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The chronic diabetic state is characterized by hyperglycemia- and lipid-induced inflammatory processes that damage tissues in a potentially self-amplifying manner (1)

Yes, switching forms is a valid strategy when symptoms remain despite normal labs

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While receptor depletion from the plasma membrane occurs due to the -arresitin binding-induced endocytosis [26], it is reasonable to assume that the receptors are still synthesized and replenished with a rate r s , which leads to the following evolution equation for the receptor density on the cell surface: Dephosphorylation and resensitization of receptor In the longer time scale, it was suggested that typically only after the receptor internalization, protein phosphotases (PPs) are at work in an acidic endosomal compartment to dephosphorylate, resensitize and restore the receptor back to the cell surface [48, 50, 56, 57]