Figure 8. Regulation of insulin sensitivity by autophagy in macrophages.

In normal conditions, autophagy regulates inflammation, ROS levels, and M1/M2 populations in macrophages. In this context, adipocytes are sensitive to insulin. However, in inflammatory conditions such as diabetes or HFD, autophagy is impaired in macrophages and its regulation of ROS, inflammation, and the M1/M2 population is also impaired, which further aggravates inflammation and autophagy impairment. Concomitantly, increased inflammatory cytokines such as IL1β, IL18, and TNFα inhibit Akt, which impairs insulin signaling, resulting in insulin resistance.