Why does a patient with longstanding type 2 diabetes often require increasing insulin dosages to manage blood glucose levels, despite initially responding to lower doses?

💡 Explanation

Insulin resistance progresses in type 2 diabetes, which leads to a decrease in GLUT4 translocation, impairing glucose uptake into cells. Because cells become less responsive to insulin, higher doses are required to achieve the same glucose-lowering effect; therefore, the answer is GLUT4 translocation decreases, rather than increased hepatic glucose production declining or beta-cell expansion.

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