetes mellitus, type 2 (DM2). DM2 is usually managed by diet, exercise, and medication (see treatment section) that increases insulin sensitivity (the opposite of insulin resistance).
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