Figure 7.

Cause-effect relationship between oxidative stress and type 2 diabetes mellitus (T2DM). Insulin stimulates insulin receptor signaling pathway, including the phosphorylation of insulin receptor substrate-1 (IRS-1), PI3-kinase, and PIP2 and the activation of Akt, eventually leading to the translocation of glucose transporter 4 (GLUT4) to the plasma membrane. Obesity-associated inflammation of the adipose tissue and liver induces macrophage infiltration and increase in pro-inflammatory cytokines and ROS generation. Increased ROS inhibits the insulin receptor signaling pathway, leading to insulin resistance and hyperinsulinemia.