Insulin binding to its receptor: is the receptor more important than the hormone?

The development of methods to measure insulin showed that many (if not most) patients with disorders of glucose metabolism have a target cell disorder rather than a secretory defect. Methods to measure the insulin receptor have shown that in patients with target cell disorders the receptor is often involved in a meaningful way. Furthermore, even in diseases where hormone secretion (deficiency or excess) is dominant, the receptor may play an important role in the clinical state of the patients. In the future, development of techniques to assess postreceptor events should uncover defects at these sites as well.