In order for insulin to have its effect, after it is secreted from the pancreas, it must go to the cells where it will act and bind. These points in the cells to which insulin binds are called receptors. Three main mechanisms play a role in the development of insulin resistance. The first is the pre-receptor level, the second is the receptor level, and the third is the post-receptor level.

Resistance at the pre-receptor level can be explained by the fact that insulin cannot have an effect even if it binds to the receptor, or cannot reach the receptor due to insufficient blood flow, due to reasons such as defective insulin secretion, insufficient blood flow in the target tissues.

Resistance at the receptor level occurs as a result of a decrease in the number of receptors or genetic mutation of the receptors. In this way, no matter how much insulin is released, it cannot have its effect because it cannot bind to the cell.

At the post-receptor level, insulin arrives normally and binds to the receptor, but it must send orders into the cell. Meanwhile, there is a malfunction in some of the signal arms on duty. As a result, it cannot have a blood sugar lowering effect.